A recent paper in Medical Education1 examined concepts of altruism and empathy among medical students and professionals in conjunction with health care initiatives designed to support the maintenance of these qualities.
Searches for the terms ‘altruism’, ‘altruistic’, ‘helping’, ‘prosocial behaviour’ and ‘empathy’ in the English-language literature published from 1980 to the present within the Ovid MEDLINE, PsycInfo and PubMed databases were carried out. Conceptual analysis was used to examine the relationships between altruism, empathy and related prosocial concepts in health care in order to understand how such factors may relate to emotional and career burnout, cynicism, decreased helping and decreased patient-centredness in care.
The findings were that altruistic ideals and qualities of empathy appear to decrease among some medical students as they progress through their education (as is now well known). During this process, students face increasingly heavy workloads, deal with strenuous demands and become more acquainted with non-humanistic informal practices inherent in the culture of medicine. In combination, these factors increase the likelihood that emotional suppression, detachment from patients, burnout and other negative consequences may result, perhaps as a means of self-preservation.
The authors suggest that alternatively, by making a mindful and intentional choice to maintain self-care and a healthy work–life balance, medical students can uphold humanistic and prosocial attitudes and behaviours.
They conclude that promoting altruism as a compensatory mechanism in a standard health care career is contradictory and misguided. Instead, a teaching approach to clinical care that is humanitarian and empathic is recommended. They recognise that health care initiatives to increase empathy and other humanistic qualities will be limited unless more practical and feasible ‘emotion skills training’ is offered to and accepted by medical students. Success will be further moderated by the culture of medicine’s full acceptance of empathy and humanism into its customs, beliefs, values, interactions and daily practices.
One of PRIME’s key aims is to enable the ‘full acceptance of empathy and humanism into the customs, beliefs, values, interactions and daily practices’ of health-care education (and hence health-care) across the globe. We do not want just to teach health care professionals how to survive and preserve their own altruism and empathy in a negative clinical environment, but to transform the clinical environment itself so that it promotes rather than destroys altruism and empathy. This we believe will not be attained only with ‘emotional skills training’, but will require the recognition that these positive values ultimately come from a Divine, spiritual source, and that only by intentionally cultivating a relationship with the Divine will health-care professionals be able to transform their clinical environments to embody altruism, compassion and empathy.
How are you doing at resourcing yourself for altruism, empathy and compassion, and at demonstrating these things in your daily practice and teaching? How much are you able to influence your clinical and educational environment to enshrine these values? PRIME’s challenge, and the challenge for all of us, is to ‘Be the change you want to happen’.
- Burks DJ, Kobus AM. The legacy of altruism in health care: the promotion of empathy, prosociality and humanism. Medical Education 2012 March; 46(3):317-325