Why empathy may not be the issue—and what’s actually behind communication gaps in HTM.
By Binseng Wang, ScD, CCE, BSI Health Technology Consulting
I have often heard that clinical engineering (CE)/healthcare technology management (HTM) professionals—especially the male practitioners—lack empathy for patients and clinicians, and thus should stay away from directly interacting with both.
I strongly disagree with this assertion, but before I try to explain my reasoning, please allow me to review the definition of empathy. Dictionaries like Merriam-Webster and others define empathy as the understanding or psychological identification with or vicarious experiencing of the emotions, thoughts, or attitudes of another.
Accusers of lack of empathy claim CE/HTM professionals are typically geeks who prefer to “talk” with machines rather than human beings and dislike getting emotionally involved with others, especially patients who are uncomfortable, upset, or even aggressive because of their health challenges. Clinicians are also often impatient and very demanding of prompt solutions.
In such situations, it is not surprising that many CE/HTM professionals don’t know how to react or behave properly, especially when they discover the alleged malfunction is actually due to improper use or lack of training by either the clinician or the patient, or both. In such situations, the CE/HTM professionals often retreat to their sanctuaries in the basement and express their frustration in work orders with pejorative comments about the users.
If, on the other hand, one stops for a moment and reflects on the situations mentioned above, it becomes clear that this is not a lack of empathy but a lack of proper introduction and onboarding of CE/HTM professionals into healthcare.
First and above all, these people are in this profession because they firmly believe they can help both patients and clinicians by providing safe, reliable equipment. If the CE/HTM professionals didn’t believe this was their mission, they would not be in healthcare. They could find much more satisfying and often more lucrative careers in information technology, artificial intelligence, computer games, or even in weapons development and production.
The Experience That Changed My Perspective
Please allow me to use my personal experience to illustrate what I am trying to say. When I was graduating from engineering school, I applied to study under the supervision of a biomedical engineering PhD who just graduated from one of the best American universities. I was very happy to be accepted after submitting my application and interviewing.
However, when the school semester started, my new advisor said, “Sorry, got bad news for you. My husband was in a car accident a few days ago and is now in a coma. So I can’t take care of you. Either you transfer to another program, or I will have to ask your medical co-advisor to guide you while I attend to my husband.”
As few comatose patients survive long, and an alternative program was over 500 miles away, I decided to hang tight.
When I was introduced to my medical co-advisor, the chief of neurosurgery, he said, “I never had an engineer under my supervision, so I don’t know what to do with you. But you can join my residents while you wait for your advisor to be available, and let’s see what happens.” So I became a “doctor,” wearing a white coat (to blend in), witnessed neurosurgeries, and sat in patient case reviews for almost six months.
One day, I attended the surgery of a young person who was comatose due to another car accident and had his skull opened to relieve pressure and search for a hematoma. (CT scanners were not yet commercialized at that time.) During the surgery, the chief was trading jokes with his residents and talked about his recent vacation overseas. Afterwards, all the residents left to attend to their patients, and since I didn’t have any assigned patients, I followed the chief to talk with the patient’s family.
He said, “We did not find a hematoma in his brain but drained some cerebrospinal fluid because the intracranial pressure was too high. He is still under sedation and hopefully will wake up soon if God wishes.” (He was a very devout Christian). He then offered to pray with the family for a few minutes. Afterwards, we walked back to the chief’s office.
After slumping into his chair, he looked at me and asked, “What did you think of the surgery?” Knowing almost nothing, I responded, “It seemed a very successful surgery because you and your team were all very happy, and you expressed optimism to his family.” Then I noticed that his mood had changed dramatically, and tears started to stream down from his eyes. He said, “I couldn’t save that poor young fellow.” I was speechless and quickly found an excuse to escape.
Afterwards, I called my brother, who was a resident in another hospital, and said, “I am quitting. This doctor is crazy like Dr Jekyll and Mr Hyde, smiling in front of residents and the patient’s family and then crying later in his office.”
My brother said, “Calm down! You need to understand that we are trained as doctors to isolate our emotions in front of the patients and only let the emotions out afterwards. So what you saw is absolutely normal.”
What I Learned About Empathy in Practice
Since that quite humbling experience, I have attended numerous surgeries and even administered experimental treatments on patients (under proper supervision) and interacted with innumerable physicians and nurses of different specialties. I never had any doubt about their empathy and dedication to their patients, and I always tried my best to also treat not only the patients but also our clients—the physicians, nurses, therapists, etc—with respect and empathy.
I learned from my early days that they are under great pressure to provide safe, prompt, and effective care to their patients. Medical devices are essential tools for them to deliver care, so it is natural that they feel frustrated when the tools are not working or appear not to be working.
As we all have experienced, many devices have been designed with insufficient input and testing by clinical users. This subject is known as human factors engineering or, more recently, as usability. Unfortunately, many device design engineers did not have enough experience working in healthcare environments and did not learn firsthand how clinicians think and use those tools. When new technologies are first introduced, many of their user interfaces are quite unintuitive (remember the first VCRs, computers, and cellphones?).
Back in high school, students typically segregated themselves into two groups: the socially oriented ones and the geeks. Obviously, the geeks went on to engineering and technical schools, while the former pursued medical and nursing programs. Now they meet in the healthcare environment and are forced to interact. So it should not be too surprising that they struggle to understand and deal with each other.
It’s Not Empathy—It’s Preparation
So my point is simple: It is not the lack of empathy. It is simply a lack of proper introduction and onboarding for CE/HTM professionals who need not only to better understand their customers but also to learn essential communication skills so they can convey empathy through verbal and written communication as well as nonverbal behaviors such as facial expressions, eye contact, and gestures.
With just a bit of guidance and reinforcement, I have found it is fairly easy to help CE/HTM professionals understand how to show empathy and communicate effectively with both clinicians and patients. Obviously, it also requires determination and tenacity from the CE/HTM professionals to learn the skills and conquer their own insecurities. No matter how competent you are, you can’t expect to earn Scot Mackeil’s “magic finger” on the first day.
Therefore, I not only beg to differ but also plead with the critics to show more empathy toward CE/HTM professionals who have not yet mastered proper communication skills. With a bit of effort and patience, the former can help the latter to feel comfortable and succeed in the healthcare environment.
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