Jefferson study shows physician's empathy directly associated with positive clin

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Jefferson study shows physician's empathy directly associated with positive

clinical outcomes

http://www.eurekalert.org/pub_releases/2011-03/tju-jss030711.php

Clinical outcomes of diabetic patients studied in landmark research

PHILADELPHIA – It has been thought that the quality of the physician-patient

relationship is integral to positive outcomes but until now, data to confirm

such beliefs has been hard to find. Through a landmark study, a research team

from Jefferson Medical College (JMC) of Jefferson University has been

able to quantify a relationship between physicians' empathy and their patients'

positive clinical outcomes, suggesting that a physician's empathy is an

important factor associated with clinical competence. The study is available in

the March 2011 issue of Academic Medicine.

" The purpose of this study was to provide an evidence-based scientific

foundation for the study of empathy as a clinically important factor in patient

outcomes, " said Mohammadreza Hojat, Ph.D., research professor, Department of

Psychiatry and Human Behavior; and director, Jefferson Longitudinal Study of

Medical Education in the Center for Research in Medical Education and Health

Care at JMC. " Our results show that physicians with high empathy scores had

better clinical outcomes than other physicians with lower scores. "

Participants in this study were 891 diabetic patients, treated between July 2006

and June 2009, by 29 physicians in the Department of Family and Community

Medicine at Jefferson University Hospital. Researchers used the Jefferson

Scale of Empathy (JSE) – developed in 2001 as an instrument to measure empathy

in the context of medical education and patient care. This validated instrument

relies on the definition of empathy in the context of patient care as a

predominately cognitive attribute that involves an understanding and an

intention to help. The scale includes 20 items answered on a seven-point

Likert-type scale (strongly agree = 7, strongly disagree = 1).

The 29 physicians completed the JSE. Each physician was identified by a numeric

code printed on the JSE scanning form and was told that the code would be used

to correlate their JSE scores with their diabetic patients' test results.

To measure how a physician's empathy impacted a diabetic patient's treatment,

the researchers used hemoglobin A1c test results to measure the adequacy of

blood glucose control according to national standards. They also analyzed the

patients' LDL cholesterol level. They believed that there would be a direct

association between a higher physician JSE score and a better control of

patients' hemoglobin A1c and LDL cholesterol levels. A1c tests were marked as

following: good control (<7.0 percent), poor control (>9.0 percent) and moderate

control ( & #8805; 7.0 percent and & #8804; 9.0 percent). LDL cholesterol levels

were marked as following: good control (< 100 mg/dL), poor control (>130 mg/dL)

and moderate control ( & #8805;100 and & #8804; 130 mg/dL).

The likelihood of good control was significantly greater in patients of

physicians with high empathy scores than in the patients of physicians with low

scores. Conversely, the likelihood of poor control was significantly lower in

the patients of physicians with high empathy scores than it was in patients of

physicians with low scores. The same can be said for the LDL cholesterol portion

of the analysis. This data points to the conclusion that empathic engagement in

patient care can contribute to patient satisfaction, trust, and compliance which

lead to more desirable clinical outcomes.

" These findings, if confirmed by larger scale research, suggest that empathy

should be viewed as an integral component of a physician's competence, " said Dr.

Hojat. " This study supports 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

empathetic skills in undergraduate and graduate medical education. "

" For those of us in primary care medicine who have devoted much of our working

lives to developing empathic relationships with our patients, research findings

of improved patient outcomes among the more empathic physicians is very

gratifying indeed. We have long believed in the importance of empathy and

finding measurably better outcomes lends support to our attempts to nurture

empathetic medical students and residents who will pursue careers in every kind

of medical and surgical specialty, " said Fred Makham, M.D., professor,

Department of Family and Community Medicine, who is also one of the study's

co-authors.

Wender, M.D., Alumni Professor and Chair, Department of Family and

Community Medicine, one of the coauthors of the study indicated that: " Although

physicians intuitively value empathy, the clinical importance of empathy has not

been known. We're now on our way to showing the power of physician empathy to

impact the health of our patients. "

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The study's other co-authors, all from the Center for Research in Medical

Education and Health Care, are: Z. Louis, M.S., Managing Director; Carol

Rabinowitz, Research and Program Analyst; and ph S. Gonnella, M.D., Founder

and Director.