Compassion in healthcare interactions

Compassion, like rapport and respect, are the outcome of an interaction. This is sometimes referred to as “relational work” in interaction. 

Research on real social interactions, such as those that use conversation analysis, show how empathy and compassion are achieved. 

There is a growing interest in compassion and empathy in this kind of research on healthcare interactions. This paper, for example, shows that “effective empathic validations must (a) demonstrate shared understanding and (b) support the patient’s position.” Poorly timed or expressed empathy can lead to patient rejection, while well-crafted empathic responses are more likely to be accepted. 

“Rather than a rush through, personalized care must at times enact a slowdown to honor the integrity of patients’ emotions.” Beach (2022, p220)

Empathy and compassion do not need to be a standalone moment in the interaction. It can be achieved while conducting biomedical work, such as demonstrating an understanding of the patient’s perspective while also conveying a biomedical perspective in the same turn. Empathy and compassion can be used to agree with a patient’s concerns and experiences. But empathy does not equal agreement. Clinicians can be empathetic without agreeing with a patient’s perspective.

Compassion is achieved through interaction. This means that improving compassion needs to focus on evidence as to how this is done in the wild. 

More research is needed to identify whether there are compassionate conversational practices that can lead to improved patient experiences and outcomes. Similarly, we need research into the external factors that may reduce compassion, such as organisational and professional cultures. This will produce greater evidence to support teaching the how of empathy and compassion to healthcare providers. In the meantime, we need: continued advocacy for person-centred care, integratation of the research that is available into teaching, and support for clinicians to engage with the complexity of conversation so that they can develop skills in responsiveness to support suitable empathic responses and to recover if empathic responses ‘misfire’.