Clinical empathy as perceived by patients with chronic illness in Canada: a qualitative focus group study

Abstract

Background: Although clinical empathy — the ability of a physician to understand a patient’s illness experience, communicate this understanding and act collaboratively to create a treatment plan — provides substantial benefits to both physicians and patients, medical students typically experience a decline in empathy during training. The primary objective of this study was to generate a model of clinical empathy grounded in the perspectives of people with chronic illness living in Canada, to promote empathy-focused curricular development in Canadian medical education. Methods: We conducted a qualitative focus group study using a constructivist grounded theory approach. We recruited adults (age ≥ 18 yr) with chronic illness who had recently seen a physician in Canada from virtual support groups. Six semistructured virtual focus groups with 3–5 participants each were scheduled between June and September 2021. We coded the transcripts using the constant comparative method, allowing for the construction of an overarching theory. Results: Twenty patients (17 women and 3 men) participated in the focus groups; 1 group had 2 participants because 1 participant failed to appear. The majority of participants (14 [70%]) had at least a college degree. The mean rating for overall satisfaction with the Canadian health care system was 5.4/10.0 (median 5.0). The emergent theory showed that the perceived presence of physician empathy engendered positive internal processing by patients, leading to increased health care efficacy and enhanced mental health outcomes. Negative patient processing in response to the perceived absence of empathy led to reduced quality of health care delivery (e.g., ineffective referrals and more appointments), increased use of health care resources, disruptions in patients’ personal lives, and negative physical and mental health outcomes. Interpretation: Clinical empathy can have life-altering impacts on patients, and its absence may increase resource use. As empathy involves understanding patients’ lived experiences, any valid intervention to improve clinical empathy must be informed by patient perspectives.

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“…The physician’s ability to understand the illness that the patient is going through, communicate and act collaboratively regarding the proposed treatment provides substantial benefits to both patients and physicians ( 51 ). The absence of empathy is a real problem when EVT is indicated and can cause severe impacts on outcomes.…”

Faire tomber les obstacles à l’admission des personnes ayant un handicap en faculté de médecine au Canada

“…Le handicap est un vaste concept, défini par la Loi canadienne sur l’accessibilité comme une « déficience […] dont l’interaction avec un obstacle nuit à la participation pleine et égale d’une personne dans la société » 7 ; il ne s’agit pas forcément d’un déficit. De nombreux médecins ayant un handicap se démarquent par leurs points forts uniques et leur capacité à faire preuve d’empathie envers la patientèle, ce qui peut améliorer la satisfaction de cette dernière, l’utilisation des ressources en santé, et même l’évolution de l’état de santé ( figure 1 ) 4 , 8 – 11 . La participation des médecins ayant un handicap à la prise de décisions quant à l’allocation et les politiques de ressources de la santé pourrait aussi mener à plus de justice et d’équité pour la patientèle en situation de handicap 10 , 11 .…”

“… Avantages potentiels des stagiaires et médecins ayant un handicap pour leurs collègues, le système de santé et la patientèle 4 , 8 – 11 . …”