title: Making space for empathy: supporting doctors in the emotional labour of clinical care.
abstract: BACKGROUND
  The academic and medical literature highlights the positive effects of empathy for patient care. Yet, very little attention has been given to the impact of the requirement for empathy on the physicians themselves and on their emotional wellbeing.
  
  
  CONCLUSIONS
  The medical profession requires doctors to be both clinically competent and empathetic towards the patients. In practice, accommodating both requirements can be difficult for physicians. The image of the technically skilful, rational, and emotionally detached doctor dominates the profession, and inhibits physicians from engaging emotionally with their patients and their own feelings, which forms the basis for empathy. This inhibition has a negative impact not only on the patients but also on the physicians. The expression of emotions in medical practice is perceived as unprofessional and many doctors learn to supress and ignore their feelings. When facing stressful situations, these physicians are more likely to suffer from depression and burnout than those who engage with and reflect on their feelings. Physicians should be supported in their emotional work, which will help them develop empathy. Methods could include questionnaires that aid self-reflection, and discussion groups with peers and supervisors on emotional experiences. Yet, in order for these methods to work, the negative image associated with the expression of emotions should be questioned. Also, the work conditions of physicians should improve to allow them to make use of these tools. Empathy should not only be expected from doctors but should be actively promoted, assisted and cultivated in the medical profession.
authors.affiliation: Researcher in Global Health Ethics, The Ethox Centre, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Oxford, OX3 7LF, UK. angeliki.kerasidou@ethox.ox.ac.uk.|The Ethox Centre, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Oxford, OX3 7LF, UK. angeliki.kerasidou@ethox.ox.ac.uk.
authors.forename: Angeliki
authors.initials: A
authors.lastname: Kerasidou
authors.affiliation: Ethics and Society Wellcome Trust Fellow & Reseacher in Ethics, The Ethox Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK. ruth.horn@ethox.ox.ac.uk.
authors.forename: Ruth
authors.initials: R
authors.lastname: Horn
mesh_terms: D004644:Emotions; D004645:Empathy; D006801:Humans; D007266:Inhibition, Psychological; D015279:Organizational Culture; D010817:Physician-Patient Relations; D010820:Physicians / Q000523:psychology*; D000068616:Professionalism; D012944:Social Support; D013315:Stress, Psychological / Q000209:etiology / Q000517:prevention & control*; D011795:Surveys and Questionnaires
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