"There was something before western medicine came, I wish we studied it's history in medical school." - Dr. kirubel Tesfaye

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Incidental peritoneal loose body in a polytrauma patient: The unnoticed scenario
[Ethiopian case report]

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"Measuring Empathy!"
[Can we build a better Doctor? Part V]

We see an array of factors that ambush the empathy that students enter medical school with- the hidden curriculum, derogatory humor (which I skipped at this time), mixed messages from residents, fatigue, and the sheer overwhelming nature of it all. The question then arises: does this have to be a given? does the system designed to train doctors have to be an empathy-depleting experience?

Well many of you here in Ethiopia and others globally have been asking whether it is possible to prevent this documented decline in empathy during medical school. All sorts of suggestions have been offered: medical humanities, flexible scheduling, reflective writing, role-playing, additional break-time (vacation), faculty mentoring, nutritious food for med students :), peer-support groups, earlier clinical exposure. Many of these things are hard to test in the typical rigorous scientific manner that is expected of any medical intervention. Mostly, these proposed solutions come from observational studies, personal philosophies, inspiration, and perhaps wishful thinking.

To actually study empathy- its decline and perhaps the prevention thereof- one first needs to be able to measure empathy in an objective manner. This may seem counter intuitive, empathy being the sort of thing most people know when they see, but a true scientific study an be done only with numbers, not feelings. And so, a numerical measure of empathy was created sometime ago.

A deceptively simple -Jefferson Scale of Empathy (JSE), a single page containing 20 statements, each to be rated from 1 to 6 was introduced. The definition of empathy used is specifically distinct from sympathy. The developers defined sympathy as emotion, actually feeling the patient’s feeling. Empathy is cognition, a thought process that allows you to understand the patient’s feelings while not necessarily feeling them yourself. In fact, maintaining your own sense of self is key part of empathy. So the definition might be reworded as the ability to stand in another’s shoes without actually leaving your own shoes (magic show!) Of course the empathic doctor needs to clearly communicate that understanding.

Now to all those following this topic with interest and are in a Med school as faculty, resident or intern or you are an outside researcher and have interest in this question, have experience with research - Do you want to collaborate in determining the Empathy Scale of the med students in your school or any medical school? If yes, let me know to be part of a multi-school assessment. Will return to discuss how to prevent the empathy decline after data is collected in few medical schools.

Thank you!

Dr. Tigistu Adamu, CMO, Public Health Physician

@HakimEthio

ሆስፒታላችን ከሰሞኑ የአገልግሎት ክፍያውን በጣም ጨምሯል። ዋጋ የመጨመር ትዕዛዙ ከፌዴራል ነው የመጣም ተብሏል።

ነገር ግን የጨመረበት መጠን በጣም ያስገርማል። ካርድ ማውጫ 5 ብር ነበር ፣ አሁን 60 ብር ነው። ተኝቶ ለመታከም የአልጋ ክፍያ በቀን ከ10 ብር ወደ 180 ብር አድጓል። የLaboratory እና ሌሎች ወጪዎችም በተመሳሳይ ጨምረዋል።

በጣም የሚገርመው በነፃ ተኝተው ይታከሙ የነበሩ የምግብ እጥረት ያለባቸው ታካሚዎች (SAM Patients) አሁን ከሌላው እኩል ለአልጋ 180 ብር እየከፈሉ ነው። ልጁ በድህነቱ ምክንያት ምግብ አጥቶ የቀጨጨበትም ወላጅ ፣ በቀን 180 ብር ከፍሎ ሲታከም አስቡት።

ለምን በዚህ መጠን ዋጋ እንደጨመረ ለማወቅ ባደርኩት ጥረት ፣ ሆስፒታሎች ከዚህ በፊት ከመጠን ባነሰ ዋጋ አገልግሎት ሲሰጡ ስለነበር ለከፍተኛ ኪሳራ እንደተዳረጉ እና አሁን የወጣው ዋጋ ግን ተገቢው ክፍያ እንደሆነ ነው። በተጨማሪም በገጠር የሚኖረው ማህበረሰብ የጤና መድህን (Health Insurance) አገልግሎት ተጠቃሚ እንዲሆን ለማበረታታት ነው።

የጤና መድህን ማለት አንድ ቤተሰብ በአመት የተወሰነ ብር (እስካሁን 400 ብር ነበር) በመክፈል ፣ የቤተሰቡ አባል ሲታመም በነፃ አገልግሎት የሚያገኝበት መንገድ ነው።

አሁን አብዛኛው ታካሚ በዋጋ ጭማሪው ምክንያት እየተቸገረ ፣ ህክምና አቋርጠው ለመውጣት እየተገደደ ፣ አስፈላጊ መድሃኒቶችን እና ምርመራዎችን ለመግዛት እየተቸገረ ሲሆን ፣ የጤና መድህን ተጠቃሚ የሆኑ ታካሚዎች ግን ያለ ምንም ችግር እየታከሙ ይገኛል።

ስለዚህ አሁን ያለው መፍትሄ በገጠሩ የሚኖረው ማህበረሰብ በሙሉ የጤና መድህን አገልግሎት ተጠቃሚ እንዲሆን ማበረታታት ነው።

የዚህ ፅሁፍ አላማም አንባቢዎች በገጠሩ ክፍል የሚገኙ ዘመዶቻቸውን ስለ ችግሩ እና መፍትሄው በማስረዳት ከወዲሁ የአገልግሎቱ ተጠቃሚ እንዲሆኑ የበኩላቸውን ጥረት እንዲያደርጉ ነው።

ሌላው ጥያቄ የሆነብኝ ነገር ግን ፣ ሆስፒታሎች ይህን የዋጋ ጭማሪ ሲያደርጉ የሚሰጠው አገልግሎት ጥራትና ፍጥነቱ ከድሮው በተለዬ ይጨምራል ወይ የሚለው ነው። ይህን በሂደት የምናየው ይሆናል።

የታካሚዎቻችን መቸገር እና መንገላታት ግን ለህክምናውም ለሃኪሙም ከባድ ራስ ምታት ነው። ተገቢው ትኩረት እና መፍትሄ ያስፈልገዋል።

ዶ/ር ሱራፌል አየለ ፤ ከጎንደር ዩኒቨርስቲ ሆስፒታል

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Message from a follower

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Ethiopian National Blood Bank Service 👏

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ሐኪም ፣ ገጣሚ ፣ ሼፍ - ዶ/ር ፌበን
📽 Zema Post

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Internship duties
Good Night 😴

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