Association Between Physician Empathy and Difficult Patient Encounters: a Cross-Sectional Study

Abstract

BACKGROUND: Physicians frequently experience patients as difficult. Our study explores whether more empathetic physicians experience fewer patient encounters as difficult. OBJECTIVE: To investigate the association between physician empathy and difficult patient encounters (DPEs). DESIGN: Cross-sectional study. PARTICIPANTS: Participants were 18 generalist physicians with 3-8 years of experience. The investigation was conducted from August-September 2018 and April-May 2019 at six healthcare facilities. MAIN MEASURES: Based on the Jefferson Scale of Empathy (JSE) scores, we classified physicians into low and high empathy groups. The physicians completed the Difficult Doctor-Patient Relationship Questionnaire-10 (DDPRQ-10) after each patient visit. Scores ≥ 31 on the DDPRQ-10 indicated DPEs. We implemented multilevel mixed-effects logistic regression models to examine the association between physicians' empathy and DPE, adjusting for patient-level covariates (age, sex, history of mental disorders) and with physician-level clustering. KEY RESULTS: The median JSE score was 114 (range: 96-126), and physicians with JSE scores 96-113 and 114-126 were assigned to low and high empathy groups, respectively (n = 8 and 10 each); 240 and 344 patients were examined by physicians in the low and high empathy groups, respectively. Among low empathy physicians, 23% of encounters were considered difficulty, compared to 11% among high empathy groups (OR: 0.37; 95% CI = 0.19-0.72, p = 0.004). JSE scores and DDPRQ-10 scores were negatively correlated (r = −0.22, p < 0.01). CONCLUSION: Empathetic physicians were less likely to experience encounters as difficult. Empathy appears to be an important component of physician perception of encounter difficulty.

The Validity and IRT Psychometric Analysis of Chinese Version of Difficult Doctor-Patient Relationship Questionnaire (DDPRQ-10)

“…A large body of researches have similarly shown a bidirectional relationship between burnout and di cult DPRs, with physician burnout being one of the contributing factors to poor DPRs (35), while di cult DPRs can also exacerbate physician burnout (36,37). Therefore, in clinical practice, taking measures to alleviate physician burnout is crucial for shaping good DPRs.…”

The Fundamental Attribution Error in Dermatology

“…1 Needle phobia is a common barrier for injectable medications. 2 Perceptions of the burden of injections are subjective and may be modifiable. We tested whether anchoring would reduce needle phobia and improve likeliness to take an injectable medication in AD patients.…”

“…Journal of Cutaneous Medicine and Surgery 28 (2) and holds stock in Sensal Health. Mr Patel and Ms Pixley have no conflicts to disclose.…”

“…Practicing empathy and challenging our own assumptions may also result in better awareness of patients’ stories, backgrounds, and circumstances. An empathetic approach may help to mitigate the stress and conflict that is associated with the all too common “difficult patient.” 2…”

A proposal for coping strategies on burnout among Japanese resident physicians

“…Resident physicians should also learn skills for coping with difficult patients who display strong negative feelings toward the physician. 5 To cope with difficult patient encounters, metacognition of their own feelings, analysis on factors of difficult situations, and improvement in the capacity to empathize are important. 5 …”