Physicians' self-assessed empathy levels do not correlate with patients' assessments

BACKGROUND: Empathy is a fundamental humanistic component of patient care which facilitates efficient and patient-centered clinical encounters. Despite being the principal recipient of physician empathy little work on how patients perceive/report receiving empathy from their physicians has been undertaken. In the context of doctor-patient interactions, knowledge about empathy has mostly originated from physicians’ perspectives and has been developed from studies using self-assessment instruments. In general, self-assessment may not correlate well with the reality observed by others. OBJECTIVES: To investigate: 1—the relationship between physicians’ self-assessed empathy and patients’ measures of physicians’ empathy; 2 –Environmental factors that could influence patients’ perceptions; and 3 –the correlation between two widely used psychometric scales to measure empathy from the perspective of patients. METHODS: This is an observational study which enrolled 945 patients and 51 physicians from radiology, clinical, and surgical specialties. The physicians completed the Jefferson Scale of Physician Empathy (JSE) and the International Reactivity Index (IRI), and patients completed the Consultation and Relational Empathy scale (CARE), and the Jefferson Scale of Patient’s Perceptions of Physician Empathy (JSPPPE). RESULTS: We did not observe any significant correlation between total self-assessed empathy and patients’ perceptions. We observed a small correlation (r = 0,3, P<0,05) between the sub-dimension Perspective Taking-JSE and JSPPPE. JSPPPE and CARE had a positive and moderate correlation (0,56; p<0,001). Physicians’ gender and sector influenced the JSPPPE score. Sector, medical specialty and the nature of the appointment (initial versus subsequent) influenced the CARE measure. CONCLUSIONS: The lack of correlation between self-assessed empathy levels and patients’ perceptions suggests patients be included in the process of empathy evaluation. PRACTICE IMPLICATIONS: Training strategies aiming the development of empathy should include patients’ evaluations and perspectives.