A recent study claimed Chatbots such as ChatGPT have better bedside manners than doctors. But GPs’ actual emotion intelligence is one of our major strengths, says columnist Dr Zoe Rog
Last week, a patient hugged me at the end of our consultation. I don’t usually encourage this, and as one of our pharmacists was sitting in with me, I felt obliged to explain.
The patient and his mum were among my first patients when I started in the practice as a GP trainee. They lived together and were devoted to one another. One day the patient phoned, sobbing and distraught that his mum had been admitted to hospital. Despite initial improvement, she had fallen, banged her head and now seemed confused. He was terrified, and I knew that he was vulnerable. I also knew that she was taking warfarin.
Moved by his distress, I felt I had to do something. Luckily, as a trainee, time was on my side. I visited the hospital with him to see his mum; I then approached the nurse looking after her to explain my worries about the warfarin, the head injury and the confusion. A few days later, my patient rang the surgery to tell me how grateful he was.
After I visited the hospital, my patient said the nurse had called a doctor back to see his mum. They had stopped her warfarin, arranged a scan and found a small subdural haematoma. She subsequently made a good recovery and was discharged home. To this day, I have no idea whether my visit made any real difference to her medical care, but my patient and his mum were delighted that I had made the trouble to go.
I stayed at my training practice and continued to see them both for quite a number of years before his mum eventually became frailer and died a peaceful, expected death. For my patient, it was an extremely difficult time; he required a lot of support to adjust to being without her. He hugs me when he sees me because he knows I cared for his mum, and that I understand how much she meant to him.
I saw the headline in recent weeks that read ‘ChatGPT gives more empathetic responses to patient queries than doctors’. I felt quite indignant when I read this, because if there is one thing that GPs should be celebrated for, it is their capacity for empathy. We discuss it at length with trainees in tutorials, they are judged on it in their exams, and a lot of the glowing feedback received by my GP colleagues is about the empathetic way in which patients have been treated.
We often make deeper emotional connections with our patients than we realise. A few years ago, a teenage girl made an appointment to see me. She had done so, she told me, because I had been to visit her family quite a few years earlier when her grandad was dying, and the family had never forgotten my kindness. She said she felt she could trust me to listen and understand how she felt. It was the first time I truly realised that even when we feel helpless, faced with a dying patient we can’t save and the terrible family grief we can’t relieve, simply conveying our empathy can be an incredibly powerful way to help that family.
When I read the article about ChatGPT in further detail, I realised that it was responding to online consultations. On reflection, it would be quite welcome to answer my e-consultations, because I hate the sterile format, lack of interaction and dearth of non-verbal information. Perhaps, in time, AI could fill its boots with form filling, results checking, routine prescription issuing and titration of medication doses. As Canadian physician Sir William Osler once said, ‘The good physician treats the disease; the great physician treats the patient who has the disease.’
We should be encouraging artificial intelligence to become really great at monotony, leaving GPs free to demonstrate how skilled they are at managing the interaction of disease with the fascinating complexity of human beings – and with enough time to show patients the empathy they deserve.
Dr Zoe Rog is a GP in Runcorn, Cheshire