Communication is a clinical skill (part 2)

Empathy

Empathy requires the use of a 3-stage approach:

1. Appreciating another person’s predicament or feelings by seeking to gather an understanding of their situation
2. Communicating that understanding back to the person
3. Pausing – coming to a full stop to let the other person absorb what has been said and give them the opportunity to say more or just feel your concern

Unlike sympathy that is more of a feeling of pity or concern outside of the client’s actual feelings or predicament, empathy is not only about being sensitive but overtly communicating that empathy to the client (Figure 1). It’s not good enough to think empathetically. You must communicate it as well. Use of empathy at appropriate times is a strong facilitative opening for clients to share more of their thoughts and concerns. This information is vital for understanding the client and working toward outcomes for the patients that take client’s concerns into consideration.

Empathetic statements are supportive comments that specifically link the “I” of the veterinarian and the “you” of the client. They both name and appreciate the client’s affect or situation. Verbal empathy is strengthened when accompanied by empathetic non-verbal communication, including facial expressions, proximity, touch, tone of voice, or use of silence.

Examples:

• “I can appreciate you were not anticipating the cost that it is going to take to get Riley back to his old self.”
• “I can hear that you are very excited to have a new puppy.”
• “I sense this is a frustrating situation for you.”
• “I can tell that you are very attached to Barney and you want what is best for him.”

It is not necessary to have shared the same experience as the client, nor do we need to feel that the situation would be difficult or evoke the same feelings for us. It is necessary to see the situation from the client’s perspective and communicate understanding back to the client.

Building a relationship is vital to the success of every appointment and use of empathy is central to building the relationship. That said, research reveals that in 300 small animal visits (150 well animals, 150 sick animals) veterinarians expressed empathy in only 7% of appointments 1.

It is estimated that empathetic opportunities exist in the majority of appointments but they are largely overlooked. It has been shown that communication training with physicians made a significant difference in a physician’s empathetic expression during patient interactions 6 months after the training 2. It’s clear that empathy can be taught, learned and integrated into clinical practice. Given the profound impact that empathy has on relationship development, it’s worth investing in.