Patients wonder, 'Could this be something serious?'

Dec 04, 2007

Nearly 4,800 patient surveys and 100 covertly recorded visits by actors posing as patients revealed that empathy is lacking in many exam rooms around the Rochester, N.Y., area – however, doctors who do convey empathy are viewed as more trustworthy.

The study, led by Ronald Epstein, M.D., professor of Family Medicine at the University of Rochester Medical Center, is published in the December Journal of General Internal Medicine. www.springerlink.com/content/f… 328bfeaaf3e5b7&pi=14

Epstein and colleagues observed how doctors responded when patients asked loaded questions indicating worry about symptoms involving chest pain. The study builds on previous work by Epstein’s group, in which they have described how good communication between doctors and patients, and a willingness to explore concerns, results in improved health care and lower costs.

An analysis of the doctor-patient interactions showed that doctors voiced empathy in only 15 percent of the office visits, even after repeated prompting by the patients.

“I think this study supports the notion that ‘mindfulness’ is an essential clinical skill,” said Epstein, who also directs Rochester’s Center to Improve Communications in Health Care. “Mindfulness helps the doctor understand the patient’s world to a sufficient degree, so that no matter what the doctor’s personal style is, he or she can express empathy.”

The research began with 100 consenting doctors (47 family physicians and 53 general internists) in the greater Rochester area in 2001-2002. The doctors agreed to receive two unannounced visits over a one-year period by actors trained to portray patients in a realistic and uniform way. The actors would record the visits without the doctors’ knowledge. Meanwhile, the research team also collected 10-minute surveys from real adult patients in a variety of doctors’ waiting rooms. About 96 percent of the all patients approached agreed to take the survey, yielding 4,746 completed questionnaires.

The actors portrayed two roles. They all claimed to be new patients, 48 years old, with chest pain. Some described their pain as characteristic of gastroesophageal reflux disease (GERD), while others presented more ambiguous chest pain, poorly characterized. They all took part in standard, 15-to-20-minute acute visits.

Researchers trained the actors to deliver prompts that might elicit empathy, such as “Do you think this could be something serious?” Or to say something like, “You hear a lot about cancer and heart disease, and I was worried about that.”

They used the patient surveys from the waiting rooms and transcripts of the audio-recorded exams to evaluate the doctors’ responses. Researchers characterized the responses by type, frequency, pattern, and communication style, and correlated them with patient satisfaction ratings. They also looked for signs that doctors doled out empty reassurances, were dismissive, or made statements that served as conversation-stoppers.

The most common physician response was a simple acknowledgement of the symptoms, followed by biomedical questions or medical explanations. Later, some physicians reassured the patients and suggested diagnostic tests, medications, or other treatments. Surprisingly, reassurance from the doctor sometimes increased patient anxiety, the study said.

Patients reported the most satisfaction when doctors empathized with them in challenging situations, such as when the medical answer was not clear-cut, the study said.

Few studies have noted that empathy makes a difference in health care, Epstein said. The research also spotlighted nuances about communication and behavior, such as whether the timing of empathetic statements is important, and how long it takes to voice empathy in the context of a typical office visit.

Source: University of Rochester Medical Center

Explore further: New research demonstrates benefits of national and international device registries

add to favorites email to friend print save as pdf

Related Stories

Machines beat us at our own game: What can we do?

Feb 17, 2011

(AP) -- Machines first out-calculated us in simple math. Then they replaced us on the assembly lines, explored places we couldn't get to, even beat our champions at chess. Now a computer called Watson has ...

Hormone spray improves male sensitivity

Apr 29, 2010

Many women have no doubt been waiting a long time for this: the neuropeptide oytocin enhances male empathy. This substance also increases sensitivity to so-called "social multipliers", such as approving or disapproving looks. ...

South Africa to treat all HIV-positive babies

Dec 01, 2009

(AP) -- South Africa announced ambitious new plans Tuesday for earlier and expanded treatment for HIV-positive babies and pregnant women, a change that could save hundreds of thousands of lives in the nation ...

Recommended for you

New approach to particle therapy dosimetry

3 hours ago

Researchers at the National Physical Laboratory (NPL), in collaboration with EMRP partners, are working towards a universal approach to particle beam therapy dosimetry.

Supplement maker admits lying about ingredients

Dec 17, 2014

Federal prosecutors say the owner and president of a dietary supplement company has admitted his role in the sale of diluted and adulterated dietary ingredients and supplements sold by his company.

User comments : 0

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.