Read the passage carefully and answer the questions that follow. Some words may be highlighted. Pay attention.

The word empathy is routinely used in discussions of patient-physician relationships. It is a psychological process that encompasses a collection of affective, cognitive, and behavioural mechanisms and outcomes in reaction to the observed experiences of another. It also indicates that intrapersonal and interpersonal outcomes have immediate and longitudinal effects on patient and physician outcomes.

The empathic process includes different psychological activities that take place within a person, leading to cognitive, affective, and behavioural changes. Antecedent factors such as the characteristics of the physician, the patient, and the clinical setting affect the physician’s internal and external activities directly and indirectly. As empathy usually involves ongoing interpretation, interpersonal outcomes (social behaviour) will, in turn, affect intrapersonal outcomes and antecedents, and intrapersonal outcomes can change the empathic processes.

Empathy should characterize all health care professions. Despite advancements in medical technology, the healing relationship between physicians and patients remains essential to quality care. The physicians must consider empathy as emotional labour (i.e., management of experienced and displayed emotions to present a certain image). Since the publication of Hochschild’s The Managed Heart in 1983, researchers in management and organization behaviour have been studying emotional labour by service workers, such as flight attendants and bill collectors. Pertinently, physicians as professionals are considered to be empathic caregivers. They engage in such emotional labour through deep acting (i.e., generating empathy-consistent emotional and cognitive reactions before and during empathic interactions with the patient, similar to the method-acting tradition used by some stage and screen actors), surface acting (ie, forging empathic behaviours toward the patient, absent of consistent emotional and cognitive reactions), or both. Although deep acting is preferred, physicians may rely on surface acting when immediate emotional and cognitive understanding of patients is impossible. A study also contends that physicians are more effective healers—and enjoy more professional satisfaction—when they engage in the process of empathy. Thus, there is a need for the physicians first to recognize that their work has an element of emotional labour and, second, to consciously practice deep and surface acting to empathize with their patients. Medical students and residents can benefit from long-term regular training that includes conscious efforts to develop their empathic abilities. This will be valuable for both physicians and patients facing the increasingly fragmented and technological world of modern medicine.

Interest in the relationship between physicians and patients is as old as the practice of medicine. Over the past 20 years, scholarly interest has increased as educators and practising professionals have realized that a therapeutic relationship, along with the integration of knowledge and skills, the content of care, information management, teamwork, and health systems is an integral part of healing and effective medical care. The context effect, better known as the placebo effect, addresses in great detail the impact of the patient-physician relationship on a patient’s recovery.

Several published articles suggest that physicians who display a warm, friendly, and reassuring manner with their patients are more effective. In addition, it is agreed that empathy makes patients more forthcoming about their symptoms and concerns, thus, facilitating medical information gathering, which, in turn, yields more accurate diagnosis and better care; helps patients regain autonomy and participate in their therapy by increasing their self-efficacy; and leads to therapeutic interactions that directly affect patient recovery. In sum, “making connexions” and “developing empathy” are fundamental to caring and enhance the therapeutic potential of patient-clinician relationships.