What's a Dentist to Do? Empathy, Part Two*

What's a Dentist to Do? Empathy, Part Two*

Jack L. Churchill, D.D.S.**:

In our last column we discussed the importance of empathy in our practices — what it means to us and our patients.

Empathy is the emotional appreciation of another’s feelings. It is putting yourself in someone else’s shoes. Commonly referred to as “bedside manner”, it is a skill which is powerful yet often overlooked in today’s high tech, bottom-line world.

Practicing empathy has many benefits. It improves treatment outcomes, betters patient compliance, reduces dento-legal risks, increases satisfaction, enhances relationships, improves the overall dentist/patient experience, and honors the patient.

In our “find it and fix it” world of dentistry where empathy is an afterthought and considered innate and impossible to acquire, experts now consider empathy a teachable and learnable skill. It is on the curriculum of many medical schools.

Our patients present to us their feelings and emotions all the time in ways overt and covert. They give us their fears, their anger, their grief, their disappointments — sometimes served on a platter, other times as a secret ingredient. They are sometimes outwardly stated, but often subtly implied. We must recognize and be alert to these opportunities to read our patients. This awareness then allows us to respond empathetically. These clues are easily missed if not looked for. Our patients will often send these clues out to us repeatedly hoping for a response. When none comes, they feel dismissed and alienated, becoming frustrated and sometimes leaving.

After looking for and discovering these clues, the dentist can offer a gesture or statement of empathy in the form of either a question (“Can you tell me more about that?”), a clarification (“Let me see if I’ve gotten this right...”), or a simple response (“I can understand how that makes you feel.”). Let them know you are with them, perceiving and understanding their feelings.

State to the patient your perception of how he or she feels so that person can confirm or, if wrongly perceived, correct, that perception.
Patient (statement of emotion): A friend of mine had a crown done and had all kinds of trouble.
Doctor (statement of empathy): I see. What kind of problems?
Patient (giving feedback): Her crown was fine for a long time, and then it broke.
Doctor (correcting perception): So you are mainly concerned with the crown’s longevity?
Patient (closing the loop): Yes, exactly.

Use active listening skills, acknowledging to your patients you are paying attention. Provide feedback, correcting perceptions when needed. Demonstrate that you want to be tracking with them. Once you have correctly perceived the patient’s emotions to your satisfaction, legitimize that emotion (“I understand how you feel.”) Respect your patient’s feelings and effort to cope, and then offer your support and partnership. (“I will work hard to get you a crown that will serve you for years to come.”)

We can come up with many reasons not to practice empathy.
• “There’s not enough time.”
• “It’s not relevant, and I’m too busy running my practice anyway.”
• “Too emotionally exhausting.”
• “I don’t even want to go there.”
• “I haven’t had enough training.”
• “I won’t have enough empathy left for my family. I’ll use it all up at work.”

Empathy, however, is different from sympathy. Sympathy can be emotionally exhausting because it implies a feeling shared with the other person as if the pain belonged to both. We sympathize with others when we share and suffer with them. As such, we can’t sympathize with our patients. We would burn out. Empathy, on the other hand, is engaged detachment. We “borrow” another’s feelings to observe and understand them, without taking them on ourselves. A big difference. And never pity a patient. Pity is condescending and contemptuous. It separates doctor from patient.
So empathize, don’t sympathize. It’s a no-lose situation. Your patients see that you care. You probably will get better case acceptance and therefore do finer dentistry. The attorneys stay away, and as importantly, you get to do more than just dentistry. You get to get close to your patients. Your patients will see you as more than just their dentist. They will see you as a friend, a confidante, a person they can trust. Yes, I know that’s low tech stuff, but it’s the stuff that gets you through the day. It’s building relationships, and that’s what this job is all about!


*Information, ideas, and concepts for this article are from The Permanente Journal, Fall 2003/Vol. 7, No. 4, A Focus on Patient-Centered Care and Office Practice Management.

**Dr. Churchill is Chair of the Minnesota Dental Association’s Committee on Ethics, Bylaws, and Constitution. He is a general dentist in private practice in Minneapolis, Minnesota.

Please e-mail us at jackchurchill@msn.com or fax us at (612) 339-3618. We look forward to hearing from you not only regarding this article, but also if you have any ethical dilemmas you would like to present to the membership. Perhaps we can help you decide what to do.