The Association Between Physician Empathy and Variation in Imaging Use

Melnick, Edward R.; O'Brien, Elizabeth; Kovalerchik, Olga; Fleischman, William; Venkatesh, Arjun K.; Taylor, Richard A.

doi:10.1111/acem.13017

Cited by 11 publications

(10 citation statements)

References 52 publications

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“…Only one precedent study has addressed the potential relationship between emergency physician empathy and frequency of ordering of CT scans ( 23 ). Melnick et al measured physician self-assessed empathy using the Jefferson Scale of Empathy (JSE) and the frequency of ordering any CT scan.…”

Section: Discussionmentioning

confidence: 99%

Perception of Physician Empathy Varies With Educational Level and Gender of Patients Undergoing Low-Yield Computerized Tomographic Imaging

Kline

Lin

Hall

et al. 2019

Journal of Patient Experience

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Objective: Lack of empathic communication between providers and patients may contribute to low value diagnostic testing in emergency care. Accordingly, we measured the perception of physician empathy and trust in patients undergoing low-value computed tomography (CT) in the emergency department (ED). Methods: Multicenter study of ED patients undergoing CT scanning, acknowledged by ordering physicians as unlikely to show an emergent condition. Near the end of their visit, patients completed the Jefferson Scale of Patient Perception of Physician Empathy (JSPPPE), Trust in Physicians Survey (TIPS), and the Group Based Medical Mistrust Scale (GBMMS). We stratified results by patient demographics including gender, race, and education. Results: We enrolled 305 participants across 9 sites with diverse geographic, racial, and ethnic representation. The median scores (interquartile ranges) for the JSPPPE, TIPS, and GBMMS for all patients were 29 (24-33.5), 55 (47-62), and 18 (12-29). Compared with white patients, nonwhite patients had similar JSPPPE and TIPS scores but had higher (worse) GBMMS scores. Females had significantly lower JSPPPE and TIPS scores than males, and scores were lower (worse) in females with college degrees. Patients in the lowest tier of educational status had the highest (better) JSPPPE and TIPS scores. Scores were invariant with physician characteristics. Conclusion: Among patients undergoing low-value CT scanning in the ED, the degree of patient perception of physician empathy and trust varied based on the patients’ level of education and gender. Given this variation, an intervention to increase patient perception of physician empathy should contain individualized strategies to address these subgroups, rather than a one-size-fits-all approach.

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Section: Discussionmentioning

confidence: 99%

Perception of Physician Empathy Varies With Educational Level and Gender of Patients Undergoing Low-Yield Computerized Tomographic Imaging

Kline

Lin

Hall

et al. 2019

Journal of Patient Experience

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“…Those with higher levels of burnout have lower levels of empathy. Previous studies have analyzed either empathy [ 6 – 9 ] or burnout [ 11 , 12 , 14 , 15 ] among emergency professionals. The relationship between empathy and well-being has been studied, although only in medical students, [ 13 ] certain groups of professionals, such as physicians of different specialities, [ 24 ] emergency nurses, [ 6 ] or in primary care.…”

Section: Discussionmentioning

confidence: 99%

“…[ 6 ] Further, its impact on issues of litigation [ 7 ] or relation with the religiosity of professionals [ 8 ] has also been studied. Researchers at the Yale University [ 9 ] looked at whether the empathic ability of emergency room professionals could have an impact when seeking complementary imaging tests.…”

Section: Introductionmentioning

confidence: 99%

Empathy and burnout of emergency professionals of a health region

et al. 2017

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“…In this phase we will visit the clinics and ask the physicians to fill 5 short, validated research questionnaires measuring risk aversion, stress from uncertainty, fear from malpractice, empathy, and burnout [ 74 , 118 ]. We assume that these behavior characteristics are substantially stable [ 119 , 120 ] as well as the practice habits [ 121 ].…”

Section: Methodsmentioning

confidence: 99%

Determinants of Medical Practice Variation Among Primary Care Physicians: Protocol for a Three Phase Study

Shashar¹,

Codish²,

Ellen³

et al. 2020

JMIR Res Protoc

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Background One of the greatest challenges of modern health systems is the choice and use of resources needed to diagnose and treat patients. Medical practice variation (MPV) is a broad term which entails the differences between health care providers inclusive of both the overuse and underuse. In this paper, we describe a 3-phase research protocol examining MPV in primary care. Objective We aim to identify the potential targets for behavioral modification interventions to reduce the variation in practice patterns and thus improve health care, decrease costs, and prevent disparities in care. Methods The first phase will delineate the variation in primary care practice over a wide range of services and long follow-up period (2003-2017), the second will examine the 3 determinants of variation (ie, patient, physician, and clinic characteristics), and attempt to derive the unexplained variance. In the third phase, we will assess a novel component that might contribute to the previously unexplained variance - the physicians’ personal behavioral characteristics (such as risk aversion, fear of malpractice, stress from uncertainty, empathy, and burnout). Results This work was supported by the research grant from Israel National Institute for Health Policy Research (Grant No. 2014/134). Soroka University Medical Center Institutional Ethics Committee has approved the updated version of the study protocol (SOR-14-0063) in February 2019. All relevant data for phases 1 and 2, including patient, physician, and clinic, were collected from the Clalit Health Services data set in 2019 and are currently being analyzed. The evaluation of the individual physician characteristics (eg, risk aversion) by the face-to-face questionnaires was started on 2018 and remains in progress. We intend to publish the results during 2020-2021. Conclusions Based on the results of our study, we aim to propose a list of potential targets for focused behavioral intervention. Identifying new targets for such an intervention can potentially lead to a decrease in the unwarranted variation in the medical practice. We suggest that such an intervention will result in optimization of the health system, improvement of health outcomes, reduction of disparities in care and savings in cost. International Registered Report Identifier (IRRID) DERR1-10.2196/18673

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The Association Between Physician Empathy and Variation in Imaging Use

Abstract: Background: Variation in emergency physician computed tomography (CT) imaging utilization is well described, but little is known about what drives it. Physician empathy has been proposed as a potential characteristic affecting CT utilization.

Cited by 11 publications

References 52 publications

Perception of Physician Empathy Varies With Educational Level and Gender of Patients Undergoing Low-Yield Computerized Tomographic Imaging

Perception of Physician Empathy Varies With Educational Level and Gender of Patients Undergoing Low-Yield Computerized Tomographic Imaging

Empathy and burnout of emergency professionals of a health region

Determinants of Medical Practice Variation Among Primary Care Physicians: Protocol for a Three Phase Study

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