MedCity Influencers, Health Tech

This isn’t another story about burnout: Why empathy fatigue is the worst threat to patient care today

At the beginning of the pandemic, we were celebrated as heroes. Now the heroes are asking for help in addressing this new phenomenon of empathy fatigue. If we fail to ignore this crisis of compassion, patients and clinicians will continue to suffer.

During a shift in the emergency room, I had a patient who tested positive for Covid-19 and needed oxygen. As I walked him through the next steps for treatment, he looked down, shook his head, and argued that his diagnosis was impossible because “Covid isn’t real.”

It’s hard to shake the frustration and fatigue after a patient encounter like this. Even more frightening, I often feel numb and apathetic. As someone who has dedicated their life to care for others, it’s strange to realize I don’t have an endless reserve of compassion for my patients.

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I almost felt guilty, but was I an anomaly? Our team regularly conducts independent research into U.S. clinicians’ views, so I investigated. Turns out I’m not alone—I’m actually in the majority. Our data shows that more than half of clinicians admitted they’ve struggled to be empathetic with patients who are eligible but refuse to get the vaccine.

This isn’t another article about clinician burnout. Instead, it’s about empathy fatigue, a far worse threat that’s plaguing clinicians across the country. It often feels like a heightened form of emotional and physical exhaustion, wrapped in an overwhelming sense of sadness.

We have passed the grim milestone of more than one million American deaths from Covid-19. Given that, I’m worried that it’s become nearly impossible for my fellow healthcare workers to treat patients objectively when they’re unnecessarily suffering. And it’s just as impossible to deny the impact empathy fatigue can have when we’re confronting patients who have a deep distrust in our healthcare system.

Addressing empathy fatigue may be even more challenging to address than widespread burnout. But there are a few things we can start doing now to address this new threat to patient care head on.

Provide clinicians with the tools and training to address misinformation

Healthcare misinformation is nothing new. In medical school, I was taught how to share the facts as clearly and objectively as possible. But Covid misinformation is a phenomenon that no one was prepared for. No textbook, medical school lecture, or continuing education course taught me how to put a patient on oxygen who refuses to believe their illness is real. Or even how to engage with a colleague who is skeptical of the vaccine. Our research found that four in five clinicians deal with Covid and/or vaccine misinformation with their patients on a weekly basis. Nearly half are dealing with it daily.

We need more than a refresher course on how to best address misinformation — it should be a core competency taught in medical school, just like bedside manner. And healthcare employers should provide clinicians with the tools and strategies they need to address judgment and bias in the exam room. We’ve all found our own ad-hoc ways to try and address empathy fatigue, but those are only band-aid solutions.

Encourage the next generation of clinicians to forge their own career paths

I’ve known I wanted to be a doctor from a very young age. But several years into my career, I ended up taking a sharp turn off my pre-destined path. In April 2020, my hospital significantly cut back on shifts after being overwhelmed with Covid patients. And I did something that I never considered as a viable career option — to make ends meet, I turned to telehealth.

I was skeptical at first but soon learned that I can easily connect with and treat patients through a computer or phone screen. And just as importantly, it gave me a break from the terrifying early days of the pandemic when there wasn’t enough PPE or even basic information about the virus. Now two years later, telehealth has helped me create the career of my dreams. I’m able to balance hospital shifts, which are important to me but often contribute to my empathy fatigue, with telehealth visits that keep me empowered and engaged.

I want the future generation of clinicians to understand that practicing virtually can be a viable career path. We need to expand medical school training to include virtual care, plus specific tracks or fellowships for students interested in virtual or hybrid opportunities. With clinician shortages only expected to get worse, doctors and nurses should feel empowered to follow the career path that works best for them.

Recognize the benefits of value-based care for clinicians, as well as patients

While many of the conversations around the benefits of value-based care (VBC) have been focused on the patient – improved outcomes, lower costs, and higher patient satisfaction – we can’t overlook the benefits of shifting towards a VBC model for clinicians.

Going to medical school in Canada, I was taught to focus on more than just the treatment or the medication. Instead, it’s about talking to the patient and listening to their story – empathizing with your patient. This whole-person care approach is what drew me to medicine in the first place.

But working in the ER, I rarely have the time I’d like to spend with each patient. Instead I am measured on how many tests I order, how many procedures I perform, and how many patients I see each shift. How can we be expected to empathize with our patients if we’re not given the time to approach them with compassion and care?

By rebooting our incentive structure from the ground up, we can do more than shift our focus on outcomes over treatments. We can also provide clinicians with the time to build relationships with their patients and start replenishing all the empathy we lost over the last two years.

At the beginning of the pandemic, we were celebrated as heroes. Now the heroes are asking for help in addressing this new phenomenon of empathy fatigue. If we fail to ignore this crisis of compassion, both patients and clinicians will continue to suffer. We won’t be able to convince clinicians—who are walking away in droves—to return to their calling. We won’t be able to inspire the next generation of caretakers. And we won’t be able to restore the lack of trust in our healthcare system.

Photo: SDI Productions, Getty Images

Pooja Aysola, MD, MBA is a practicing emergency medicine clinician and the Executive Medical Director and the Head of Clinical Operations at Wheel, the health tech company powering the next generation of healthcare. As the head of Wheel’s clinical team, Dr. Aysola is responsible for leading Wheel’s robust clinical quality assurance program and ensuring the delivery of safe and professional care from Wheel’s trusted network of board-certified clinicians. Prior to joining Wheel, Dr. Aysola served as the Director of ER Quality for her institution and was a faculty member at Brown University. She completed her medical degree and residency at McGill University in Montreal, Quebec.