Kate* came into the student health clinic very worried that she had a serious heart condition. She was having episodes of chest pain with shortness of breath. She was concerned that she had a blood clot since she recently started a birth control pill and recalled some risks being mentioned. She spent 5 minutes with the provider prior to being sent off to complete labs and an EKG. She felt confused and dismissed when the visit ended abruptly by the provider stating everything was normal and that an anxiety medication was sent to the pharmacy. Kate left the visit feeling even more unsure.
Kate’s story highlights the importance of taking an extra minute for connection. The provider did all of the appropriate tests and considered an extensive differential diagnosis. However, there was no patient-provider collaboration. Promoting connection with a patient results in multiple benefits including improved care quality, safety, and patient satisfaction. On the contrary, serving patients in an unconnected manner results in dissatisfaction of both the provider and patient and can even cause harm. There are multiple small modifications in communication that can be learned and practiced. This week we are going to focus on one simple and powerful tool: empathy statements.
Empathy Statements
Empathy statements are words that acknowledge another person’s emotions or feelings. Taking a moment to acknowledge an emotion increases trust and facilitates providing patient-centered care. Empathy promotes positive care outcomes including increased patient satisfaction and adherence to treatments. This also allows the provider to take a moment for mindful human connection. This is the connection that drives our purpose to be working in healthcare.
There are many ways to respond with empathy and it can take practice to find your own style. Here are some ideas adapted from the book Communication Rx.
Label the Emotion: “That sounds like a very lonely situation.”
Partnership: “I am glad you scheduled this visit so that we can work on this together and get you feeling better.”
Respect: “I can see how hard you have worked on this. You are a very dedicated person.”
When you hear a patient expressing an emotion make an effort to be mindful and give the patient your full attention. Turn so your whole body is facing the patient. Avoid using electronics while they are talking and practice active listening. Take a deep breath and pause when the patient finishes the statement and then provide an empathy statement.
Example of Using Empathy
In the case of Kate coming in with chest pain, the patient interaction would greatly benefit from the provider taking a moment to express empathy when Kate describes her symptoms. Let's see how an empathy after the patient describes their symptoms with worry in their voice can transform the visit.
Provider: Chest pain is a scary symptom. Let's work together to figure out what is causing your pain. (Partnership Empathy Statement)
Kate: Yeah, I have been really worried about it since I started a birth control pill recently. I remember being told about a really serious risk of blood clots. Do you think this could be causing my pain?
Provider: That is an understandable concern and I am glad you came in to get that checked out. Based on your symptoms I think it is unlikely to be the cause, but I recommend we do some tests to make sure there are not signs of a blood clot.
Kate: Okay, that sounds like a good plan. Thank you.
Next Steps
Make a goal for the week to try out an empathy statement. If you are not a medical provider, you can easily adapt these skills to be practiced in interactions with others including colleagues, friends, or family!
If this is a new skill for you, then consider a scripted statement. This could be as simple as responding to the reason for the visit with “I am sorry you haven’t been feeling well. Let’s work through this together to get you feeling healthy again.”
Interested in having your team have further training on these skills? Check out Empowered Care’s training on Trauma-Informed Communication
Footnote
*Please note that patient examples in this workshop are intended to be generic cases based on numerous patient interactions over the writer's clinical experience. The cases are not meant to represent individual experiences. Details, including identifying information, have been changed to protect patient privacy and do not correlate to specific people.
References
Chou C, Cooley L. Communication Rx: Transforming Healthcare Through Relationship-Centered Communication. McGraw Hill Education; 2018.
Boissy A, Windover AK, Bokar D, et al. Communication Skills Training for Physicians Improves Patient Satisfaction. J Gen Intern Med. 2016;31(7):755-761. doi:10.1007/s11606-016-3597-2.
Dambha-Miller H, Feldman AL, Kinmonth AL, Griffin SJ. Association Between Primary Care Practitioner Empathy and Risk of Cardiovascular Events and All-Cause Mortality Among Patients With Type 2 Diabetes: A Population-Based Prospective Cohort Study. The Annals of Family Medicine. 2019;17(4):311-318. doi:10.1370/afm.2421