Could your doctor’s attitude hurt your health?
An intriguing new study demonstrates that physician sensitivity and empathy is associated with reduced clinical complications and improved outcomes among patients.
The study was lead by a team of Thomas Jefferson University and Italian researchers who evaluated relationships between physician empathy and clinical outcomes among 20,961 diabetic patients and 242 physicians in Italy.
Italy was chosen as the site of study because of universal health coverage and the fact that patient-provider relationships are often stable with a very low percentage of patients changing doctors.
The study is found in the journal Academic Medicine, and serves as a follow-up to a smaller study published in the same journal in March 2011 from Thomas Jefferson University investigating physician empathy and its impact on patient outcomes.
That earlier study included 891 diabetic patients and 29 physicians and found that patients of physicians with high empathy scores had better clinical outcomes than patients of other physicians with lower scores.
The new study was much larger — 20,961 diabetic adult patients from Parma, Italy, enrolled with one of 242 primary care physicians.
In order to more accurately measure empathy, researchers also designed and validated a new instrument to measure physician empathy in the context of medical education and patient care. The tool relies on the definition of empathy in the context of patient care as a predominately cognitive attribute that involves an understanding of patient’s concerns, pain, and suffering, and an intention to help.
In the current study, researchers sought to measure how a physician’s empathy impacted a diabetic patient’s treatment outcomes. To do this, the researchers used the results of two medical tests: the hemoglobin A1c test and cholesterol levels measurements.
Investigators found a direct association between a higher physician empathy score and better control of patients’ hemoglobin A1c and cholesterol level.
“This new, large-scale research study has confirmed that empathic physician-patient relationships is an important factor in positive outcomes,” said researcher Mohammadreza Hojat, Ph.D.
“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 level of medical complications among hospitalized patients was also accessed.
Physicians in the higher empathy score group had a lower rate of patients with acute metabolic complications. For example, physicians with higher empathy levels had 29 (out of 7,224) patients admitted to the hospital.
Physicians with lower levels of empathy had 42 (out of 6,434) patients admitted to the hospital — a 30 percent increase.
Researchers say the Italian health care system mandates that all residents enroll with a primary care physician. “This regulation results 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, M.S.
“Italy has a lower rate of switching doctors, facilitating long-lasting physician patient relationships,” added co-author Vittorio Maio, Pharm.D., M.S., M.S.P.H.
According to the federal 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.
Researchers say the results of the study confirm that a validated measure of physician empathy is positively associated with improved clinical care among diabetic patients with acute metabolic.
Source: Thomas Jefferson University