Tuesday, January 13, 2015

Surgeons receive no empathy training. This needs to change.

Communication skills are an essential part of clinical practice.  It plays an especially important role in creating patient satisfaction, delivering bad news and conflict resolution.  Unfortunately there is little training in communication skills, particularly in the surgical specialties.  As surgeons, we generally think we are fine with this and quickly acquire the skills with clinical experience.  We do tend to have self confidence in our skills which possibly goes hand in hand as to why we have become surgeons in the first place. But then again, it is probably the very reason we need to be better trained in communication skills.

General practice training in Australia includes hands on training in communications skills. Trainees are observed as they interview and assess patients for full sessions.  Additional to this, they undergo patient interviews that are video recorded and then reviewed with a mentor where self reflection and critique of the interviews are undertaken.  With surgical training, it is uncommon (why don't we make that never) to ever have a single patient interview observed by a mentor.  Certainly, there would not ever be any video recording of a patient interview for training purposes.  The closest we get to supervised patient interview is a mini CEX which in reality has been a tick box exercise for surgical trainees in Australia and even the majority of trainers do not take it seriously. 

So where is all this leading to? I recently attended the Urological Society of Australia and New Zealand NSW Section Meeting held in Hobart.  It was an honour to be there as an invited keynote speaker but an even greater honour to meet Helen Reiss who is a psychiatrist affiliated with the Harvard Medical School and Massachusetts General Hospital in Boston.  Dr Reiss has become prominent in the teaching of communication skills, particularly empathy.  Her address to a urological surgeon audience was warmly received and taught us about empathy and interpersonal skills training.

See her TED talk.

It was quite notable that the talk by Dr Reiss was attended by those who probably least needed to see the presentation.  It was also interesting that the preceding talk by Dr Nader Awad was on the subject Narcissism in Surgery - it was a bit a of joke over lunch where everybody felt that those most in need in seeing these presentations were absent from the meeting.

This week I have taken the opportunity to do the online modules created by Dr Reiss and are available on the Empathetics website.  It takes about three hours to complete the three modules.  Without performing a detailed critique of the modules, I am convinced that every doctor in clinical practice with face to face contact with patients should be doing this type of course or equivalent. I am convinced that empathetic practice can be taught. 

It seems crazy that in spite of the fact that our work as front line clinicians involves communication there is minimal such content throughout our training.  Do the Empathetics course modules and you will change your mind if you do not already have such an opinion.


  1. Interviewed by Australian Doctor and published today

  2. Thanks for sharing this Henry. Very topical given the strife RACS is in right now!