To truly heal, physicians need to learn about patient values and goals and to understand the various ways that patients can suffer. As I expressed in my article, physicians begin the learning process by asking questions and making observations. Dialogue ensues between physician and patient. Yes, understanding the patient's views requires good communication. However, what Kutner fails to appreciate is that good communication requires empathy. Imagining what it is like to be the patient sitting before you positively shapes the words and gestures one uses to communicate. Empathic physicians acquire an intellectual and emotional understanding of the patient's predicament. This understanding impels them to communicate and behave in ways that they themselves would approve of if they were in the patient's present situation.
I might add that perfect or total empathy may not be possible, nor is it necessarily desirable: "Physicians must be able to shift back and forth between
Gianakos D. Understanding Patient Values Requires Communication, Not Empathy-Reply. Arch Intern Med. 1996;156(14):1586. doi:10.1001/archinte.1996.00440130132016
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