The view
from here
Do we need to be taught
how to care?
Faraz Mughal, Accident and Emergency Department, Heart of England NHS Foundation
Trust, Birmingham, UK
Arwa Meki, Department of Elderly Medicine, Heart of England NHS Foundation Trust,
Birmingham, UK
D
uring medical school
training we are taught how
to be doctors: to take
histories, examine, investigate
and manage patients confidently
and with a high level of patient
quality and safety, whilst also
addressing the patient’s ideas,
concerns and expectations. Many
medical students and doctors are
proficient in all of the above, and
yet so many lack the ability to
compassionately care for their
patients. We feel that these
qualities are poorly covered in
modern medical training.
In completing his speech
given to medical students at
Harvard in 1926, Dr Francis W
Peabody, emphasised to the
young doctors before him, that
‘One of the essential qualities of
the clinician is interest in
humanity, for the secret of the
care of the patient is in caring
tct_12121.indd 231
for the patient’.1 This is acknowl-
edged in modern medical train-
ing, and the General Medical
Council highlights that each
doctor must show respect for
human life and treat patients as
individuals.2
A lack of care and compassion
remains one of the leading
causes of patient distress,
dissatisfaction, and almost
certainly, of patients’ complaints.
The recent UK Francis Report, an
independent public inquiry into
patient care at Mid Staffordshire
NHS Foundation Trust, highlight-
ed the lack of kindness and
empathy from staff towards
patients and their families as a
significant reason for the
overwhelming patient conse-
quences that occurred.3
Empathetic clinicians have been
shown to induce greater patient
satisfaction, lower levels of
© 2014 John Wiley & Sons Ltd. THE CLINICAL TEACHER 2014; 11: 231–232 231
patient distress and superior A lack of care
clinical outcomes.4 Prince Charles and compassion
once urged clinicians to address
remains one of
the body and mind of their
patient when treating them, and the leading
now, 30 years later, he reiterates causes of
this exact point, and asks ‘Are we patient distress
doing enough to ensure there is
sufficient empathy and compas-
sion instilled throughout training
in medical schools and in later
hospital training?’5
Although medical schools
have included important princi-
ples into their curricula – empa-
thy, communication,
confidentiality and ethical
principles – the problem arises
when one approaches these
principles in an abstract and
theoretical manner. It is neces-
sary for medical professionals to
incorporate these principles into
everyday medical tasks: ward
rounds, patient consultations,
4/21/2014 3:34:45 PM
 We should be discharge letters and discharge
encouraged to planning – skills that are rarely
addressed at medical school.
recognise Undergraduate training should
compassion include dedicated clinical skills
and care as sessions, combining such
principles, specifically those
fundamental
patient needs applying care and compassion
with the daily tasks required as a
medical professional. In post-
graduate medical training, the
e-portfolio offers a method of
assessing the ability of a doctor
to implement such principles, for
example, through work-based
assessments specific to patient
care, and through reviewing and
auditing the quality of acute
medical management, in-patient
care and discharge planning.
Corresponding author’s contact details: Faraz Mughal, Heart of England NHS Foundation Trust, Good Hope Hospital, Accident and Emergency
Department, Birmingham, B75 7RR, UK. E-mail: farazm@doctors.org.uk
Funding: None.
Conflict of interest: None.
Ethical approval: Not required.
doi: 10.1111/tct.12121
232 © 2014 John Wiley & Sons Ltd. THE CLINICAL TEACHER 2014; 11: 231–232
tct_12121.indd 232
One might argue that princi-
ples of care and compassion are
innate qualities, which cannot
necessarily be taught. We
disagree. In the same way that
we learn to manage a patient
safely and communicate effec-
tively, we should be encouraged
to recognise compassion and care
as fundamental patient needs,
and to address these throughout
patient interaction and care.
REFERENCES
1. Hurst JW Dr., Francis W. Peabody,
We Need You. Tex Heart Inst J
2011;38:327–329.
2. General Medical Council. Good
Medical Practice: Duties of a doctor.
2013. Available at http://www.
gmc-uk.org/guidance/good_
medical_practice/duties_of_a_
doctor.asp . Accessed on 5 May
2013.
3. Royal College of General
Practitioners. RCGP Summary The
Francis Report, February 2013.
Available at http://www.rcgp.org.
uk/policy/rcgp-policy-areas/~/me-
dia/Files/Policy/A-Z-policy/RCGP-
Francis-Report-Overview-2013.ashx.
Accessed on 5 May 2013.
4. Derksen F, Bensing J, Lagro-
Janssen A. Effectiveness of
empathy in general practice: a
systematic review. Br J Gen Pract
2013;63:e76–e84.
5. HRH. Integrated health and post
modern medicine. J R Soc Med
2012;105:496–498.
4/21/2014 3:34:49 PM
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