Can acting classes help physicians learn to show empathy?

February 25, 2019

Showing empathy improves patient satisfaction, but not every doctor is naturally good at expressing feelings to patients. 

Editor's Note: Welcome to Medical Economics' blog section which features contributions from members of the medical community. These blogs are an opportunity for bloggers to engage with readers about a topic that is top of mind, whether it is practice management, experiences with patients, the industry, medicine in general, or healthcare reform. The opinions expressed here are that of the authors and not UBM / Medical Economics.

One of the keys to improving patient satisfaction is learning to show empathy, but this is not something that every doctor is naturally good at doing.  

So how can physicians learn to demonstrate our feelings to our patients-that we care and understand their concerns? One way is by taking acting classes.

In fact, I’m firmly convinced that high school drama club taught me more interpersonal technique than anything I learned in my clinical skills medical school courses.  

I’m not the only one who thinks so.  

David A. Watson, MD, a family physician in West Virginia, attributes much of his success in the office to studying acting in high school and college. “I remember wanted to be an actor as early as kindergarten,” says Watson, who starred in his first school play in the fourth grade. 

From that first play, Watson was hooked. He began writing and performing plays with a friend, and in high school he excelled in speech and oral interpretation classes. In college, he auditioned at open tryouts and was cast in a large role. Although he majored in English literature, Watson took many theater and acting classes, and after graduation he participated in community theater events.

Watson eventually decided to go to medical school. His career as a physician has limited his theatrical extracurricular activities, but he still uses his acting skills in the office every day.

“I remember the first time that I realized that I needed to use acting as a physician,” Watson says. “I was a young doctor, and I got my first complaint from a patient. My supervisor called me in to discuss it and said, ‘can’t you just pretend that you care?’ I was hurt! The truth is I did care-but the patient didn’t understand how I felt because I wasn’t communicating it effectively.”

Essentially, acting is communicating, explains Watson. “Acting is emoting-it doesn’t mean that you’re faking it. You’re simply putting out there how you feel.”

And indeed, a study from the American Psychological Association shows that teaching role-playing (or acting) can not only help medical students to appear empathetic but can create true empathy. This is important, because while most medical students start out with extremely high levels of empathy, the trauma of third year clinical rotations often causes those natural empathy levels to plummet. Just learning how to actin an empathetic way seems to counter this reduction in empathy. Another study corroborates this finding, showing that people who are naturally introverted are actually happier when they act, or pretend, to be extroverted.

So, let’s take a clue from Hollywood television drama and incorporate a bit of acting into our day-to-day profession, especially since when we are in front of patients, in a way we are “onstage.”

No one expects you to win an Oscar-but if you are having a bad day, you can use acting to put your own personal feelings and behaviors to the side to show your caring, competent, and compassionate qualities. It’s not so much “faking it” as learning to embody the characteristics that create a good bedside manner.

This is exactly what Watson does in the exam room, and he always starts by first asking himself: “Who is my character beyond ‘doctor?’” In other words, what kind of doctor does the patient hope to get?”  

He says that you can figure this out by listening to the patient, who often tells you what they want directly- and keep in mind that patients tend to seek the qualities in doctors that they personally value or recognize in themselves. Just by paying attention to the patient, you can often determine what type of doctor they are looking for.

“Does the patient want knowledgeable, matter-of-fact, down-to-business doctor? Or is he looking for the folksy, old-time country doc?  Some patients want a bit of hand-holding, while others are in search of the persuasive physician-‘help talk me into doing the right thing.’ And of course, there are patients who want the ‘customer is always right’ doctor.”  

As a physician, it’s essential to ‘know your script’ before you go into the exam room. “The best advice I ever got was to know what you are going to say before you go into the room,” says Watson. “This doesn’t mean that you can’t change what you say as the visit evolves, but you should have a good idea of the message you want to communicate ahead of time.”

This is especially important during those frequently given spiels-the new diabetes lecture, why antibiotics don’t work for viruses, etc.  “Even though you say it over and over again, it may be the first time the patient is hearing it.  You have to say it each time like you’ve never said it before,” advises Watson.  “And remember, there are no small roles, just small actors!”

So, how does a doctor without any acting experience learn how to embody a character in the exam room?

Take an acting workshop, find a community theater group online, or just get together with a friend or two to practice. Even just practicing in a mirror or videoing yourself can be helpful. “Getting feedback is essential,” says Watson.  “And it doesn’t necessarily have to be dramatic acting-try a speech class or practice oral interpretation through a story or poetry reading.”

And who knows-you might just have fun doing it.

Rebekah Bernard is a family physician and the author of Physician Wellness: The Rock Star Doctor’s Guide and How to Be a Rock Star Doctor: The Complete Guide to Taking Back Control of Your Life and Your Profession.  She can be reached at her self-titled site, Rebekah Bernard, MD.