Karen Muchowski, MD, FAAFP
As Family Physicians, we have a daily battle to keep up with massive amounts of information on all of the illnesses that affect our patients. And now there is COVID.... So I thought it would be good to remind ourselves that just being present is therapeutic for our patients. Following are two abstracts and two podcast links that show the power of empathy. Empathic patient-physician relationships increase the likelihood that patients will adhere to treatments and have better health outcomes. These relationships also lead to fewer medical errors and malpractice claims.
Research shows that we are linked to each other’s experiences and pain. Empathy literally binds us together and sets us up to help each other. We need empathy and compassion, especially during a pandemic, if we are going to survive as a community.
A Dream Think Do Podcast by Mitch Matthews focusing on a “secret weapon to thriving.”
Dr. David Notter is a retired Wenatchee oncologist and discusses the power of empathy and his thoughts about learning more from his patients about healing than he taught them.
This study helps us understand the importance of human interaction in a therapeutic encounter.
To evaluate the effects of patient-practitioner interaction on the severity and duration of the common cold.
We conducted a randomized controlled trial of 719 patients with new cold onset. Participants were randomized to three groups: no patient-practitioner interaction, “standard” interaction or an “enhanced” interaction. Cold severity was assessed twice daily. Patients randomized to practitioner visits used the Consultation and Relational Empathy (CARE) measure to rate clinician empathy. Interleukin 8 (IL-8) and neutrophil counts were obtained from nasal wash at baseline and 48 hours later.
Patients’ perceptions of the clinical encounter were associated with reduced cold severity and duration. Encounters rated perfect on the CARE score had reduced severity (Perfect: 223, sub-perfect: 271, p=0.04) and duration (Perfect: 5.89 days, sub-perfect: 7.00 days, p=0.003). CARE scores were also associated with a more significant change in IL-8 (Perfect: mean IL-8 change 1586, sub-perfect: 72, p=0.02) and neutrophil count (Perfect: 49, sub-perfect: 12, p=0.09).
When patients perceive clinicians as empathetic, rating them perfect on the CARE tool, the severity, duration and objective measures (IL-8 and neutrophils) of the common cold significantly change.
This study helps us understand the importance of the perception of empathy in a therapeutic encounter.
Patients of physicians with high empathy scores, compared with patients of physicians with moderate and low empathy scores, had a significantly lower rate of acute metabolic complications.
To test the hypothesis that scores of a validated measure of physician empathy are associated with clinical outcomes for patients with diabetes mellitus.
This retrospective correlational study included 20,961 patients with type 1 or type 2 diabetes mellitus from a population of 284,298 adult patients in the Local Health Authority, Parma, Italy, enrolled with one of 242 primary care physicians for the entire year of 2009. Participating physicians’ Jefferson Scale of Empathy scores were compared with occurrence of acute complications (hyperosmolar state, diabetic ketoacidosis, coma) in diabetes patients hospitalized in 2009.
Patients of physicians with high empathy scores, compared with patients of physicians with moderate and low empathy scores, had a significantly lower rate of acute metabolic complications (4.0, 7.1, and 6.5 per 1,000 patients, respectively, P < .05). Logistic regression analysis showed physicians’ empathy scores were associated with acute metabolic complications: odds ratio (OR) = 0.59 (95% confidence interval [CI], 0.37–0.95, contrasting physicians with high and low empathy scores). Patients’ age (≥69 years) also contributed to the prediction of acute metabolic complications: OR = 1.7 (95% CI, 1.2–1.4). Physicians’ gender and age, patients’ gender, type of practice (solo, association), geographical location practice (mountain, hills, plain), and length of time the patient had been enrolled with the physician were not associated with acute metabolic complications.
These results suggest that physician empathy is significantly associated with clinical outcome for patients with diabetes mellitus and should be considered an important component of clinical competence
We know there can be a decline in empathy during medical education that persists beyond training — this is often referred to as “burnout” or “compassion fatigue.” Caring for people who are suffering emotionally and/or in physical pain can be overwhelming for the caregiver who may become distant or hardened in response.
AAFP’s collection of Resources for battling Physician Burnout & achieving a Work-Life Balance are impressive and I highly suggest you take time to check them out here.