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Letters to the Editor

In Reply to Ho

Riess, Helen MD

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doi: 10.1097/ACM.0000000000000613
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I am pleased that the E.M.P.A.T.H.Y. acronym and framework led to Dr. Ho’s timely reminder “to slow down, to take a brief moment—an extra pause” in the name of empathy for our patients. The potential benefits of this slower, more mindful approach can be seen elsewhere as well. For example, society is grappling with the health consequences of the fast food era, and one response has been the “slow food” movement. The fast food era has been criticized for devaluing the experience of eating and enjoying nutritious food rather than valuing the benefits of mindfully purchasing, cooking, and savoring real food that nourishes our bodies. The slow food movement grew by questioning what was being lost. Perhaps we were saving time, but what were we losing?

In medicine, we are speeding at a reckless pace toward ever shorter patient visits. What once would have been unthinkable is now routine: We are now encouraged to see patients every 7 to 15 minutes. How do physicians truly see the person before them and appreciate the patient as a unique human being when they are racing through every visit just to meet productivity requirements? What is being lost? Who will choose to enter our profession if the relationship to patients, the meaning in our work, and the joys of human connection that make the labor of medicine worthwhile are eroded? We may be saving time, but what if we are losing our doctors?

Demonstrating empathic behaviors does not necessarily take more time, and can certainly save clinical time in the long run by knowing our patients. The time has come to challenge the notion that quality in not sacrificed during “fast visits.” When the eye is on the clock, and the hand on the office door handle, what messages are we conveying to our patients? That quantity means more than quality? That racing through the day is the new standard? I agree with Dr. Ho that, by racing through our work, we will surely miss the subtle cues: the confused look on a patient’s face that says, “I don’t understand what you just said, but I know you don’t have time to explain it.” The look of disgust that says, “Even though you recommend these pills, they cause nausea, so I’m not going to take them.” Or the look of gratitude that says, “Thank you for taking my concerns seriously.” It’s time to pause and reflect on where we are headed. It’s not only our patients that are losing hope. Their doctors may be saving time but may not be here for the long haul. We can’t afford to go any faster.

Helen Riess, MD

Associate professor, Harvard Medical School, and director, Empathy and Relational Science Program, Massachusetts General Hospital, Boston, Massachusetts; [email protected]

© 2015 by the Association of American Medical Colleges