The of inferiority and disempowerment. A healthcare professional,

word “sympathy” has been used previously to refer to what we know today as
empathy. Goleman described sympathy as a state “where we feel sorry for the
person but do not taste their distress in the least, but empathy is distinct fromsympathy33,34.Empathy creates more
meaningful connections between patients and the healthcare professional.The
feeling of sympathy on the other hand develops from the acknowledgment that
another person – your patient – is suffering. It is /can be a genuine and
honest feeling. A sympathetic healthcare professional may feel sorry or pity
for their patients but can create a sense of inferiority and disempowerment. A
healthcare professional, at some point may need to put their own opinions and
issues away and comforting patients would need to take over as priority. On the
other hand, reacting in sympathy can compromise the ability to function as an
effective healthcare professional.

Empathy has shown to
decrease as an adaptive response of health professionals as they progress
through their careers. Studies among
nurses and physicians have suggested a relationship between age and different
levels of empathy; younger members show greater levels of empathy than older

According to a systematic by Neumann’s review,
self-perceived empathy declines significantly during medical school and
residency (particularly, in students who choose non-clinical specialties).36  The results were similar in other studies
among dental students whose empathy declined significantly in the clinical
phase of training.37 Many explanations have
been put forward for this phenomenon, the main being the coping mechanism.
These students associate humane treatment (display empathizing signals with
patients) with suffering and as an increasing source of potential distress and
thus to protect themselves applies a non-empathic caring style to protect
themselves from suffering.36,38

Other authors have suggested that the
unrealistic expectations of medical trainees (e.g. medicine can always cure) or
an increase in responsibility and demands under undesirable situations may lead
them to be non-empathetic in front of stress, thus finishing their work by
focusing on organs, systems and data instead of the patients to protect
themselves27. Another factor could be the deficiencies during
medical/nursing/ dental training where there is a recognized lack of exercise
to prepare students to support difficult situations. These decreased empathic
levels rarely improve in their future career. Thus, it is important that these
students learn coping techniques to confront their personal distress and work
disappointments, before they apply the unempathic manner and dehumanizing
caring style as coping methods.

Empathy has shown to
differ by gender and medical specialties.Different
people perceive and respond to emotional stimuli differently, although little
is known about the factors that influence clinicians’ response to the patient’s
concerns in medical interviews. 39 Higher empathy scores are shown in women
than men, and some studies confirm this gender distinction based on different
health settings.40,41

Regarding health professionals, female
physicians spent more time with their patients and render more preventive care.
40.Moreover, women were more likely than men to pursue primary care
disciplines where empathic and communicating skills are critical, unlike male
physicians who were more likely to pursue to surgical specialties with
prominent technical skills. 42

Skeptic and pragmatic health professionals
with less empathic attitudes may pay less attention to the emotional patients’
needs and tend to direct their skills towards the technical improvement of the
illness. Hence, medical students who planned to pursue “people-oriented”
specialties – primary care, obstetrics and gynecology, emergency medicine,
psychiatry and pediatrics) scored higher empathy levels than their counterparts
enrolled in “technology-oriented” specialties(hospital-based specialties,
surgery, surgical subspecialties, and radiology or pathology). 40,43
According to studies by Díaz-Morán et al,gender has shown to be a strong
predictor for empathic attitudes (women were associated with higher empathy).44
Explanation for this as some studies suggests could be that women have better
understanding of patients’ issues and concerns than men, due to their great
receptive ability to emotional signals.45It could be also due to
“gender-differences” related to pain awareness 46 and strategies to solve
emotional tasks 47: women seem to recruit more emotion-related regions of the
brain whereas men activate more cognitive-related areas.Health care
professionals, physicians and nurses particularly, have to deal quite commonly
with options and decisions which can be mediated by a patient’s religion: from
aggressive treatments in critically ill or terminal patients 48to crucial
advice on drugs, diets, customary habits and other health-related issues.49

As religion can work as a motivational factor
for positive attitudes, it seems reasonable to expect that professionals should
know how to assess spirituality needs.Studies have shownlinks between
agreeableness/conscientiousness and religiousness. Hence, personal dispositions
such as religion and an empathic caring style may interact with medical
settings to predict behaviors that are considered expressions of underlying
personality traits. Health professionals with altruistic concerns may have more
mental flexibility to understand and accept the needs of other people.