Does Your Doctor ‘Get You’?

Does your doctor understand you? Does he (or she) know what you’re thinking? Does he really feel your pain? In short, does he care?

Seems this is something you should really care about. According to a study just published in Academic Medicine, patients of doctors who are more empathic have better outcomes and fewer complications.

Researchers from Thomas Jefferson University together with a team from Parma, Italy evaluated relationships between physician empathy and clinical outcomes among 20,961 Italian diabetic patients and their 242 physicians.

The study was a follow up to a smaller one undertaken at Thomas Jefferson University that included 891 diabetic patients and 29 physicians, and showed that patients of physicians with high empathy scores had better clinical outcomes than patients of other physicians with lower scores.

“This new, large-scale research study has confirmed that empathic physician-patient relationships is an important factor in positive outcomes,” said Mohammadreza Hojat, Ph.D., Research Professor in the Department of Psychiatry and Human Behavior and the Director of Jefferson Longitudinal Study at the Center.  “It takes our hypothesis one step further. Compared to our initial study, it has a much larger number of patients and physicians, a different, tangible clinical outcome, hospital admission for acute metabolic complications, and a cross-cultural feature that will allow for generalization of the findings in different cultures, and different health care systems.”

The Italian researchers used the Jefferson Scale of Empathy (JSE) –an instrument used to measure empathy in the context of medical education and patient care. The JSE includes 20 items answered on a seven-point scale (strongly agree = 7, strongly disagree = 1) and measures understanding of patient’s concerns, pain, and suffering, and an intention to help.

The primary outcome measure of the study was acute metabolic complications, including hyperosmolar state, diabetic ketoacidosis, and diabetic coma. These were used because they require hospitalization, can develop quickly, and their prevention is more likely to be influenced by the primary care physicians.

A total of 123 patients were hospitalized because of such complications. Physicians with higher empathy levels had 29 : 7,224 patients admitted to the hospital, whereas physicians with lower levels had 42 : 6,434 patients admitted.

There are many factors that add to the strength of the study. Firstly, because of universal health care coverage in Italy, there is no confounding effect of difference in insurance, lack of insurance or financial barriers to access care.

“What’s more, this study was conducted in a health care system in which all residents enroll with a primary care physician resulting in a better defined relationship between the patients and their primary care physicians than what exists in the United States,” said co-author Daniel Z. Louis.

According to the Centers for Disease Control and Prevention, over 25 million people in the U.S. population have been diagnosed with diabetes, with almost 700,000 hospitalizations per year. There are approximately 2 million new cases per year. Worldwide, the number of total cases jumps to 180 million.

“Results of this study confirmed our hypothesis that a validated measure of physician empathy is significantly associated with the incidence of acute metabolic complications in diabetic patients, and provide the much-needed, additional empirical support for the beneficial effects of empathy in patient care” said Dr. Hojat. “These findings also support the recommendations of such professional organizations as the Association of American Medical Colleges and the American Board of Internal Medicine of the importance of assessing and enhancing empathic skills in undergraduate and graduate medical education.”

Does your doctor get you? Let us know.