Empathy vs Emotional Reasoning

Is there a difference between empathy and emotional reasoning? Michael LaFerney, PhD, PMHCNS-BC, believes that healthcare professionals often confuse the two, and this can often hinder or derail patient-provider communication. In the current edition of Advance for Nurses, Dr. LaFerney defines empathy "as the ability to understand another person's circumstances, point of view, thoughts and feelings." He goes on to explain that, "Empathy involves communication. Trying to understand what another person is experiencing without communication leads to interpretation without meaning. It becomes a mechanism of internal thought processes rather than an understanding of another's point of view or feelings." Dr. LaFerney describes emotional reasoning as "mind reading" on the part of the healthcare professional; unconsciously inferring one's own feelings, anxiety, or needs to the patient. Emotional reasoning is a lot faster for harried physicians and nurses than empathetic communication, because it does not require slowing down and taking time to truly listen to the patient. But as Dr. LaFerney points out it often leads to misdiagnosis and disconnection from the patient's needs, fears, or desires. The bottom line is MORE COMMUNICATION LEADS TO QUALITY HEALTHCARE.

What are your thoughts on empathy vs. emotional reasoning?

Medicine in the Age of Twitter

Dr. Pauline Chen poses an interesting question in her NY Times article, Medicine in the Age of Twitter: Does online social media help or hinder patient-provider communication? If you haven't heard about Twitter, it is a new social media platform that allows users to communicate via short, 140 characters or less, "tweets" to other users. I am intrigued about the possibilities of connection, but am wary of the lack of human touch. What do you think?

Letting the Patient Call the Shots

Today's New York Times has an interesting article written by Dr. Pauline Chen exploring what we, in the healthcare system, really mean by "patient centered care". Does the definition of patient centered care shift if we are in the role of patient or healthcare professional? In the article, Letting the Patient Call the Shots, Dr. Donald Berwick, president of the Institute for Healthcare Improvement in Cambridge, Massachusetts, suggests that, “ We would all be far better off if we professionals recalibrated our work such that we behaved with patients and families not as hosts in the care system, but as guests in their lives.” Radical changes in our healthcare system will need to occur to allow this to happen, are we ready for such changes? What do you think?

Perfectly Happy?

Cognitive scientists who have conducted research on happiness have found that we are not very good at predicting what will make us happy. Ironically, chronic pain, constant noise can decrease our happiness dramatically and winning the lottery or achieving a life long wish often do not substantially increase our overall happiness. A recent Boston Globe article, Perfectly Happy, explores "happiness research" and its role in guiding priorities for social and health policy.

What do you think?

Quality of Life

Thank you to those of you who alerted me to a wonderful documentary series which aired on WBUR in Boston last week. It is beautifully written and produced, an informative view of the dilemma over end of life care in this country. The title of the documentary is Quality of Death, End of Life Care in America: Inside-Out. As I listened to the documentary I felt a more appropriate title might be Quality of Life instead of Quality of Death because even as patients, families and healthcare providers prepare for death, life continues. Perhaps our emphasis on what we DON'T want done at the end of life overshadows what we DO want done? I read an interesting article recently that proposed changing the terminology of D.N.R. (Do Not Resuscitate) to A.N.D. (Allow Natural Death). Is there is a difference in your mind between these two statements, or do you feel it is only semantics? This is difficult topic to wrestle with but one that is growing in prominence in the health care world as we confront a rapidly aging population as well as staggering healthcare costs.

Healing Music in the Neonatal Intensive Care Unit

Sometimes healing comes through low-tech interventions in high-tech medical environments. That thought resonated with me when I came across an article in the McAllen Chronicle, describing the work of Dr. Anatoliy Ilizarov, the medical director of the Neonatal Intensive Care Unit (NICU) at Mission Regional Medical Center in Mission, Texas. As you can imagine, stress is rampant in a NICU, for staff, families and the tiny, fragile patients. Dr. Ilizarov, a trained classical pianist, began streaming music into the NICU to help reduce stress, and discovered that the premature infants began to gain weight faster, and began to feed earlier. Staff and families felt more relaxed as well. Dr. Ilizarov theorizes that the beat of the music, between 60-80 beats per minute, mimics the mother's heartbeat while the infant is in the womb. I was struck by the simple beauty of this intervention, a doctor who is a pianist using his gifts of art and science to heal gently. Good work, Dr. Ilizarov!

Stress So Bad It Hurts

An article caught my eye in today's Wall Street Journal..."Stress So Bad It Hurts -- Really" by Melinda Beck. The article presents a patient's perspective on being told that chronic physical pain is caused by stress and it is "all in your head". Without further explanation, the patient feels indignant and angry that the health care provider does not believe their pain is "real". The medical community is slowly becoming more comfortable with the notion that psychological stress can exacerbate and even produce physical pain in individuals. Yet, we currently do not have a health care system that is set up to be multidisciplinary in response to chronic pain. There are initiatives going on around the country that begin to address multidisciplinary ways of dealing with complex pain issues. I am currently involved in graduate work at Tufts University School of Medicine's Pain Research, Education and Policy Program, the only one of its kind in the United States. As an initiative to share information and dialogue about pain management, we have started a blog (http://www.go.tufts.edu/pain) on the complex subject of pain research, education and policy and would welcome your voice. I hope that as President Obama considers health care reform, we as health care providers and consumers take on a vocal role of advocating for a multidisciplinary approach to true "health" care and not procedure oriented "illness" care. Only when we begin to acknowledge the innate connection between the body, mind and spirit will we truly begin to understand the complexities of the human body.

I would love to hear your thoughts!