Empathy across different medical specialties

In this study psychiatrists have the highest mean empathy score on The Jefferson Scale of Physician Empathy. They were folowed by Internists, general pediatrics, emergency medicine and family medicine. The differences in empathy scores among psychiatrists and physicians in internal medicine, pediatrics, and emergency medicine were not statistically significant, but physicians in all other specialties scored significantly lower than psychiatrists. In the middle were physicians in general surgery, obstetrics and gynecology. Anesthetists scored the lowest followed by orthopedic surgery, neurosurgery, radiology and cardiovascular surgery.

These differences might reflect the notion that different individuals have different empathy scores and are attracted to different specialties. These differences might also be explained by differences in training for each specialty.

How was this study done?

the Jefferson Scale of Physician Empathy (with 20 Likert-type items) was mailed to 1,007 physicians affiliated with the Jefferson Health System in the greater Philadelphia region; 704 (70%) responded. Construct validity, reliability of the empathy scale,
and the differences on mean empathy scores by physicians’ gender and specialty were examined.

In this study empathy was defined as a cognitive attribute that involves an ability to understand the patient’s feelings and perspective and the capability to communicate this understanding. Empathy is more complex than that.

What is empathy (the long version)?
The most clarifying definition of empathy is based on viewing it as a process. This process of empathy consists of the following stages.

  • The patient expresses feelings by way of verbal and non-verbal communication. Patients are not always aware of these expressions.
  • The doctor also notices these emotions in himself more or less voluntary, more or less conscious. He or she coming aware of these feelings usually comes after the fact (affective empathy).
  • Realizing these feelings as being from the patient is the cognitive empathy. Together with everything the doctor knows about the patient as a patient and as a person, he or she is coming to know the inner feelings of the patient(cognitive empathy).
  • The doctor can now express these feelings for the patient or act on them for the patient(expressed empathy).
  • The patient receives this empathy (received empathy).

It’s important during medical education, and for the Patient Doctor Relationship. Especially this last one is under pressure since the changes in the economics of medical practice. The most important question about empathy is: can we teach empathy or is it a trait? What do you think?

ResearchBlogging.org
Hojat M, Gonnella JS, Nasca TJ, Mangione S, Vergare M, & Magee M (2002). Physician empathy: definition, components, measurement, and relationship to gender and specialty. The American journal of psychiatry, 159 (9), 1563-9 PMID: 12202278