Previous studies have shown that when doctors undergo brief training programs to improve their empathy, patients benefit significantly.
The new study, conducted by Thomas Jefferson University researchers, published in Academic Medicine, consisted of 242 doctors and 20,961 diabetic patients from Italy; it was a follow up to the March 2011 trial involving 29 doctors and 891 patients with diabetes. Both trials resulted in similar findings, revealing that doctors who show empathy have patients with better outcomes, compared to physicians who had low empathy scores.
Mohammadreza Hojat, Ph.D., professor at the Department of Psychiatry and Human Behavior and director at Jefferson Longitudinal Study of Medical Education in the Center for Research in Medical Education and Health Care at Jefferson Medical College, commented:
"This new, large-scale research study has confirmed that empathic physician-patient relationships is an important factor in positive outcomes. It takes our hypothesis one step further. Compared to our initial study, it has a much larger number of patients and physicians, a different, tangible clinical outcome, hospital admission for acute metabolic complications, and a cross-cultural feature that will allow for generalization of the findings in different cultures, and different health care systems."
The 20,961 diabetic patients involved in the current study were part of a population of more than 284,000 adults from the Local Health Authority, Parma, Italy, and were patients of any of the 242 different doctors.
Experts utilized the JSE (Jefferson Scale of Empathy), a tool used to calculate empathy levels in regards to patient care and medical education.
The validated instrument depends on empathy as being a mainly mental state in which the health care professional has a proper understanding of the patients' worries, concerns, agonies, pain and overall suffering - and is committed to helping them.
The JSE, completed by the doctors, involved 20 questions answered on a seven-point Likert-type scale. (1=strongly disagree to 7=strongly agree)
During the 2011 study, the scientists applied two medical tests:
- the hemoglobin A1c test
- cholesterol level measurements
The researchers wanted to find a different significant outcome. Therefore, acute metabolic issues were utilized as the outcome measured, because they result in hospitalization, occur rapidly, and primary care physicians are the main weapon against them. These included comas and diabetic ketoacides.
In 2009, 123 diabetic patients were sent to the hospital because of these acute metabolic complications. When treating these patients, the doctors with the highest empathy scores had patients with lower rates of reoccurring acute metabolic problems.
Out of 6,434 patients, doctors with low empathy levels had 42 admitted to the hospital. On the other hand, doctors with higher empathy levels only had 29 out of 7,224 patients sent to the hospital.
The strength of this study depends on many different components. One example is that universal health care coverage in Italy makes it difficult to analyze the astonishing effects that insurance has on different patient outcomes.
"What's more, this second study was conducted in a health care system in which all residents enroll with a primary care physician resulting in better defined relationship between the patients and their primary care physicians than what exists in the United States", said Daniel Z. Louis, co-author of the study.
Vittorio Maio, PharmD, M.D., MSPH, associate professor at the Jefferson School of Population Health, added: "Italy has a lower rate of switching doctors, facilitating long-lasting physician patient relationships."
The CDC (Centers for Disease Control and Prevention) has stated that in the U.S., upwards of 25 million people suffer from diabetes, resulting in close to 700,000 hospitalizations each year.
Every year, 2 million new cases of diabetes appear - making the worldwide number of diabetes cases around 180 million.
Dr. Hojat concluded:
"Results of this study confirmed our hypothesis that a validated measure of physician empathy is significantly associated with the incidence of acute metabolic complications in diabetic patients, and provide the much-needed, additional empirical support for the beneficial effects of empathy in patient care.
These findings also support the recommendations of such professional organizations as the Association of American Medical Colleges and the American Board of Internal Medicine of the important assessing and enhancing empathic skills in undergraduate and graduate medical education."
A 2008 study revealed that doctors ignored the chance to be empathetic toward their lung cancer patients, a finding that may be a red flag for patients when dealing with their doctors.