There is much to like; scratch that — there is much to love about Daniel Goleman’s new book on Focus. Daniel became immensely popular through an earlier book on Emotional Intelligence. In one sense Goleman piggybacked onto Howard Gardner’s popularization of multiple intelligences, which in another sense is a popularization of the principles advanced by Hans Furth and the developmental optometrist Harry Wachs. I want to focus for a moment on Chapter 10 of Goleman’s new book, which addresses The Empathy Triad. It is a subject that has been on my mind not only because of our increasing involvement with with children on the Autistic Spectrum, but because of the five part series I just finished on the interface between optometric vision therapy and ophthalmology. Consider this passage regarding empathy balance and the doctor-patient relationship:
“Not listening is is the top of the list of complaints patients have about their physicians. For their part, many physicians complain they are not given the time they need with their patients and so the human side of their interaction gets short shrift. The barrier to human contact rises as physicians – mandated to keep digital records – tap notes on a computer keyboard during patient interviews, and so end up communing with their laptop rather than with the patient.”
Goleman cites an article, “Let Me See If I Have This Right” from the Annals of Internal Medicine that makes the following observation: “Empathy, the ability to connect with patient – in a deep sense, to listen, to pay attention – lies at the heart of medical practice”. Orienting to the patient’s emotions builds rapport. Tuning out feelings, and focusing only on clinical details builds a wall.
Goleman observes that during their socialization process into the profession, medical students are traditionally conditioned that having too much empathy, or literally feeling the patient’s discomfort or pain while conducting procedures interferes with the doctor’s focus on the medical imperatives of the procedure. Ultimately practicing physicians become more robotic and detached as they formulate differential diagnoses while talking to the patient, and subconsciously block empathy while performing medical procedures.
Chapter 10 on the Empathy Triad is followed by Chapter 11 on Social Sensitivity, and it was here that an intriguing thought popped into my head: Do medical schools unwittingly select candidates who are on the high functioning end of a spectrum in which eye contact and empathy are viewed as by-products of subjectivity? Further, does medical training and education unwittingly condition physicians to value objectivity and test results over the patient narrative? In the final analysis, is the shortage of quality time with the patient dictated by third party practices, interfering with both doctor and patient satisfaction in the practice of medicine? Dialogues from within the medical profession, as in this collection of expert opinions, appears to support Goleman’s concerns about the need to restore balance.
I’m suggesting here that empathy comes naturally to Doctors of Optometry specializing in developmental vision. I’m also suggesting that patients can discern this focus, and that it is a driver of excellence.