Physician, heal thy heart

A RECENT study found that physicians displayed empathy to lung cancer patients in only 10 percent of opportunities. Published last month in the Archives of Internal Medicine, the study found that doctors missed the vast majority of chances to recognize, much less ease, the worries of their patients. And yet doctors who connect help patients make more informed decisions, and help themselves prevent professional burnout.

"A lot of forces work against us," said oncologist Tom Lynch of Massachusetts General Hospital, where the Kenneth B. Schwartz Center promotes emotional connection between clinician and patient. "The percentage of committed internists is dropping, and those we have are so inundated with paperwork, they can barely make it through the day."

Lynch says the system devalues emotional connection between doctor and patient.

Boston is a laboratory for restoring the humanity that fades away after medical school. The Schwartz Center holds special rounds to share tough scenarios. "It's a powerful thing when a senior doctor gets up before 100 people talking about crying at night when he goes home," Lynch said. In 13 years, the "Schwartz Center Rounds" have expanded to 160 hospitals in 29 states.

At Children's Hospital, actors improvise scenarios for young and veteran clinicians in four-hour workshops. "You can have good communications skills, but in the absence of real emotion, the doctor comes across as sterile. The patient feels like being at a counter at McDonald's," said pediatrician and medical ethics professor Robert Truog. "The thing we're learning is that even if you don't have perfect communications skills, if the patient feels you're connecting with them, they forgive everything else."

Researchers coin this "emotional intelligence." What is in the physician's heart matters as much as what is in the head.