Physician Empathy Is Not Associated with Laboratory Outcomes in Diabetes: a Cross-sectional Study

Abstract

BACKGROUND: One widely cited study suggested a link between physician empathy and laboratory outcomes in patients with diabetes, but its findings have not been replicated. While empathy has a positive impact on patient experience, its impact on other outcomes remains unclear. OBJECTIVE: To assess associations between physician empathy and glycosylated hemoglobin (HgbA1c) as well as low-density lipoprotein (LDL) levels in patients with diabetes. DESIGN: Retrospective cross-sectional study. PARTICIPANTS: Patients with diabetes who received care at a large integrated health system in the USA between January 1, 2011, and May 31, 2014, and their primary care physicians. MAIN MEASURES: The main independent measure was physician empathy, as measured by the Jefferson Scale of Empathy (JSE). The JSE is scored on a scale of 20-140, with higher scores indicating greater empathy. Dependent measures included patient HgbA1c and LDL. Mixedeffects linear regression models adjusting for patient sociodemographic characteristics, comorbidity index, and physician characteristics were used to assess the association between physician JSE scores and their patients' HgbA1c and LDL. KEY RESULTS: The sample included 4176 primary care patients who received care with one of 51 primary care physicians. Mean physician JSE score was 118.4 (standard deviation (SD) = 12). Median patient HgbA1c was 6.7% (interquartile range (IQR) = 6.2-7.5) and median LDL concentration was 83 (IQR = 66-104). In adjusted analyses, there was no association between JSE scores and HgbA1c (β = − 0.01, 95%CI = − 0.04, 0.02, p = 0.47) or LDL (β = 0.41, 95%CI = − 0.47, 1.29, p = 0.35). CONCLUSION: Physician empathy was not associated with HgbA1c or LDL. While interventions to increase physician empathy may result in more patient-centered care, they may not improve clinical outcomes in patients with diabetes.

Investigating the relation between self-assessment and patients’ assessments of physicians-in-training empathy: a multicentric, observational, cross-sectional study in three teaching hospitals in Brazil

“…To develop empathy studies relevant to inform medical education, it is crucial, at this moment, to clarify which scale—if any—offers measure which correlates with meaningful clinical or educational outcomes. For example, recently, Chaitoff et al 21 found that self-assessed empathy levels of primary care physicians were not correlated with laboratorial outcomes in patients with diabetes. This result enlightens the debate on the correlation between self-assessed empathy and clinical outcomes by showing that a relationship of cause–effect between those two variables is unlikely.…”

“…It is thus likely that the same is the case for resident or student empathy, but this remains to be confirmed empirically. Moreover, a recent study showed a lack of correlation between self-assessed empathy by primary care physicians and clinical outcomes in patients with diabetes 21. The lack of correlation between self-assessed empathy and both patients’ assessments and clinical outcomes is a powerful argument to expand the field towards including patients’ perspectives.…”

Empathy in Medicine National Norms for the Jefferson Scale of Empathy: A Nationwide Project in Osteopathic Medical Education and Empathy (POMEE)

“…14,15 More importantly, statistically significant associations have been reported between physicians' scores on the JSE and tangible clinical outcomes in diabetic patients in the United States 16 and Italy. 17 Although researchers at the Cleveland Clinic failed to reproduce significant associations between physician empathy and patient outcomes, 18 this inability to reproduce the findings was attributed to issues related to the internal and external validity of the findings. 19 Another study 20 22 In a study at the Cleveland Clinic, 23 statistically significant associations were observed between physicians' JSE scores and standardized measures of patients' communication experiences with their physicians.…”

Encouraging perspective taking: Using narrative writing to induce empathy for others engaging in negative health behaviors

“…Research has shown that a practitioner’s ability to empathize is a trait preferred by some patients [12] and that the ability to take the perspective of patients is associated with greater patient satisfaction [13]. Further, physicians who score highly on a measure of empathy have patients with more positive clinical outcomes for diabetes [14]—however, there also exist discordant data [15]—and patient ratings of provider empathy are associated with better health outcomes, including a shorter and less severe experience with the common cold [16, 17].…”