We are starting a new series on Healthcare Musings: Journal Club. This series will highlight important and interesting studies in the medical literature and how they impact the practice of critical care medicine or healthcare in general. The first study we will review was published on April 11, 2024: Physician Empathy and Chronic Pain Outcomes.
It was a study of 1470 patients who were followed over time, and they wanted to see if physician empathy - measured objectively - will have an effect on outcomes in chronic low back pain. This condition, chronic low back pain, can be very difficult to treat, and it can be associated with significant adverse outcomes. If the physician in empathic, will these outcomes be better?
The short answer, according to this study, is yes.
The researchers compared the outcomes of those patients who rated their physicians as “slightly empathic” with those who rated their physicians as “very empathic.” The way empathy was measured was by the Consultation and Relational Empathy (CARE) measure, which has 10 questions, and each question has a scale of answers from “poor” to “excellent.” The minimum score is 10, and the maximum score is 50.
“Slightly empathic physicians” had a CARE Measure score of 29 or below (with most answers being “fair” or “poor”), and “very empathic physicians” had a score of 30 or greater (with most answers being “good,” “very good,” or “excellent”). And the study found that the outcomes of those patients with “very empathic physicians” did much better:
This is truly remarkable. As noted above, chronic low back pain can be very debilitating and very difficult to treat. To see that physician empathy can have such a positive impact on patient outcomes is so very encouraging.
In the discussion of the article, the authors wrote:
Although our findings suggest that greater physician empathy should be encouraged during encounters for chronic pain, there is a longstanding debate about whether it can or should be taught. One view is that physician empathy cannot be achieved in the patient-physician relationship and questions attempts to measure it. An alternative view is that it is a skill that, although partly genetic, can be purposefully grown, broadened, and fine-tuned through life experiences to improve medical care.
I am of the latter opinion: this skill can be taught. We can learn how to be better listeners; we can learn how to make our patients feel at ease; we can learn how to explain things clearly to our patients as well. And if we become proficient at being empathic, this study shows that we can have a positive outcome on our patients.
And, this intervention does not cost any money. It is not a procedure that can cause complications. It is something we all can do: today in the here and now.
Would it help improve septic shock or ARDS outcomes in the ICU? Maybe not. At the same time, it would be safe to say that having an empathic physician will help any patient - and their family - feel better when confronted with any sort of illness.
So, clinicians: let’s take this study to heart. Let us learn to be more empathic with our patients. It can go a long way to help our patients feel, and maybe even do, better over time.
Reference: Licciardone JC, Tran Y, Ngo K, Toledo D, Peddireddy N, Aryal S. Physician Empathy and Chronic Pain Outcomes. JAMA Netw Open. 2024;7(4):e246026. doi:10.1001/jamanetworkopen.2024.6026
Journal Club: Physician Empathy and Chronic Low Back Pain