Doctors seek balance of ‘kindness and curing’

Many young doctors believe they should be distant to be professional, according to Dr David Jeffrey. Photograph: Getty
Many young doctors believe they should be distant to be professional, according to Dr David Jeffrey. Photograph: Getty
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Doctors need to be given more time to show empathy to their patients if the NHS is to become a more caring institution, a Scottish expert has argued.

Dr David Jeffrey, an honorary lecturer in palliative medicine at Edinburgh University, said the balance between care and medicine needs to be reset and called for action to address concerns about overwhelming time pressure, poor support and lack of patient continuity.

The call follows a major shift in perception of how doctors should behave in the wake of the Mid Staffs scandal in England, where hundreds of patients are believed to have died as a result of poor care. Writing in the Journal of the Royal Society of Medicine, Jeffrey argued that caring was a vital part of medicine but doctors were at risk of personal distress and eventual burnout if their feelings of sympathy and compassion for patients take over.

Jeffrey said: “The balance between care and medicine needs to be reset. We need to remove the barriers that prevent people from being kind.

“I don’t think it is a question of telling people to be more empathetic. We have to look at the context – so things like time or continuity of care can really make a difference.”

He has previously called for an end to the culture of “institutional unkindness” in medicine, where being kind may be seen as attribute of losers among highly competitive doctors.

There can also a deficit of empathy in medical education, which means many young doctors believe they should be distant to be professional, he argued.

Jeffrey said: “Students and more senior doctors need support and we need a culture that gives that to them. I don’t think the need for time is valued enough.

“This psychological care is as important as knowing when to do a scan. It is what the patients really value.”

The article suggested that asking medics to show empathy rather than forcing them to sympathise was the best way to combat unkindness and burnout in doctors.

Jeffrey added: “As a concept, empathy is a lot more use than compassion because it involves feeling for someone but looking at it through their point of view, rather than your own.

“Empathy also brings action. You want to help when you see someone in pain and it spurs you into action.”

Patient campaigners called for doctors to be given longer appointments so they can understand their patients better.

Margaret Watt, chairwoman of the Scotland Patients Association, said: “Patients should be treated with understanding and compassion so any action is a step in the right direction.

“Doctors need to be given more time to be able to help patients and to be able to make their diagnoses.

“Things are missed and it isn’t always their fault as they have so much to do.”