Empathy: An Overdue Prescription

Last week I discussed the phenomenon that, though more women experience pain than men, they are chronically undertreated. Ethnic minorities, including African Americans, are known to be undertreated as well. Not surprisingly, low-income patients experience the same disparity.

One could point to subtle gender, class, and racial biases as the reason why such disparities exist. While I would agree that these are problems we ought to address, I think the real culprit is far more subtle and prevalent: physicians just have a low aptitude for empathy.

Unfortunately, when receiving medical education in the United States, students are taught to be emotionally detached from their patients. Instructors place greater emphasis on the technology of medicine than on its humanity. The fear is that, if the emphasis were reversed, being emotionally invested in patients would lead to burnout among medical professionals.

I have never believed that we face a binary choice between technology and humanity in medicine. Indeed, as we learn more about chronic pain, we find that empathy is indispensable in pain management. Some medical schools, such as Weill Cornell, are making more room for empathy in education, but far few schools are there yet. As writer Judy Foreman pointed out, veterinary schools do a better job of training their students in pain management than medical schools do.

Over the long term, the best hope for people with pain—whether they are women, racial minorities, the economically disadvantaged, or others—is for society to become better organized to deal with this health challenge. As a comparison, greater awareness, broader public support, and increased funding for breast cancer and AIDS wouldn’t have been possible without people coming together and putting pressure on decision makers.

Similarly, change will not happen in pain treatment unless we demand it. This was the reason why I published my book The Painful Truth and felt strongly that my former patients’ stories should be the basis for a documentary.

That said, I recognize that social movements don’t happen overnight. While we’re waiting for better conditions to exist surrounding pain, we all need to individually do what we can to make progress. For example, people in pain can become more active in their own medical treatment. I was struck by the simple truth in this commercial that patients ought to be asking their physicians more questions about their condition and treatment. Such a simple thing! Yet it can be the beginning of more effective medical care.

To be sure, patients need their physicians to lead them. But sometimes physicians need their patients to lead them as well. When both sides take on the responsibility to lead, empathy begins to grow.

Disparities in treatment of people with pain bother me a great deal. Sadly, there are no quick fixes. Speaking up and banding together may not seem like a lot at first blush, but I have staked my remaining years on doing both.