Dr. Bruce W. Newton, professor and chair of anatomy at Campbell University’s Jerry M. Wallace School of Osteopathic Medicine, discussed the anatomy and practical application of physician empathy at the first Grand Rounds of the semester.
“There are two different kinds of empathy — affective and cognitive empathy,” Newton reminded Grand Round attendees. “Affective is emotional, your gut response, and is related to how your brain responds to pain. Cognitive empathy involves more of a thinking process.”
Newton also discussed the neural basis of empathy and the anatomy of how the brain expresses empathy
“The ventromedial prefrontal cortex is where cognitive empathy is expressed,” Newton said. “Traumatic brain injury and dementia can decrease both types of empathy.
“As a physician, you will directly and indirectly inflict pain on patients; studies show that expert physicians don’t think of the procedures they perform as being as painful as a novice learning the technique — experts have learned to suppress their affective empathy, their response to another’s pain, with time.”
Newton discussed Dr. Mohammadreza Hojat’s Jefferson Scale of Physician Empathy and Dr. Albert Mehrabian’s Balanced Emotional Empathy Scale in relation to his research with students in Arkansas and now at Campbell. These studies reflect a decline in empathy as students progress through medical school — especially those students who plan to continue into non-primary care specialties.
“Empathy is important because it positively impacts both physician/patient relations and patient outcomes,” Newton said. “However, too much affective empathy is not good because you would be thinking about how to manage your own emotions and be distracted from helping the patient. The question is, how empathic should a physician be? The answer is to train yourself to dampen, but not completely suppress, affective empathy and to use cognitive empathy to effectively communicate with your patients and establish an empathic bond of trust.
“That is what we are trying to do to equip you to become great Campbell physicians.”