The ability to quantify empathy

The public gets much of its health-related news from lay-oriented synopses of scientific papers published in refereed medical journals or presentations at major medical conventions. Longer, more detailed commentary is published in the print media, but the majority are short pieces posted on many websites or blogs. I try to familiarize myself with information pertaining to cardiovascular disease as well as predisposing conditions such as diabetes and hyperlipidemia with the presumptuous intent of interpreting the good, bad and the ugly.

Moreover, I have openly acknowledged my inherent bias as a cardiac surgeon towards statistically proven hypotheses as opposed to speculative, soft data. Thus my reaction to the headline that a new study indicated a doctor’s empathy was important for the care of diabetic patients and that empathy should be considered an important skill for successful medical practice was predictable.

Researchers are wasting their time and grant money studying the obvious, editors are reviewing and publishing a given and readers are asking why these supposedly professionals are insulting our intelligence.

In this circumstance rather than shaking my head and making a cynical aside, I acted true to the academic’s code and sought out the original source. And I am glad I did. Dr. Mohammodieza Hojat and a multidisciplinary team at Jefferson Medical College in Philadelphia have previously published 5 articles validating an objective and reproducible measure of empathy exhibited by physicians in the context of medical education and patient care. They hypothesized that a physician’s empathy would positively effect clinical outcome, not just patient satisfaction.

To test their theory, they chose patients with diabetes, a chronic disease that requires frequent engagement between patient and doctor, much patient education and communication as well as strict compliance to designated treatment protocols. Moreover, there are definable and easily measurable indicators of improved clinical outcomes. Appropriate statistical controls were used to separate the effect of empathy from other know determinants of outcome such as gender, age and socioeconomic status.

They followed 891 diabetic patients for 3 years and conclusively showed that physicians’ empathy itself resulted in a 40-50% improvement in the measured results. Finally, in their concluding remarks, the researchers acknowledged any limitations to their methodology, but stated that their results do provide sufficient evidence warranting replication of this line of investigation at other institutions and with a variety of diseases.

I became a convert. There is an evidence-based scientific foundation for studying empathy as an important factor in patients’ health. In the context of cardiac surgery, all the risk modification that is just as important postoperatively in determining long term outcome as the operation itself could be improved by fostering the patient-physician interaction. No new therapeutic breakthrough need be implemented. Moreover, the ability to quantify empathy gives medical educators and professional organizations a tool to assess and enhance empathic skills at the graduate and postgraduate levels. This is new and valuable information and I salute the investigators and thank them for enlightening me.

Norman Silverman is a cardiothoracic surgeon and founder of Heart Surgery Guide.

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