Everyone wants a physician who cares, listens and understands their needs and concerns. However, does this really make a difference in patient care and outcomes? Does it really matter if your physician is empathic? In an interesting study in the September, 2012 issue of the journal Academic Medicine (Academic Medicine 2012; 87:1243), researchers from Jefferson Medical College worked with physicians in Italy to answer this question.
Two hundred and forty two primary care physicians in the health authority region of Parma, Italy were recruited and agreed to complete the Jefferson Scale of Empathy (JSE), a validated questionnaire developed in 2001 as a tool to measure physician empathy in the context of patient care. Empathy was defined as the understanding of patient experiences, concerns and perspectives, combined with a capacity to communicate this understanding with an intention to help. The JSE includes 20 items meant to identify such qualities as perspective taking, compassionate care, and “walking in the patient’s shoes”.
The researchers then correlated the results of the JSE with the outcome of care in diabetic patients under the care of these physicians. Specifically, they looked at acute complications of diabetes, including coma, ketoacidosis, and extremely elevated blood sugars. The rate of complications in the high, medium and low empathy score categories were 4.0, 7.1 and 6.5 per 1,000 patients, consistent with a beneficial clinical effect.
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This study is consistent with other research studies. In one recent study, physician understanding of their diabetic patients view of the condition was associated with better self care and self management of the diabetes. Another study showed a relationship between physician empathy and patient outcomes such as hemoglobin A1C and LDL (bad cholesterol).
These reports should not come as a surprise. Physicians who are caring and communicative are more likely to be effective in educating their patients and in motivating them to care for themselves. So what does this mean for you? It is unrealistic to think you will change the communication skills of your physicians, but it is important to realize that both physicians and patients have different styles and communication strategies. A doctor with whom you feel comfortable, and who facilitates your understanding of your health issues and motivates you to do better, may be viewed by another patient as distant and uncaring. You, as an individual, need to identify a primary care physician who is right for you, who makes you feel comfortable in asking questions, and motivates you to take responsibility for your personal health.
