Empathy, burnout, and the hidden curriculum in medical training

Abstract

While debate exists on the relationship between the constructs of “empathy” and “burnout,” what is rarely disputed in medical education is the interrelatedness of “burnout,” “empathy,” and “professionalism” as mediated by the hidden curriculum. By associating empathy with burnout, natural science studies argue that a lack of empathy is related to unprofessional behaviors. Culturally, health professionals negotiate what it means to be a “good” physician by navigating formal and informal expectations and balancing competing priorities and interests in the workplace. More often than not, the hidden curricula of medicine valorize a culture that values efficiency over wellness, thus reinforcing perceptions that there is no time for self-empathy, let alone demonstrating empathy in patient care. To date, the erosion of empathy has been addressed through interventions targeting individuals and often designed to regulate “bad” or “harmful” behaviors and practices, rather than reforming health systems issues. In this chapter, we will explore the relationship between the hidden curriculum, professionalism, empathy, and the practices that lead to attitudes on health and wellness that are not conducive to empathy or compassionate care for both patients and trainees themselves.