Intended for healthcare professionals

Practice Practice Pointer

The power of caring in clinical encounters

BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m4100 (Published 30 October 2020) Cite this as: BMJ 2020;371:m4100
  1. Paul Dieppe, emeritus professor of health and wellbeing1,
  2. Ian Fussell, associate dean of medical education1,
  3. Sara L Warber, clinical professor emerita, family medicine, honorary professor23
  1. 1University of Exeter, Medical School, Exeter, UK
  2. 2University of Michigan, Ann Arbor, MI, USA
  3. 3University of Exeter Medical School, Truro, UK
  1. Correspondence to SL Warber swarber{at}umich.edu

What you need to know

  • Validation is distinct from empathy or compassion and is a fundamental component of caring

  • Caring consultations require the doctor to be fully present emotionally and mentally and for the patient and doctor to feel safe

  • Be prepared to be vulnerable and human

  • Find out what the patient would like their good health back for

“One of the essential qualities of the clinician is interest in humanity, for the secret of the care of the patient is in caring for the patient.”1 Francis Peabody’s memorable quote from almost one hundred years ago still rings true today. However, when under pressure in our current medical practices (for example, during the covid-19 pandemic), it can be easy to forget that our human-to-human connections make a difference for our patients. In this article we explore how doctors can consciously use their interest in humanity and the power of caring in their clinical work. We focus on the individual clinician’s choices and actions, although we recognise that systematic problems such as limited time with patients also affect the extent to which caring can be brought into a consultation. We define “caring” as a mindset of healthcare professionals that helps them protect the humanity of themselves and others and fosters positive transpersonal relationships that feature love and kindness.2Box 1 exemplifies a consultation in which humanity was shared and that resulted in a major life change for the patient.

Box 1

A person with neck pain

After having every treatment known to man, I was told at the pain management clinic that there was no cure, and that I would never work again as a musician or in fact any other job, because of the pain and its restrictions. They said I would have the pain for life and that it would get worse as I got older. It seemed that, …

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