Empathy: Key to Patient Satisfaction

People don't care how much you know until they know how much you care. ―Theodore Roosevelt

In a heart-wrenching moment, my mom, in her 30s, learned from a doctor that surgery was her only option. As she began to cry, the doctor briefly looked at her before focusing back on his paperwork. Then, he immediately proceeded to outline the surgery details, while my mom's tears continued. After we left the office, my mom said she would go to a different doctor, who cares for patients’ feelings. My mom's experience underscored empathy's crucial role in healing, demonstrating that professional knowledge alone cannot secure a patient's trust and satisfaction.

Empathy is our ability to sense and understand other people's thoughts, perspectives, and preferences. Within the health care setting, there is a growing consensus that therapeutic empathy or clinical empathy involves not only understanding and expressing that understanding but also acting on that understanding in a helpful or therapeutic manner (1). In contrast (specifically within the health care setting), compassion is often perceived as encompassing feelings of warmth or caring without understanding the other person's situation. It does not inherently necessitate a follow-up action. Empathy empowers physicians to understand the nonverbal needs of patients and their families, which may not always be possible by merely asking routine questions. Patients' perceptions of physician empathy significantly affect their evaluation of the physician–patient relationship (2). Empathy from clinicians is linked to enhanced patient satisfaction, which correlates with reduced hospital readmissions, improved patient safety, and lower postsurgery mortality rates (1). This emphasizes the critical role of empathy in achieving both patient satisfaction and tangible health benefits. A study published in Annals of Internal Medicine systematically reviewed randomized trials to evaluate the effect of health care practitioner empathy on patient satisfaction (1). This analysis pooled data from 14 randomized trials involving 80 practitioners and 1,986 patients across hospitals and primary care settings in North America, Europe, Asia, and Africa. It included a diverse group of health care professionals, such as physicians, nurses, and psychologists, highlighting the variety of health care practices and research approaches. All 14 trials demonstrated a positive impact on patient satisfaction. However, limitations in drawing conclusions emerged due to concerns about the quality and applicability of the underlying evidence. In addition, clinicians' empathy promotes better medication adherence, improving patient outcomes and higher quality of care. A study involving more than 700 cancer patients highlighted that physicians' empathy was positively associated with improvements in patient-reported outcomes, specifically regarding depression and quality of life (3). Similarly, another study that included over 20,000 diabetic patients showed that those under the care of physicians with high empathy scores experienced significantly lower rates of metabolic complications (4).

Every human being longs to be seen, heard, and understood. Empathy is the true art of medicine that gives us fulfillment as physicians to make a difference in our patients’ lives and build rewarding human connections.

References

1. Keshtkar L, Madigan CD, Ward A, et al. The effect of practitioner empathy on patient satisfaction. A systematic review of randomized trials. Ann Intern Med. 2024;177:196-209. [PMID: 38285985] doi:10.7326/M23-2168
2. Wu Q, Jin Z, Wang P. The relationship between the physician-patient relationship, physician empathy, and patient trust. J Gen Intern Med. 2022;37:1388-1393. [PMID: 34405348] doi:10.1007/s11606-021-07008-9
3. Neumann M, Wirtz M, Bollschweiler E, et al. Determinants and patient-reported long-term outcomes of physician empathy in oncology: a structural equation modelling approach. Patient Educ Couns. 2007;69:63-75. [PMID: 17851016]
4. Del Canale S, Louis DZ, Maio V, et al. The relationship between physician empathy and disease complications: an empirical study of primary care physicians and their diabetic patients in Parma, Italy. Acad Med. 2012;87:1243-9. [PMID: 22836852]

Farzana Hoque, MD

Dr. Farzana Hoque is an academic hospitalist and an associate professor of medicine at Saint Louis University School of Medicine. She serves as the codirector of the Internal Medicine Acting Internship and the inaugural medical director of Bordley Tower at SSM Health Saint Louis University Hospital. Dr. Hoque is a fellow of the Royal College of Physicians of the United Kingdom and the President of the Society of Hospital Medicine St. Louis Chapter.