Empathy: Real Stories to Inspire and Enlighten Busy Clinicians >A Brief Clinician's Guide to Empathic

Expression
Daniel E. Epner+

Traditional Approach Empathic or Exploratory Approach

“Doc, I know where you're going with this. I hate to be asked all these questions all the time. You're talking to me like I'm a criminal and you think I'm trying to sell my pain medicines.”

“I hear you're frustrated. I know it's hard to hear these questions repeatedly, but we want to make sure
you're using your pain medications safely and getting the most benefit from them. I get really worried
“We're doing all this for your safety and the safety of those around you.”
when you can't accurately describe how you use your meds and you sometimes take them in ways
that are different than how we prescribe them.”

“You don't know how I feel. I may not look like I'm hurting, but I have a high pain tolerance. I need meds.”

“I can't possibly know how you feel. I realize you are suffering. Our job is to follow safe practice to help
“I'm just trying to do what's best for you now.”
you live as well as possible.”

“I've been coming to this clinic for two years, and every doctor has given me the meds I need. You are the first doctor who has denied me.”

•Key Concept: Oftentimes, empathy should be tempered with a dose of reality.

•“Your situation now is different than it was before. I know it seems like I'm being punitive, but I really just want to take good care of you and make sure we use these medications safely.”

“I am afraid I will become addicted.”

•Provider: “I can see why you're nervous about that. Tell me more about what worries you.”
•Patient: “My daughter is addicted to dope and has been in jail a few times. I finally had to break off
“Do you or anyone in your family have a history of substance use?”
ties with her. I'm raising her two-year-old daughter.”
•Provider: “It sounds like you're going through a real rough patch. It must be hard to see your daughter
suffer like that, and I'm sure you're suffering too.”

“I've been giving my son some of my pain medication.”

“I can understand why you would, because you can't stand to see him suffering like this. If he were my
“You should not share your medications, and your son should take only what we prescribe him in the kid, I might do the same thing. I can tell you really love him and will do anything for him. Having said
way we prescribe it.” that, I think we can do an even better job taking care of his symptoms, and we think it's important that
you not share medications with him for everyone's safety.”

“Weed is the only thing that helps. I smoke five times a day.”

“I don't blame you for doing everything you can to get by. Cancer is not easy. Having said that, I think
“Marijuana is illegal and unregulated. We don't want you to mix the marijuana with the pain
we can do a better job of controlling your symptoms than you can with marijuana. In addition, I'm
medications.”
concerned marijuana won't mix well with your other medications, like pain medication.”

“I got this weed from a state where it's legal, so it is regulated.”

 “I don't have any moral stance on using marijuana, and I realize it's legal in many states. However, I'm
“It's not regulated in Texas, which is where we are. Therefore, I cannot and will not recommend using
concerned about potential side effects between marijuana and your other medicines like your pain
it.”
medicines. We want to work with you to try to taper off marijuana to the extent possible.”

Date of download: 12/29/22 from AccessMedicine: accessmedicine.mhmedical.com, Copyright © McGraw Hill. All rights reserved.