title: Routine, empathic and compassionate patient care: definitions, development, obstacles, education and beneficiaries.
abstract: BACKGROUND
  We believe that this study represents an innovative approach to clarifying the definitions of routine, empathic and compassionate health care, as well as of sympathy. We emphasize the importance of affective empathy and its intensification in the context of patient suffering (compassion), without abandoning the ideal of clinical equanimity.
  
  
  METHODS
  We develop a pedagogical model for clinicians and trainees who are weaker in their empathic skills that includes four levels of growth. We clarify representative obstacles to empathic and compassionate care in education and clinical practice. We summarize the four beneficiaries of empathic and compassionate care (clinicians, patients, trainees, institutions). We suggest areas for future research, including the development of a compassion scale and conclude with a statement on how the conceptual and professional confusion we address adversely impacts patients and trainees. The article represents the consensus work of a group of health care professionals and students at Stony Brook University Hospital and School of Medicine who have been engaged in this project for several years through the Center for Medical Humanities, Compassionate Care, and Bioethics, established in August of 2008.
  
  
  CONCLUSIONS
  We discern a shift away from concepts of clinical empathy and compassionate care that deny a significant place for an affective component and that idealize 'detachment'.
authors.affiliation: Department of Pediatrics, Stony Brook University School of Medicine, Stony Brook, NY, USA.
authors.forename: Stephen G
authors.initials: SG
authors.lastname: Post
authors.forename: Lauren E
authors.initials: LE
authors.lastname: Ng
authors.forename: Janet E
authors.initials: JE
authors.lastname: Fischel
authors.forename: Mary
authors.initials: M
authors.lastname: Bennett
authors.forename: Linda
authors.initials: L
authors.lastname: Bily
authors.forename: Latha
authors.initials: L
authors.lastname: Chandran
authors.forename: Jeremiah
authors.initials: J
authors.lastname: Joyce
authors.forename: Briana
authors.initials: B
authors.lastname: Locicero
authors.forename: Kelly
authors.initials: K
authors.lastname: McGovern
authors.forename: Robyn L
authors.initials: RL
authors.lastname: McKeefrey
authors.forename: Jackie V
authors.initials: JV
authors.lastname: Rodriguez
authors.forename: Michael W
authors.initials: MW
authors.lastname: Roess
mesh_terms: D001291:Attitude of Health Personnel; D026686:Beneficence; D003479:Curriculum; D004501:Education, Medical; D004645:Empathy; D005260:Female; D006801:Humans; D008297:Male; D010819:Physician's Role; D010817:Physician-Patient Relations / Q000941:ethics*; D010818:Practice Patterns, Physicians' / Q000941:ethics; D011787:Quality of Health Care
keywords: beneficiaries; compassionate care; developmental levels; empathy; obstacles; professionalism; sympathy; teaching