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Instead of being urged to simply “be more compassionate,” doctors should learn specific empathy skills during their training to improve their care of patients, one doctor argues in a new paper.

According to Dr. David Jeffrey, an honorary lecturer in palliative medicine at the Center for Population Health Sciences in Edinburgh, Scotland, who wrote the paper, there is concern about a general lack of psychological and social support for patients from doctors. Some studies have found that medical students experience a decline in empathy for their patients as they get further along in their training.

In addition, the “commercialization of health care leaves people vulnerable” to being treated as though their care is simply an instrument to bring in money to the system, Jeffrey said. Patients can become dehumanized by the system, he said.

But there is also concern that if doctors become too emotionally involved with their patients, they may experience psychological distress and burnout, Jeffrey said.

In his article, Jeffrey distinguishes among the three terms that are often used interchangeably — empathy, sympathy and compassion — in an attempt to provide some clarity to this problem. Jeffrey argues that doctors would best serve their patients by striving to have empathy for their patients, rather than sympathy or compassion. [7 Medical Myths Even Doctors Believe]

For example, having empathy means imagining what it is like to be a specific person undergoing a specific experience, rather than imagining that they themselves are undergoing that experience, Jeffrey said.

“This more sophisticated approach requires mental flexibility, an ability to regulate one’s emotions and to suppress one’s own perspective in the patient’s interests,” Jeffrey told said.

In contrast, having sympathy means taking a more “self-oriented” approach, and imagining what it would be like for yourself to be in another person’s situation.

This is a way of trying to identify with a person, but it means that you assume that people will think and feel the way you do, Jeffrey said. Also, a doctor who attempts to sympathize with a patient may focus on the doctor’s own distress, and risk burning out, he said.

Having compassion means being aware of the suffering of others, but not necessarily understanding their views, Jeffrey said.

What’s more, Jeffrey said, compassion and sympathy are simply reactions, that don’t involve much reflection.

It takes skill to develop empathy, and developing this skill should be a goal for medical education, Jeffrey said.

In Jeffrey’s view, doctors should develop empathy by learning to build a connection with their patients that involves emotional sharing, as well as an “other-oriented” perspective, in which the doctor tries to imagine what it is like to be the patient. Doctors can then act appropriately on the understanding they have gained to help the patient, Jeffrey said.

“A benefit of this model of empathy is that it focuses on developing skills, attitudes and moral concern rather than just urging medical students and doctors to be more compassionate,” Jeffrey said. “Empathy, unlike compassion or sympathy, is not something that just happens to us, it is a choice to make to pay attention to extend ourselves. It requires an effort.”

The paper was published yesterday (Dec. 6) in the Journal of the Royal Society of Medicine.

Original article on Live Science.