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Physicians' Empathy and Clinical Outcomes for Diabetic Patients

Hojat, Mohammadreza PhD; Louis, Daniel Z. MS; Markham, Fred W. MD; Wender, Richard MD; Rabinowitz, Carol; Gonnella, Joseph S. MD

Academic Medicine:
doi: 10.1097/ACM.0b013e3182086fe1
Empathy
Abstract

Purpose: To test the hypothesis that physicians' empathy is associated with positive clinical outcomes for diabetic patients.

Method: A correlational study design was used in a university-affiliated outpatient setting. Participants were 891 diabetic patients, treated between July 2006 and June 2009, by 29 family physicians. Results of the most recent hemoglobin A1c and LDL-C tests were extracted from the patients' electronic records. The results of hemoglobin A1c tests were categorized into good control (<7.0%) and poor control (>9.0%). Similarly, the results of the LDL-C tests were grouped into good control (<100) and poor control (>130). The physicians, who completed the Jefferson Scale of Empathy in 2009, were grouped into high, moderate, and low empathy scorers. Associations between physicians' level of empathy scores and patient outcomes were examined.

Results: Patients of physicians with high empathy scores were significantly more likely to have good control of hemoglobin A1c (56%) than were patients of physicians with low empathy scores (40%, P < .001). Similarly, the proportion of patients with good LDL-C control was significantly higher for physicians with high empathy scores (59%) than physicians with low scores (44%, P < .001). Logistic regression analyses indicated that physicians' empathy had a unique contribution to the prediction of optimal clinical outcomes after controlling for physicians' and patients' gender and age, and patients' health insurance.

Conclusions: The hypothesis of a positive relationship between physicians' empathy and patients' clinical outcomes was confirmed, suggesting that physicians' empathy is an important factor associated with clinical competence and patient outcomes.

Author Information

Please see the end of this article for information about the authors.

Dr. Hojat is research professor of psychiatry and human behavior, Department of Psychiatry and Human Behavior, and director, Jefferson Longitudinal Study of Medical Education, Center for Research in Medical Education and Health Care, Jefferson Medical College, Philadelphia, Pennsylvania.

Mr. Louis is managing director, Center for Research in Medical Education and Health Care, and associate professor, Department of Family and Community Medicine, Jefferson Medical College, Philadelphia, Pennsylvania.

Dr. Markham is professor, Department of Family and Community Medicine, Jefferson Medical College, Philadelphia, Pennsylvania.

Dr. Wender is professor and chair, Department of Family and Community Medicine, Jefferson Medical College, Philadelphia, Pennsylvania.

Ms. Rabinowitz is research assistant and data manager, Center for Research in Medical Education and Health Care, Jefferson Medical College, Philadelphia, Pennsylvania.

Dr. Gonnella is dean emeritus, distinguished professor of medicine, and founder and director, Center for Research in Medical Education and Health Care, Jefferson Medical College, Philadelphia, Pennsylvania.

Correspondence should be addressed to Dr. Hojat, Jefferson Medical College, 1025 Walnut Street, Suite 119, Philadelphia, PA 19107; telephone: (215) 955-9459; fax: (215) 239-6939; e-mail: Mohammadreza.Hojat@Jefferson.edu.

First published online January 18, 2011.

© 2011 Association of American Medical Colleges