title: Is empathy cost efficient?
abstract: In an attempt to constrain rising health-care costs, third-party payers are currently encouraging psychiatrists and other physicians to focus on the financial aspects of their treatment approaches. This paper has attempted to address the impact of this cost-efficient attitude on our empathy and by tracking the evolution of our health-care-delivery system since the turn of the century. I have described three overlapping phases: the humanist, the scientific, and the current corporate phase, and emphasized the importance or trivialization of an empathic practice-style associated with each stage. I have warned how the corporate delivery system, with its focus on cost constraints, may inhibit our capacity to be empathic by stimulating self-serving concerns about the corporation's monetary welfare and our own financial well-being. This unempathic stance may result in treatment being driven by financial factors that override clinically driven needs of the patient. At its extreme, this approach may render psychiatrists vulnerable for viewing patients as bad objects that deprive financially, and for countertransferentially retaliating against them through "warehousing" and abandonment.
authors.affiliation: Women's College Hospital, Toronto, Ont., Canada.
authors.forename: H E
authors.initials: HE
authors.lastname: Book
mesh_terms: D000328:Adult; D001883:Borderline Personality Disorder / Q000523:psychology / Q000628:therapy; D003363:Cost Control / Q000639:trends; D003362:Cost-Benefit Analysis / Q000639:trends; D004645:Empathy; D005260:Female; D006265:Health Care Coalitions / Q000191:economics / Q000639:trends; D006801:Humans; D008297:Male; D009769:Object Attachment; D010817:Physician-Patient Relations; D011613:Psychotherapy / Q000191:economics* / Q000379:methods; D012557:Schizoid Personality Disorder / Q000523:psychology / Q000628:therapy; D014481:United States