Patient Empathy Improves Care, Benefits Practice

What does empathy have to do with improving a patient’s health? According to a report published in the Canadian Medical Association Journal, a physician’s ability to empathize with a patient improves the quality of care he or she provides.

The good news, says James Merlino, MD, director of the Cleveland Clinic’s Office of Patient Experience in Cleveland, is that physicians tend to have a head start in that area.

“If you look at people who take on a role of helping others, especially in healthcare, we like to believe that they already have the elements of good, empathetic caring in them,” Merlino says. “Something drove them to want to help people, and that’s the foundation of what empathy is.” Even if they don't have that skill, he says, empathy can be taught.

The Ability to Be Introspective

How can a physician know whether he or she needs to improve on patient empathy? David Sigman, MD, with Chesapeake Urology Associates in Baltimore, says the practice routinely conducts evaluations where doctors and staff are assessed by their peers in several areas -- one of those areas is the compassion and empathy they show for their patients.

“If you ask patients what they most want and value, it’s the interaction with the physician who’s caring for them,” Sigman says. “It’s making sure that their physician competently cares for them, but also has that personal side to care for them. And I think the word empathy is the best word to describe that.”

Merlino suggests that physicians need to be sensitive to the patient interaction. He believes that physicians learn how to do that as they’re coming up through training, but somewhere along the way some of them lose it. Physicians sometimes lose the ability to be introspective of their interactions, as well. He says it’s critical to be able to step back and say, “How’s the interaction going? Do you think the patient understands that you’re there for them, and that you understand what they’re going through?”

“You have to pay attention to what cues the patients are giving you,” Merlino says. “Does it seem like they’re comfortable? Are they making eye contact with you? Are they opening up to your questions? Are they responding with open-ended responses as opposed to just yes or no?” he says. “There are specific cues you can follow.”

Taking a Common Sense Approach

The road to improving patient empathy starts with taking the time to know your patient, Merlino says. Do you know about their family life? Do you know something personal about them? Are you taking an interest, and demonstrating that you care about them as a person? Do you make eye contact? Do you enter the room and if there’s family and friends there, do you take a minute to excuse yourself and come back? Do you take time and introduce yourself? Do you ask the patient’s permission if it’s okay to speak about the patient’s condition in front of family members?

“Those things demonstrate to patients that you’re willing to make a connection beyond just your job of delivering care; that their identity is important to you,” Merlino says. “Those are the types of things that we talk to our physicians about.”

Sigman of Chesapeake Urology agrees. Patients want to know that their physician doesn’t just deliver care in a competent fashion, but that the physician truly cares about them. “Eye contact, body language, attentiveness, phone calls to the patient to follow up on how they’re doing, and how you treat their family members and loved ones -- all of these things go hand in hand,” he says.

Impact of Empathy on a Practice

Can improving empathy have a positive impact on a medical practice? “Absolutely,” Sigman says, noting that word-of-mouth is one of his best referral sources. “Not that I treat patients that way to get referrals -- it’s just who I am. But [being empathetic] certainly adds to my practice,” he says.

Merlino of Cleveland Clinic tells the story of a third-year medical student who, after going through a maintenance course, reported that she was rounding on the medicine service, and that there was a patient the students were seeing who was very angry and felt the team wasn’t addressing his needs. After rounds, she went back and talked to the patient, sat on the patient’s bed and touched the patient. She also told the patient that she knew what the patient was going through, and that it was very hard. Using the tools she was taught, she turned a bad situation into a positive experience for the patient.

“Our CEO has said numerous times that it’s not enough just to be a good doctor,” Merlino says. “Because you can be a good doctor, but you’re not a good physician if you don’t have the whole picture.”