Physician empathy associated with outcomes for diabetes patients

Diabetes patients who have highly empathic primary care doctors have better clinical outcomes than those whose doctors are less empathic, a new study found.

Researchers retrospectively examined 2009 data from 20,961 type 1 or type 2 diabetes patients in Parma, Italy. These patients were enrolled with one of 242 primary care physicians, all of whom completed a Jefferson Scale of Empathy test. The physicians' scores were compared with their patients' occurrence of acute metabolic complications, including hyperosmolar state, diabetic ketoacidosis and coma, as identified by ICD-9-CM codes. Results were published in the September 2012 Academic Medicine.

Patients of physicians with high empathy scores had a significantly lower rate of acute metabolic complications (4.0 per 1,000 patients) than patients of doctors with low empathy scores (6.5 per 1,000 patients; P<0.05) and moderate empathy scores (7.1 per 1,000 patients; P<0.01). There was no significant difference in complication rate between patients of doctors with low and moderate empathy scores. Doctors with low empathy scores were associated with acute metabolic complications in logistic regression analysis compared to high-scoring physicians (odds ratio [OR], 0.59; 95% CI, 0.37 to 0.95). Older patients (at least 69 years old) were also more likely to have acute metabolic complications (OR, 1.7; 95% CI, 1.2 to 2.4). Factors that weren't associated with acute metabolic complications included physicians' gender and age, patients' gender, physicians' type of practice (solo or group), physicians' geographical location of practice, and the length of time a patient had been enrolled with a physician.

Patients whose physicians are more empathic may trust their doctors more, and thus may be more likely to communicate and comply with treatment plans, which could affect outcomes, the researchers noted. The study was limited by its correlational design, which prohibits making cause-effect assumptions, they wrote. Also, there were many potentially confounding variables for which the researchers were unable to control, they added. Still, the findings suggest empathy is an important part of patient care and physician competence that should receive more attention in medical education, they concluded.