Abstract
Neurologists regularly care for patients with complex, chronic, and often incurable conditions. These circumstances impose profound emotional burdens on the patient and physician. Whereas empathy is central to therapeutic effectiveness in clinical practice, sustained empathic engagement can contribute to emotional exhaustion and physician burnout, a condition now endemic in neurology. This review synthesizes insights from neuroscience, psychology, and clinical education to propose "skillful empathy" as a trainable capacity that integrates affective resonance with cognitive perspective-taking. We describe how emotional contagion harms clinician well-being and advocate for the integration of empathy training into medical education to support sustainable, compassionate neurological care. ANN NEUROL 2026;99:35-48.