Etiquette-Based Medicine: Complement or Affront to Evidence-Based Medicine?
A leading rheumatologist discusses communication-based empathy techniques and why physicians should ‘fake it until you make it.’
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Much has been said about the idea that we can teach empathy simply by advocating enhanced communication skills and practicing “etiquette-based medicine” (i.e., introduce yourself, be at eye level, use, touch, inquire of the patient’s experience, etc.). Some claim these techniques are adequate while others decry it as ‘fake news’ and unlikely to succeed over the long haul.
My reflections on these techniques are a bit mixed. On the one hand, practicing etiquette-based medicine surely is better than cold and callous patient interactions, and thus it will help improve satisfaction. It is also of value, when practiced as a habit, for the days when we are tested, being fatigued or irritated over issues at work or at home.
On the other hand, it’s merely a skill, one that’s not likely to be enduringly satisfying to the physician or buffer them against emotional fatigue and burnout. This is where the actual empathic health of the caregiver begins to demonstrate its importance. For a healer who is mindful, and filled with empathy and compassion, the well source of empathy comes naturally and will be inexhaustible. Practicing mind-body techniques such as meditation, especially for those whose orientation is compassionate, may be the best way to grow into this state.
So what is the answer? Etiquette-based good behavior or naturally growing compassionate-based empathy? My answer is both! Do etiquette-based medicine now and ‘fake it till you make it’ by growing your own inexhaustible empathy.
Dr. Calabrese is Director of the R.J. Fasenmyer Center for Clinical Immunology.