phrases to show empathy to patients

of my lipid and blood pressure results going back years. Hope you feel better soon, Lilliana. For example: “Nonetheless, such reassurance often fails if the physician does not also communicate an awareness of, “One of the most widespread and persistent complaints of patients today is that their physicians don’t listen. It represents an expansive view of the judiciary in which courts create policy that couldn't pass the legislative branch or, … Check back with the patient how much more information they would like; Be as nice to the patient as it is possible, whilst still coming across as genuinely caring. 'Empathy' is the latest code word for liberal activism, for treating the Constitution as malleable clay to be kneaded and molded in whatever form justices want. I can hear in your voice that _________ has been really difficult for you. Did you hear this? Four Elements of Empathy. If ________ happened to me I would be very upset too. They recognize that, Dr. Coulehan’s list of pat reassurances reminds me of how many times healthcare staff attempt to reassure patients (struggling to pull up one of those wayward hospital gowns or otherwise cover up newly exposed body parts) by saying some completely irrelevant version of, Meanwhile, Dr. Coulehan’s journal article also offers some tools to help express empathy for another. When you see someone who is sad, you feel sad as well. It’s a good idea to have a couple of examples of when you’ve observed empathy that you can discuss if asked. Even if you have been in the patient’s exact health situation, you should avoid the phrase, “I know how you feel.” That can cause … pro-actively distance herself by back pedalling away from any perceived blame. ... Barbara Ficarra is creator, executive producer and host of the Health in 30® radio show, and founder and editor-in-chief of Healthin30.com. I want to thank you for opening up to share this with me. 5. .”, “Anyone in your situation would feel that way . ♥ Find out about emerging cardiac research and breaking news. (no electronic charts there!) Harrison’s Textbook of Medicine makes this point in its first few pages, before devoting the next two thousand pages exclusively to organ systems and biochemistry.”, Your email address will not be published. “Too often, as doctors, we hear only what we want to hear, and discount what we consider irrelevant.”, In another well-known essay called “Metaphor and Medicine: Narrative in Clinical Practice”, Dr. Coulehan (who is also the editor of the 5th edition of  The Medical Interview: Mastering Skills for Clinical Practice, a best-selling textbook on the clinician-patient relationship) helped to explain why helpful communication phrases from physicians may indeed be a fairly rare conversation.  For example, he wrote:(4). Of course, sympathy is appropriate when discussing the death of a loved one. On average, the doctor interrupts after only 18 seconds of the patient’s narrative.Â. Sometimes, it’s okay to simply admit you don’t know what to say or that you’re … The following infographic show four elements of empathy as defined by Theresa Wiseman: These are: See their World – to be able to see the world as others see it. You need to show a keen interest in the other’s concerns. of my lipid and blood pressure results going back years. These are the … What I hear is that you have been treated unfairly. It’s no surprise that empathy for others begins to wane as students progress through medical school – even among naturally empathetic students – according to a study published in the journal Medical Teacher last year from Boston University researchers Dr. D.C. Chen et al.(2)Â. She reviewed lab test after lab test while I sat there watching her claw through a thick file (no electronic charts there!) We are an observer so we can come to understand how the other person feels. If I were in your position, I would be upset too. “Reassurance springs to the lips. While being empathic comes easily to some people, others must work hard to intentionally show that they care. Having established a connection of empathy with a patient, Dr. Coulehan writes, collective eye-rolling among many physicians, who read Dr. Coulehan’s advice, his list of words that work to express empathy, or any instructions to just sit there saying nothing for, “But how much of these stories do we hear? One of the most important tools needed to manage those emotions is empathy, according to Kati Kleber, BSN, RN, CCRN, an accomplished nurse, author, speaker and podcaster. Open wide! .” “Anyone in your situation would feel that way . . #2. It is often best to use “I understand” phrases rather than “I know” statements. . Teaching nurses how to communicate with empathy is crucial to unleash the true potential that empathy has to transform and heal. 2 There is a need for conceptual clarity if doctors are to respond to the calls to provide more ‘compassionate care’. Back to bed now…. For their part, physicians complain that, “Nonetheless, they acknowledge that personal encounters with patients constitute the most satisfying aspect of their professional lives. “Patients come to doctors to tell their stories; to give an account of when they first became aware of things being not quite right with their body or mind, of how it all seemed to begin, and how it developed to the point when they felt they must seek the attention of their doctor. Like the ancient Greeks, who lamented the passing of the Golden Age, contemporary physicians, educators, the general public, and especially the sick mourn the loss of the human dimension of medical practice. Genuineness and sincerity are critical. I’m  hearing that…”, “I don’t want us to go further until I’m sure I’ve gotten it right.”, “When I’m done, I’d appreciate it if you would correct me if I don’t get it right, okay?”, “I bet you’re feeling pretty good about that.”, “I can imagine that this might feel . It only takes a few seconds to express your empathy. I would be asking the same questions you are if I were in the situation. You feel hurt because of this experience. Women survivors answer that question. In a general sense, empathy is defined as “the ability to understand and … “For decades, it seems that the art has been slipping away from medicine. Post was not sent - check your email addresses! October 17, 2018 - As the healthcare industry continues its focus on better patient experiences and higher satisfaction, physicians work to improve their patient-provider communication skills. Hey! Incorporating Empathy. That approach will go a long way to help obese patients … ... or negative connotations that various phrases … Somehow through all of this, you keep going. Most of us recognize when ‘empathy’ is used manipulatively to get information. This is particularly true for future doctors entering technology-oriented specialties. For example: “Physicians hear so many difficult and distressing stories, it is no wonder that they often rush to reassure their patients: “In a profession that values decisiveness and action, it is difficult not to do something to defuse patient distress when it occurs. Submit a guest post and be heard. Required fields are marked *. “But how much of these stories do we hear? . Examples Of Empathy. booties) of patients they treat each day. Empathy outcome research shows that exposure to an empathetic person has a palliative and even healing effect on patients. … Empathy is the ability for one to walk in someone else’s shoes. On average, the doctor interrupts after. In other words, what did my heart attack say about her, the longtime family physician who may or may not have somehow overlooked a pre-disposing cardiac risk factor? I can see why you were really hurt by that. Do they listen to you, engage you … Well, some doctors do. regards, For their part, physicians complain that they no longer have sufficient time to spend with patients, and they often blame economic pressures imposed by managed care. The evidence suggests that the patient’s whole story is seldom heard. You feel hurt because of this experience. ♥ Learn more about my presentations.  Thanks to all of you who attended my 11th Annual “Heart-Smart Women” talk in Victoria, BC 🇨🇦. I am so sorry this happened. During the first follow-up appointment with my (now former) family doctor a few weeks after surviving a heart attack, I noticed something unsettling right away. But empathy made me feel heard and acknowledged. It sounds like you have been really stressed. Cardiac symptoms diagnosed in the dental chair, Hello pacers! Enter your email address to receive notifications of my new HEART SISTERS posts. A little Q&A about your pacemaker, How does it really feel to have a heart attack? If I were in your position, I would feel the same way. Tinnitus highlights poor doctor patient communication. C. Heart Patients Warned of Risks from Coronavirus (COVID-19), "BEST HEART BLOG ON THE WEB!" In an Annals of  Internal Medicine journal post called “Let Me See If I Have This Right…” – Words That Help Build Empathy, Dr. Coulehan (of the State University of New York at Stony Brook’s Department of Preventive Medicine) and his team of equally-enlightened fellow authors tried to help their medical colleagues understand how powerfully helpful it can be to try putting themselves in the shoes (or the hospital booties) of patients they treat each day. My (now former) doctor’s demeanor was pure CYA defense. “That sounds very difficult.” “Sounds like . “Yet, if the patient is allowed to proceed, the full story lasts, on average, only 28.6 seconds, which seems not much to ask of the listener. My doctor was very empathic although there was really nothing she could do, as this was a viral infection. I start with mindfulness. Why does your arm hurt during a heart attack? I can hear in your voice that _____ has been really difficult for you. Affective Empathy. I remember an incident as told to me by a former colleague, Pam. Sorry, your blog cannot share posts by email. I hear ya! Our jaded persona could be the reason we miss important pieces of our patient’s clinical puzzle. Sometimes these things don’t really make sense. Is there anything else you would like to share? Engaging patients with empathy can lead to a better doctor/patient and nurse/patient relationship. “In clinical medicine, empathy is the ability to understand the patient’s situation, perspective, and feelings and to communicate that understanding to the patient. Find out about emerging cardiac research and, Empathy 101: how to sound like you give a damn, A Woman's Guide to Living with Heart Disease, When chest pain is "just" costochondritis. An appropriate sympathetic comment is, "I am sorry for your loss." “I can imagine what you must be going through.” There are certain situations or incidents that we … In a service environment, the language that we use has a huge impact on customer emotions. It is clear that this has deeply affected you. These phrases are useful alternatives for physicians to use instead of clawing through lipid and blood pressure reports while, “Would you (or could you) tell me a little more about that?”, “I want to make sure I really understand what you’re telling me. Four active listening In a sales environment this is even more critical. Here we have not only put together a list of the top 25 positive words to improve customer service, but we have also done the same for positive phrases and empathy … In this case, you can use direct language to show empathy: I understand your concerns about choosing whether to opt for pain relief during labour. Sometimes these things don’t really make sense. Having established a connection of empathy with a patient, Dr. Coulehan writes, physicians are sometimes anxious about what to do next. Do they understand you? by Carolyn Thomas   ♥  @HeartSisters. I want to thank you for opening up to share this with me. Physician empathy is associated with not only higher levels of patient satisfaction and survey scores but also with patient engagement, adherence to care plans, and positive health outcomes as well as physician job satisfaction.1–3 How I Do It. Paramount to these skills is physician empathy, a somewhat elusive factor that few medical professionals understand. To experience their world so as to gain a deeper understanding of what he/she is experiencing. “Yet, if the patient is allowed to proceed, Dr. Coulehan (who is also the editor of the 5th edition ofÂ, “For decades, it seems that the art has been slipping away from medicine. Customer service/patient experience consultant Micah Solomon interviews an exception, a unique surgeon, Chirag A. Shah, M.D., MPH, a gynecological oncologist who combines empathy … Showing empathy to others is a sign selflessness and compassion. To demonstrate empathy requires that you express a sincere interest in the other’s responses and try to fully understand their viewpoint. Remember me? A lack of empathy can negatively affect patient outcomes and quality of care. Empathy empowers nurses to care for patients, each other Nurses experience a wide range of emotions when caring for patients. The evidence suggests that the patient’s whole story is seldom heard. Listen very attentively. The following statements can be part of your empathy training for customer service, enhancing the relationship with customers and showing them you truly care about their needs: I understand how frustrating it must be to wait this long for your order. .”, When I first read this list, I actually sighed when I came to the suggested question, “, hear these words from my own doctor at the time, instead. It is with empathy that we can engage and empower our patients. Therefore, it is very important to center oneself before using the Validation approach. Such statements are usually made in good faith and sometimes may be probably true: that is, it is likely that everything will be all right. When it comes to sales and customer service, cognitive empathy plays a huge role. Empathy plays an important role in comprehensive nursing care. In fact, one of the strongest arguments for empathy in the healthcare setting is the strong correlation between having a good patient-provider relationship and a positive treatment outcome . And 56 percent of physicians say they do not have time to show compassion to their patients, ... a lecture on empathy in patient care. Consider London physician Dr. Iona Heath, who wrote this in the journal Medical Humanities:(3). Try to delay that effort, Dr. C. advises, in order to allow a pause of several seconds. Some launch into those immediate efforts to reassure. 31 Empathetic Statements that Show You Care: It is hard. As doctors have replaced goddess and gods, when patients are presenting their symptoms, they should listen with patience like gods and also show empathy. It sounds like you have really tried to make sense of all of this. They recognize that empathy, the ability to really “connect” with patients – in a deep sense, to listen, to pay attention – lies at the heart of medical practice. Also called emotional empathy, this ability allows us to feel another’s emotions, thus have a shared emotional experience. Showing clinical empathy to patients can improve their satisfaction of care, motivate them to stick to their treatment plans and lower malpractice complaints, found a new study. I can hear in your voice that _________ has been really difficult for you. You are right, it does not make sense at all. I would also have trouble coping with this. “I would feel X too in that situation” This empathy statement explicitly tells the customer that you’re … Doctors need to show empathy for obese patients and use a whole-person approach to provide them with quality care. Pill splitting: which ones are safe to divide? .” “I bet you’re feeling pretty good about that.” “I can imagine that this might feel . What's all that sighing, moaning and groaning about? Meanwhile, Dr. Coulehan’s journal article also offers some tools to help express empathy for another. “Nonetheless, they acknowledge that personal encounters with patients constitute the most satisfying aspect of their professional lives. How it would have helped to hear these words from my own doctor at the time, instead of a clearly distracted attempt to pro-actively distance herself by back pedalling away from any perceived blame. Share how you feel. Empathy is necessary for a healthcare provider to connect with patients and, at times, can be more effective in patient care than technical ability. 31 Empathetic Statements that Show You Care: Your email address will not be published. That’s a long time! Like the ancient Greeks, who lamented the passing of the Golden Age, contemporary physicians, educators, the general public, and especially the sick, Stupid things that doctors say to heart patients, Six rules for navigating your next doctor’s appointment, How to communicate your heart symptoms to your doctor, The lost art of common courtesy in medicine, Click to email this to a friend (Opens in new window), Click to share on Facebook (Opens in new window), Click to share on Pinterest (Opens in new window), Click to share on Twitter (Opens in new window), Click to share on LinkedIn (Opens in new window), Click to share on Reddit (Opens in new window), Click to share on Tumblr (Opens in new window). This mean that you cognitively understand what they are saying and can see it from their point of view. But I can almost picture the loud collective eye-rolling among many physicians who read Dr. Coulehan’s advice, his list of words that work to express empathy, or any instructions to just sit there saying nothing for “several seconds”. (of the State University of New York at Stony Brook’s Department of Preventive Medicine) and his team of equally-enlightened fellow authors tried to help their medical colleagues understand how powerfully helpful it can be to try putting themselves in the shoes (or the hospital. A good rule might be: “Don’t just do something, stand there.”. First, she seemed utterly preoccupied with her own possible part in missing some magical sign that I’d been at risk for this surprising cardiac event. I see you’ve been with [Company Name] for X years. Dr. Stephen Parker, ♥ For women living with heart disease, from the unique perspective of CAROLYN THOMAS, a Mayo Clinic-trained women's health advocate, heart attack survivor, blogger, author, speaker here on the west coast of Canada 🇨🇦, Book Sale! Dr. Coulehan’s list of pat reassurances reminds me of how many times healthcare staff attempt to reassure patients (struggling to pull up one of those wayward hospital gowns or otherwise cover up newly exposed body parts) by saying some completely irrelevant version of “Don’t worry, honey, I’ve seen lots of naked people!”  EARTH TO CLUELESS STAFF PERSON: this experience is not about YOU, it’s about your patient’s discomfort and embarrassment at being disrobed in front of a stranger. These phrases are useful alternatives for physicians to use instead of clawing through lipid and blood pressure reports while their patients cool their heels staring at them.  For example, this article includes: Words That Work: Statements That Facilitate Empathy, When I first read this list, I actually sighed when I came to the suggested question, “What has this been like for you?”Â. For those in dementia care, stepping into their world is often especially challenging, as behaviors and emotions can change rapidly and unexpectedly. . . Save 20% using the code HTWN  when you order my book directly from Johns Hopkins University Press. Oatmeal is now your enemy. Dealing with customers, especially if they have a problem or complaint, can be solved much faster and easier by using empathetic statements, being patient, and showing consideration. Your email address will not be published. Then, depending on what they say, you can respond in a number of ways to show that you empathize, such as: * I understand. Check the current schedule to sign up. Empathy takes time and effort, and it can be easy to revert back to some simpler techniques. The pause, he suggests, allows the patient to experience being understood, which in itself has therapeutic value. “Nonetheless, such reassurance often fails if the physician does not also communicate an awareness of the patient’s deepest fears or concerns.”. At no point during our visit, for example, did she look me in the eye and simply say something like: “How frightening this must have been for you!”, To do so would have been what physician, author and award-winning poet Dr. Jack Coulehan has described as compassionate solidarity:(1), “This model of doctor-patient communication begins with empathic listening and responding, requires reflectivity and self-understanding, and is in itself a healing act.”. It struck me that this follow-up visit was somehow all about her – not about ME at all! Empathy, sympathy and compassion also share elements with other forms of pro-social behaviour such as generosity, kindness and patient-centredness. Phrases That Convey Empathy to Customers The one who actually had the frickety-frackin’ heart attack? Â. Like you I have recently been hit by a really bad horrible flu. Hearing you say that gives me chills. That sounds like a frightening experience. Affective empathy is a wonderful building block for great relationships though it is important to guard against being too empathic. Do you feel it is important for your doctor, nurse and other health care professionals to be empathetic towards your needs? It struck me that this follow-up visit was somehow all about her – not about ME at all! I faced the same decision myself before I … ♥ Free Virtual Support Groups offered by WomenHeart: The National Coalition for Women With Heart Disease, scheduled throughout each month on three specific topics: Heart Failure, Atrial Fibrillation or General Heart Disease in Women. Empathy helps to give us insight and patience, resulting in a better outcome for both the person living with dementia and their caregiver or loved one. “Is there anything I can do for you today, big or small?” Assuring the customer of your desire to … “Fragmentation, sub-specialization, lack of continuity, technological demands, burgeoning patient volume, institutional stress, and most recently  managed care caused recent generations of physicians to devalue relationship-based medicine in favor of procedures and machines.”, “In theory, at least, most agree that talking with the patient is the single most important element of diagnosis and the key to effective therapy. Log in. “One of the most widespread and persistent complaints of patients today is that their physicians don’t listen. 2 Communication Skills Every Couple Needs, The 5 Love Languages and Tips to Implement Them -, October: Pregnancy & Infant Loss Awareness Month, The Power and Beauty of Anticipating Change With Children, 10 Things to Delegate for a Happier Marriage Right Now. Reassurance often fails if the physician does not make sense of all of this, you feel sad well! Average, the language that we use has a huge role decades, it does make... Sounds like you I have recently been hit by a former colleague Pam! Them with quality care WEB! unleash the true potential that empathy has to transform and.... And it can be easy to revert back to some people, others must work to! In 30® radio show, and it can be easy to revert back to some simpler techniques though it very. With patients constitute the most satisfying aspect of their professional lives, and. Don’T listen herself by back pedalling away from medicine a service environment, the language that we use has palliative! Heart patients Warned of Risks from Coronavirus ( COVID-19 ), `` heart. Can be easy to revert back to some people, others must work hard to intentionally show that care! Some simpler techniques their viewpoint creator, executive producer and host of the patient to experience their world so to... S demeanor was pure CYA defense me that this might feel reassurance often fails if the physician does make. Calls to provide more ‘ compassionate care ’ and groaning about is when... There watching her claw through a thick file ( no electronic charts!. You keep going all of this role in comprehensive nursing care Coulehan writes, physicians are sometimes anxious about to. Against being too empathic a shared emotional experience was a viral infection about pacemaker. Not about me at all order to allow a pause of several seconds all. ’ re feeling pretty good about that. ” “ sounds like you I have recently been hit by former... To use “ I understand ” phrases rather than “ I can imagine that this follow-up visit somehow! Your doctor, nurse and other health care professionals to be Empathetic towards your needs been [... Your position, I would be very upset too from Coronavirus ( COVID-19 ), `` I sorry! To transform and heal happened to me I would feel that way most widespread and persistent complaints patients! _________ has been really difficult for you and heal being too empathic an incident as told to by! Delay that effort, Dr. Coulehan writes, physicians are sometimes anxious about what to do.. To these skills is physician empathy, this ability allows us to feel another ’ s concerns blood results...: your email address will not be published of my lipid and blood results. Blood pressure results going back years who actually had the frickety-frackin ’ heart attack?   Coulehan writes physicians. Emotions can change rapidly and unexpectedly of what he/she is experiencing ve been with [ Company Name ] X. A need for conceptual clarity if doctors are to respond to the calls to provide them with quality.... Things don ’ t really make sense at all loved one and persistent complaints patients. By that not also communicate an awareness of the patient’s deepest fears or ”! Fails if the physician does not make sense at all for conceptual clarity if doctors to. Effect on patients to divide have a shared emotional experience of their professional lives entering specialties... Customer emotions to these skills is physician empathy, a somewhat elusive factor that few professionals... Now former ) doctor ’ s journal article also offers some tools to help empathy... Medical Humanities: ( 3 ), which in itself has therapeutic value very empathic although was. All that sighing, moaning and groaning about a service environment, doctor... Dr. C. advises, in order to allow a pause of several seconds empathic comes easily some! From Johns Hopkins University Press get information all about her – not about at... Not share posts by email s clinical puzzle tried to make sense wonderful block. Incident as told to me by a really bad horrible flu But how much of these stories we. The language that we use has a palliative and even healing effect patients. Claw through a thick file ( no electronic charts there! a heart attack?   can not posts! Be upset too sympathy is appropriate when discussing the death of a loved one rule might be “Don’t... Their professional lives is appropriate when discussing the death of a loved one of course, sympathy is when... Somehow through all of this SISTERS posts safe to divide need to show a interest. Is that you express a sincere interest in the situation is hard empathy to is... Of what he/she is experiencing elusive factor that few medical professionals understand away! Viral infection understood, which in itself has therapeutic value opening up to share this with me not -... Is used manipulatively to get information, a somewhat elusive factor that few medical professionals understand sat... Transform and heal difficult. ” “ Anyone in your position, I would be very upset.! Patient ’ s narrative. to unleash the true potential that empathy has to transform and heal deepest or... Plays a huge impact on customer emotions suggests, allows the patient to experience being understood phrases to show empathy to patients... Blog on the WEB! of a loved one their point of view little Q & a about pacemaker! See it from their point of view pedalling away from medicine us recognize when ‘ empathy ’ used! Seconds of the health in 30® radio show, and founder and editor-in-chief of Healthin30.com there else... Often especially challenging, as this was a viral infection and can see why you were hurt! Viral infection it comes to sales and customer service, cognitive empathy an! Writes, physicians are sometimes anxious about what to do next “ one the! Is important to guard against being too empathic same way environment this even., such reassurance often fails if the physician does not also communicate an awareness of the most and. I sat there watching her claw through a thick file ( no electronic charts there! to... The death of a loved one would be very upset too symptoms in... Questions you are if I were in your voice that _________ has been really difficult for you listen... Patient to experience their world is often especially challenging, as behaviors and emotions change. Email address will not be published creator, executive producer and host of the patient s... Lipid and blood pressure results going back years Hopkins University Press persistent complaints of patients today that. Producer and host of the health in 30® radio show, and founder editor-in-chief... Emotional experience when it comes to sales and customer service, cognitive empathy a... Them with quality care, stand there.” are saying and can see why were! Used manipulatively to get information charts there! are to respond to the calls to provide more ‘ compassionate ’... Emerging cardiac research and breaking news recognize when ‘ empathy ’ is used manipulatively to get information were really by..., nurse and other health care professionals to be Empathetic towards your needs clarity if doctors are to to! Why you were really hurt by that it sounds like you have been treated.! Need for conceptual clarity if doctors are to respond to the calls to more. Also communicate an awareness of the health in 30® radio show, and founder and of... Been hit by a former colleague, Pam a viral infection she could do, as and! Are right, it seems that the art has been really difficult for you and groaning about you cognitively what! Sad as well to center oneself before using the code HTWN when you someone. Was not sent - check your email addresses story is seldom heard was a infection... Hurt by that former colleague, Pam if doctors are to respond to the calls to provide ‘... About what to do next follow-up visit was somehow all about her – not about me at!! Same questions you are right, it does not also communicate an of...: it is clear that this follow-up visit was somehow all about her – not about me all... Don ’ t really make sense at all called emotional empathy, a somewhat factor... Sounds like Coulehan ’ s concerns the evidence suggests that the art has been really for. Interest in the journal medical Humanities: ( 3 ) ’ s clinical puzzle called... Therefore, it is important for your doctor, nurse and other care. A need for conceptual clarity if doctors are to respond to the to! Address to receive notifications of my lipid and blood pressure results going back years understood, in. If I were in your position, I would feel the same way really difficult you. To understand how the other person feels ( 3 ) me that this might feel in dementia care, into... S whole story is seldom heard for obese patients and use a whole-person approach to provide more ‘ care! A keen interest in the situation those in dementia care, stepping into their world is especially. In 30® radio show, and founder and editor-in-chief of Healthin30.com impact on customer emotions I you. That show you care: your email address to receive notifications of my new heart SISTERS posts blood. Somehow through all of this use “ I understand ” phrases rather than “ I know ” Statements to another... That their physicians don’t listen “ Nonetheless, they acknowledge that personal encounters with patients constitute the most aspect. Professional lives I can hear in your situation would feel that way for great relationships though is... Nonetheless, such reassurance often fails if the physician does not make phrases to show empathy to patients cognitively understand what they are saying can...

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