Burnout Is Reducing the Empathy of Health Care Workers

A loss of empathy and burnout often go hand in hand—to the detriment of doctors and patients
September 28, 2020 Updated: September 28, 2020

Empathy is being able to put yourself in someone else’s shoes or experience the emotions of the other person. It allows you to convey that understanding to them so they know they are understood in a visceral way. While undoubtedly important for many aspects of life, being empathetic is especially useful for those working in health care.

Empathy helps ensure people receive the best quality health care, helps patients from all backgrounds and cultures receive care that works best for them, and helps patients feel safe about their health care procedures. But all too often, those working in health care can become burnt out—which may have a serious impact on their ability to relate to and be empathetic, with patients.

Empathy can be overlooked for its importance in patient care. Being able to be empathetic can also be difficult to achieve, especially since it may require staff to open themselves up to trauma and pain. Staff may not have time to nurture relationships with patients, and empathy also requires health care workers to be flexible in order to adapt to each patient and their unique needs, especially if a patient’s beliefs conflict with their own.

Burnout and Empathy

These sorts of problems in care can also contribute to burnout, which is common in health care workers. Symptoms of burnout can include exhaustion, detachment, cynicism, and a reduced sense of achievement, all of which make quality patient care more difficult.

Burnout happens for a range of reasons, including high-pressure workplaces, lack of support, and poor work-life balance. It can also be caused by feeling a lack of control over, overwhelmed by, or in conflict with the work itself. Not surprisingly, research shows that as either empathy or burnout increases, the other one decreases—that is, they are negatively associated to each other. More burnout means less empathy. More empathy means less burnout.

But there’s a culture in the medical field that stigmatizes mental health problems such as burnout in doctors. And many general practitioners (GPs), for example, report not having the time to meaningfully relate to patients and colleagues.

Unlike some other professions, medicine also traditionally encourages practitioners to manage alone. In the United Kingdom’s National Health Service (NHS), where 1 in 12 posts remain vacant, and administration and patient loads can be “relentless,” this can be a recipe for disaster.

In a study my colleagues and I conducted exploring GPs’ experiences of workplace stress and their coping strategies, one GP told us that they went into a stupor after coming home from work. This due to the large number of people they saw and the emotions they experienced without having time to process them. Another highlighted the constant fear GPs have of making mistakes.

Two doctors and a nurse talk to each other in a hospital hallway.
Debriefing with colleagues may help reduce burnout. (Jacob Lund/ Shutterstock)

Our research also shows how burnout creeps up on doctors, leaving them feeling broken and trapped. Not surprisingly, alcohol and drug dependencies are the most common medical problems for doctors after depression. Interestingly, however, we found that recovery from burnout could mean greater empathy for patients with mental health problems, as GPs might better understand the patient’s experiences.

Manageable caseloads, debriefing, peer, and organizational support may all help people avoid (or recover from) burnout and low empathy. Some advice for those working in health care might be to set boundaries in your relationships with patients. For example, counselors of abused children might have to remind themselves they are not the child’s parent. Health care professionals might also engage in self-care (such as taking time off, exercising, or meditating), and make time to regularly debrief with a colleague about difficult experiences.

But self-care can only go so far. Interestingly, the concept of “moral injury” is beginning to compete with “burnout” as a way of understanding the plight of health care workers. This is the idea that people can be exposed to trauma at work that violates their moral sense of right and wrong, resulting in a conflict with deeply held values and feelings like shame and betrayal.

Originally used to understand the experiences of war veterans, the term “moral injury” highlights the role of authorities in the way workers may violate their own morals, resulting in work dysfunction. An example of moral injury might be when doctors are so overworked their heads are “too full” to think straight, or when forced to choose which patient to admit into the hospital first for treatment.

Cultivating empathy can be difficult for those working in the health care sector, especially when the stressful environment can make burnout common. But there is some research that higher empathy levels might protect against burnout.

While this link needs to be studied more, the researchers involved speculate that doctors able to better understand the perspective of their patients might feel more connected—and useful—to their patients. This could alleviate some of the stresses of the work.

 is a professor of health studies at the University of Westminster in the UK. This article was first published by The Conversation.