Expressions of empathy by a doctor can improve patient satisfaction. And there is evidence that expression of empathy can be taught. But does consultation with an empathetic doctor result in better symptom control than consultation with a doctor who is not as empathetic? A recent review of the topic found seven RCTs addressing this point. The outcomes were measured on a continuous scale so they could be combined through their standardised mean difference in a meta-analysis. All point estimates were favourable and there was a statistically significant effect across all seven included studies. The difference of 0.42 of a standard deviate for pain was described as ‘moderate’, but sounds impressive to me. The study also included trials of ‘positive communication’ designed to engender good expectations of treatment effect. Again, modest effects were noted, but I am cautious about such an approach as it may topple over into dishonesty. Empathy is a different matter and this paper provides yet more evidence on how important it is. Doctors need to display warmth, consideration and appropriate affect – they have to make an effort and do ‘emotional work’. Building a relationship with patients is the essence of practice. Making the diagnosis and performing procedures is the easy bit for experienced doctors. But there is no ceiling to excellence in patient communication.
— Richard Lilford, CLAHRC WM Director
- Kim SS, Kaplowitz S, Johnston MV. The Effects of Physician Empathy on Patient Satisfaction and Compliance. Eval Health Prof. 2004; 27(3): 237-51.
- Lilford RJ. Is it Possible to Teach Empathy? NIHR CLAHRC West Midlands News Blog. 10 November 2017.
- Howick J, Moscrop A, Mebius A, et al. Effects of empathic and positive communication in healthcare consultations: a systematic review and meta-analysis. J Roy Soc Med. 2018.