Understanding Patient Values Requires Communication, Not Empathy

I am writing in response to the commentary "Empathy Revisited."¹ Gianakos¹ offers a convincing argument for the importance of empathy in the physician-patient relationship. I agree with the author that physicians "do not necessarily have the total answer to the patient perceived problem unless they understand the patient values and beliefs...."¹ Empathy, however, is not synonymous with understanding patient values and beliefs. I would argue that the physician does not need empathy to truly help a patient. Physicians can understand patient values and beliefs without imagining that they are the patient. In fact, it may be arrogant to believe that we, as physicians, can truly empathize with a patient without having been in the patient's situation. Empathy does not guarantee that a physician is able to "determine whether the patients' opinions about what is best for them seems reasonable."¹ If the physician were truly empathetic, he