Person-centered medical care consists of the empowerment of patients to play active roles in their pursuit of wellness (Castro et al., 2016). Treating patients as people rather than an illness or billable code is central to humanistic, dignified medical care (Chochinov, 2023). It also involves collaboration between patients and their medical team throughout treatment (Akinci & Patel, 2014). Although physicians are experts within their respective medical subfields, patients are best equipped to offer their subjective experiences with health and illness. Treatment of various medical diagnoses including cancer, infection, and heart disease is inherently complex – physicians are required to maintain competence in treating patients’ concerns (e.g., Siminoff & Step, 2005). However, along the road to wellness, patients often become conceptualized primarily by their diagnosis, and physicians may become detached and excessively formal (Halpern, 2001; Marcum, 2008). Empathy, a concept existing for many decades and most commonly associated with Carl Rogers’ (1980) work on person-centered psychotherapy, is paramount to supplementing medical care with an ability to feel patients’ suffering.
Given the historical treatment of patients from the biomedical model and the shift toward a more holistic, biopsychosocial model (Engel, 1977), physicians should consider and integrate empathy into their medical practice (Decety & Fotopoulou, 2015). The hope is for readers to gain an understanding about the importance of physician empathy within the physician-patient relationship and healthcare. The medical model of care must adapt to a patient-centered and holistic model of care because cultural identities, access to resources, and health disparities play an integral role in patients’ lived experiences. This necessary shift implies a difference between the traditionally detached physician and the empathic physician.
What is Physician Empathy
Sympathy often gets confused with empathy as an interchangeable term despite their differences (Jeffrey, 2016a). Broadly, sympathy describes feeling for someone’s pain and suffering, while empathy is an affective and cognitive skill in which someone feels with another individual. However, Jeffrey (2016b) highlighted additional benefits of empathy in medical care that make it more optimal to patient communication than sympathy; for instance, empathy is more complex, intentional, other-oriented, imaginative, and integrative of affective and cognitive approaches to understanding someone’s experiences. Empathy facilitates a shift from emotional detachment toward a deeper understanding of patients’ concerns in order to provide a better course of treatment than a detached approach entails (Halpern, 2001). By being able to imagine one’s experiences with illness and think about and feel for their struggles, physicians are increasingly attuned to their patients’ needs and concerns.
Empathy remains a broad concept that needs a clear definition in order to accurately integrate it within a patient-physician relationship. Clark (2007) suggested that empathy involves “the capacity to think and feel oneself into the inner life of another person” (p. 123). Physicians are tasked with diagnosing and treating patients largely based on patients’ self-reported symptoms. Using both their training and patients’ subjective experiences, they must arrive at a diagnosis and course of treatment most appropriate for recovery. Doing so involves more than basic, surface-level listening skills – it requires a heightened level of understanding one’s symptoms through empathy, curiosity, and effective communication skills to facilitate patients’ openness and trust (Bellet & Maloney, 1991; Kurtz et al., 2020).
Popularized by its utilization in psychotherapy, empathy strengthens the working alliance between patient and clinician (Duan & Hill, 1996). Empathic medical care should center around the patient, and it must prioritize the ongoing relationship between patient and their physician. Thus, although its origins were within the psychotherapeutic relationships, empathy among physicians should be embedded in their medical interventions. Patients trust their physicians’ medical expertise and rely on them as they heal from or manage their symptoms; these vulnerable states of being and reliance on a professional for longevity and wellness should be treated with empathic concern. Thus, empathy is crucial in providing quality patient care (Howell, 2016). Its importance has a number of implications on both patients and physicians themselves.
The Importance of Physician Empathy
The positive outcomes of physician empathy are seemingly boundless. One of the clearest reasons to support the study and integration of empathy into practice is based on the developmental of trust between patient and physician (Gabay, 2015). Distrust in the patient-physician relationship may lead to patients feeling closed off from their physicians and less likely to report the full extent of their symptoms (Cook et al., 2004). Conversely, physicians who build trust through empathy are more likely to improve patient compliance and outcomes than detached physicians (Halpern, 2012; Hojat et al., 2011; Roter et al., 1998). The value of trust in the patient-physician relationship is evident. Patients are likely to follow their physicians’ guidance by adhering to medications and treatment recommendations, directly suggesting the importance of physician empathy in healthcare (Renter, 2015).
Moreover, physician empathy suggests a reciprocal relational process that, in turn, benefits both the patient and the physician (Janssen & MacLeod, 2012; Kadji & Schmid Mast, 2021). Although the power differentials are different between physicians and patients, empathic physicians strive for synchrony in body language and vocal tone (Finset & Ørnes, 2017). By cultivating empathic communication, physicians start to access and experience patients’ inner worlds – this allows them to gather more clinical information about symptoms in order to formulate a correct diagnosis and course of treatment (Derksen et al., 2013; Irving and Dickson, 2004). Evidently, empathy has wider-reaching impact on patients than simply fostering a sense of comfort in the examination room; the importance of empathy is clear in the broad patient-physician relationship and in the improved outcomes for patients treated by a warm and compassionate physician.
Impact of Physician Empathy on Patients
Research supports the relationship between physician empathy and patient outcomes (Hojat, 2007). In previous studies, researchers used the Consultation and Relational Empathy scale (CARE; Mercer et al., 2004) and the Jefferson Scale of Empathy (JSE; Hojat et al., 2001) to measure the effects of physician empathy on patient wellbeing. The evidence regarding this relationship is promising. Using the CARE and JSE measures, higher ratings of physician empathy supported better patient outcomes when treating the common cold (Rakel et al., 2009), asthma (Wu et al., 2020), and diabetes (Del Canale et al. 2012). High physician empathy was also positively related to healthy patient outcomes regarding pre-surgical anxiety (Soltner et al., 2011), migraine (Attar & Chandramani, 2012), and recovery from trauma (Steinhausen et al., 2014). In addition to the positive implications of physician empathy on the treatment of various illnesses, empathy leads to advantageous experiences in the provision of medical services. For instance, a survey of 550 patients in Korea found that patients who rated their physicians as high in empathy also reported high patient satisfaction and treatment compliance; this positive relationship was mediated by interpersonal factors including trust and collaboration (Kim et al., 2004). Finally, researchers found promising results by measuring physician empathy in oncology – they found that high physician empathy was positively related with increased patient self-efficacy, satisfaction, and perceived sense of control over recovery from cancer (Zachariae et al., 2003). The advantages of physician empathy in clinical application are clear – patients receiving treatment for a variety of physical health diagnoses will experience better outcomes from an empathic physician than from an emotionally-detached physician.
In addition to concrete health-related impacts on patients, physician empathy also serves as a process of patient empowerment. One of the clearest examples of empathy as a vehicle for empowering patients is shared decision-making (SDM; Adams & Drake, 2006). SDM involves collaboration between patients and physicians regarding treatment options, patient preferences, and patients’ sociocultural contexts (Nicholas, 2016). It also takes various forms – SDM might involve patients who view their physicians as the primary decision-makers, while other patients prefer to play a balanced role in weighing their treatment options (Adams & Drake, 2006, as cited in Nicholas, 2016). Despite the nuances in individualized treatment and patient preferences, SDM centers around a collaborative dynamic in which patients and physicians agree on health-related goals (Pan et al., 2022; Politi et al., 2012). Additionally, patients still have their rights to autonomy and can make decisions that are or are not accordance with their physician’s guidance. Physician empathy has led to optimistic outcomes related to adherence – researchers found that a positive physician-patient relationship that fosters SDM resulted in increased patient adherence to medication (Stavropoulou, 2011; Zolnierek & Dimatteo, 2009). Empathy facilitates a collaborative relationship, one in which patients feel increasingly empowered to ask questions and actively engage with physicians throughout their care (Mercer & Reynolds, 2002).
Impact of Physician Empathy on Physicians
Caring for patients during their most stressful and troubling times is not an easy position to be in. Physicians are commonly tasked with treating patients throughout all stages of life, including end-of-life care that warrants an especially sensitive approach to treatment (Calvo et al., 2014). Further, all physicians take the Hippocratic oath and vow to do no harm to patients (Miles, 2005). Along the way to treating patients across various settings for their respective diagnoses, physicians who integrate empathic practice might find themselves reaping benefits as well. For instance, a trusting relationship between physicians and patients enables patients to disclose more information about themselves and their experiences (Golda et al., 2018; Hoff & Collinson, 2017; Hojat et al., 2002). Openness creates opportunities for physicians to correctly diagnose and treat patients, which promotes patient satisfaction (Morgan et al., 2020; Wang et al., 2022).
Beyond the increased trust and comfort in the working relationship, physician empathy has practical benefits for physicians. From a broad perspective, open communication between physicians and patients reduces the chances of malpractice claims (Huntingdon & Kuhn, 2003). Notably, physicians have fewer malpractice claims when they engage in empathic behaviors (e.g., spending more time with patients during their visits, checking with patients to confirm their understanding of symptoms; Levinson et al., 1997). Moreover, in a sample of emergency medicine physicians who made empathic statements toward patients, researchers found empathy to be correlated with fewer thoughts of suing physicians (Smith et al., 2016). Physician empathy appears to reduce both thoughts and behaviors regarding malpractice claims against physicians. Physician empathy has clear impacts on physicians. Not only does physician empathy promote positive patient outcomes and a strong working relationship, physicians also enjoy the benefits of fewer risks of litigation.
Training Physicians on Empathic Practice and its Impact on Patients
The shift of medical practice toward an increasingly humanistic approach suggests the importance of teaching empathy throughout medical school and beyond. The reasons for the inclusion of empathy as an area of learning include improvements in SDM, treatment adherence, and patient satisfaction (Barry & Edgman-Levitan, 2012; Betancourt, 2003). Medical education can support the teaching of empathy in a few ways. Broadly speaking, nonverbal behavior is critical to attend to – Riess and colleagues (2014) developed a tool to facilitate empathic nonverbal behaviors. Shortened to E.M.P.A.T.H.Y., researchers highlighted nonverbal behaviors that are central to conveying empathy in patient care (Riess et al., 2014). The acronym stands for eye contact, muscles of facial expression, posture, affect, tone of voice, hearing the patient, and the physician (your) response. E.M.P.A.T.H.Y. was first tested as a training tool divided into three modules that focused on implementation of positive nonverbal skills. Physicians who completed the modules were rated higher in empathy by their patients than physicians who did not complete the training (Riess et al., 2014). These suggested nonverbals are important for students, residents, and physicians to be more intentional with, and research supports the relationship between empathic nonverbals and patient outcomes (e.g., Ambady et al., 2002; Pollak et al., 2007).
Decety (2020) suggested the importance of physicians who are “comfortable with themselves and feel safe, so that they can be more open to others and express a caring attitude” (p. 566). Medical education on empathy does not exclusively focus on delivering quality services to patients. Training also prioritizes trainees’ and physicians’ competence with self-reflection and self-awareness (Riess et al., 2012). Physicians can foster their empathy for patients by checking in with themselves, and medical training encourages physician to monitor themselves and their experiences. Self-reflective training starts early in medical school to promote introspection as an ongoing process of learning and growth. Students are encouraged to reflect on their feelings toward patients and to be self-aware of how they interact with patients (Arhweiler et al., 2014). Humanizing clinical practice should be valued by medical educators to instill processes of self-reflection and self-awareness among students who will, one day, graduate into the physician role.
Empathy must be conceptualized as a core competency in medical training and practice (Ogle et al., 2013). It appears to be more detrimental than helpful to patients if their physicians are emotionally detached or distant (Kee et al., 2018). There is inherent value within medical education to frame patients’ humanity through empathy, and physicians should be attuned to the physical and psychological tolls of illness on patients (Kimball, 1973). Fortunately, the medical field has evolved from a strictly biomedical approach toward an increasingly holistic and collaborative model. Education and training continue to shift with these changes, and there is more to be explored with regard to fostering empathy.
Adams, J. R., & Drake, R. E. (2006). Shared decision-making and evidence-based practice. Community Mental Health Journal, 42(1), 87–105. https://doi.org/10.1007/s10597-005-9005-8
Ahrweiler, F., Neumann, M., Goldblatt, H., Hahn, E. G., & Scheffer, C. (2014). Determinants of physician empathy during medical education: Hypothetical conclusions from an exploratory qualitative survey of practicing physicians. BMC Medical Education, 14, 122. https://doi.org/10.1186/1472-6920-14-122
Akinci, F., & Patel, P. M. (2014). Quality improvement in healthcare delivery utilizing the patient-centered medical home model. Hospital Topics, 92(4), 96–104. https://doi.org/10.1080/00185868.2014.968493
Ambady, N., Koo, J., Rosenthal, R., & Winograd, C. H. (2002). Physical therapists’ nonverbal communication predicts geriatric patients’ health outcomes. Psychology and Aging, 17(3), 443–452. https://doi.org/10.1037/0882-79220.127.116.113
Attar, H. S., & Chandramani, S. (2012). Impact of physician empathy on migraine disability and migraineur compliance. Annals of Indian Academy of Neurology, 15(5), 89–94. https://doi.org/10.4103/0972-2327.100025
Barry, M. J., & Edgman-Levitan, S. (2012). Shared decision making: Pinnacle of patient-centered care. The New England Journal of Medicine, 366(9), 780–781. https://doi.org/10.1056/NEJMp1109283
Bellet, P. S., & Maloney, M. J. (1991). The importance of empathy as an interviewing skill in medicine. Journal of the American Medical Association, 266(13), 1831–1832. https://doi.org/ 10.1001/jama.1991.03470130111039
Betancourt, J. R. (2003). Cross-cultural medical education: Conceptual approaches and frameworks for evaluation. Academic Medicine, 78(6), 560–569. https://doi.org/10.1097/00001888-200306000-00004
Calvo, V., Palmieri, A., Marinelli, S., Bianco, F., & Kleinbub, J. R. (2014). Reciprocal empathy and working alliance in terminal oncological illness: The crucial role of patients’ attachment style. Journal of Psychosocial Oncology, 32(5), 517–534. https://doi.org/10.1080/07347332.2014.936651
Castro, E. M, Van Regenmortel, T., Vanhaecht, K. Sermeus, W., & Van Hecke, A. (2016). Patient empowerment, patient participation and patient-centeredness in hospital care: A concept analysis based on a literature review. Patient Education and Counseling, 99(12), 1923-1939, https://doi.org/10.1016/j.pec.2016.07.026
Chochinov, H. M. (2023). Dignity in care: The human side of medicine. Oxford University Press.
Clark, A. J. (2007). Empathy in counseling and psychotherapy: Perspectives and practices. Lawrence Erlbaum Associates Publishers.
Decety, J. (2020). Empathy in medicine: What it is, and how much we really need it. The American Journal of Medicine, 133(5), 561–566. https://doi.org/10.1016/j.amjmed.2019.12.012
Decety, J., & Fotopoulou, A. (2015). Why empathy has a beneficial impact on others in medicine: Unifying theories. Frontiers in Behavioral Neuroscience, 8, Article 457. https://doi.org/10.3389/fnbeh.2014.00457
Del Canale, S., Louis, D. Z., Maio, V., Wang, X., Rossi, G., Hojat, M., & Gonnella, J. S. (2012). The relationship between physician empathy and disease complications: An empirical study of primary care physicians and their diabetic patients in Parma, Italy. Academic Medicine, 87(9), 1243–1249. https://doi.org/10.1097/ACM.0b013e3182628fbf
Derksen, F., Bensing, J., & Lagro-Janssen, A. (2013). Effectiveness of empathy in general practice: A systematic review. The British Journal of General Practice, 63(606), e76–e84. https://doi.org/10.3399/bjgp13X660814
Duan, C., & Hill, C. E. (1996). The current state of empathy research. Journal of Counseling Psychology, 43, 261–274. https://doi.org/10.1037/0022-018.104.22.1681
Engel, G. L. (1977). The need for a new medical model: A challenge for biomedicine. Science, 196(4286), 129–136. https://doi.org/10.1126/science.847460
Finset, A., & Ørnes, K. (2017). Empathy in the clinician–patient relationship: The role of reciprocal adjustments and processes of synchrony. Journal of Patient Experience, 4(2), 64–68. https://doi.org/10.1177/2374373517699271
Gabay, G. (2015). Perceived control over health, communication and patient-physician trust. Patient Education and Counseling, 98(12), 1550-1557. https://doi.org/10.1016/j.pec.2015.06.019
Golda, N., Beeson, S., Kohli, N., & Merrill, B. (2018). Recommendations for improving the patient experience in specialty encounters. Journal of the American Academy of Dermatology, 78(4), 653–659. https://doi.org/10.1016/j.jaad.2017.05.040
Halpern, J. (2001). From detached concern to empathy: Humanizing medical practice. Oxford University Press.
Halpern, J. (2012). Gathering the patient’s story and clinical empathy. The Permanente Journal, 16(1), 52–54. https://doi.org/10.7812/tpp/11-107
Hoff, T., & Collinson, G. E. (2017). How do we talk about the physician-patient relationship? What the nonempirical literature tells us. Medical Care Research and Review, 74(3), 251–285. https://doi.org/10.1177/1077558716646685
Hojat, M. (2007). Empathy in patient care: Antecedents, development, measurement, and outcomes. Springer: New York.
Hojat, M., Gonnella, J. S., Nasca, T. J., 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), 1563–1569. https://doi.org/10.1176/appi.ajp.159.9.1563
Hojat, M., Louis, D. Z., Markham, F. W., Wender, R., Rabinowitz, C., & Gonnella, J. S. (2011). Physicians’ empathy and clinical outcomes for diabetic patients. Academic Medicine, 86(3), 359–364. https://doi.org/10.1097/ACM.0b013e3182086fe1
Hojat, M., Mangione, S., Nasca, T. J., Cohen, M. J. M., Gonnella, J. S., Erdmann, J. B., Veloski, J., & Magee, M. (2001). The Jefferson Scale of Physician Empathy: Development and preliminary psychometric data. Educational and Psychological Measurement, 61(2), 349–365. https://doi.org/10.1177/00131640121971158
Howell, S. J. (2016). Empathy and its role in quality care. Osteopathic Family Physician, 8(4), 20–23.
Huntington, B., & Kuhn, N. (2003). Communication gaffes: A root cause of malpractice claims. Proceedings (Baylor University Medical Center), 16(2), 157–161. https://doi.org/10.1080/08998280.2003.11927898
Irving, P., & Dickson, D. (2004). Empathy: Towards a conceptual framework for health professionals. International Journal of Health Care Quality Assurance Incorporating Leadership in Health Services, 17(4-5), 212–220. https://doi.org/10.1108/09526860410541531
Janssen, A., & MacLeod, R. (2012). Who cares for whom? Reciprocity of care at the end of life. Journal of Palliative Care and Medicine, 2(7). https://doi.org/10.4172/2165-7386.1000129
Jeffrey, D. (2016a). Clarifying empathy: The first step to more humane clinical care. The British Journal of General Practice, 66(643), e143–e145. https://doi.org/10.3399/bjgp16X683761
Jeffrey, D. (2016b). Empathy, sympathy and compassion in healthcare: Is there a problem? Is there a difference? Does it matter? Journal of the Royal Society of Medicine, 109(12), 446–452. https://doi.org/10.1177/0141076816680120
Kadji, K., & Schmid Mast, M. (2021). The effect of physician self-disclosure on patient self-disclosure and patient perceptions of the physician. Patient Education and Counseling, 104(9), 2224–2231. https://doi.org/10.1016/j.pec.2021.02.030
Kee, J. W., Khoo, H. S., Lim, I., & Koh, M. Y. (2018). Communication skills in patient-doctor interactions: Learning from patient complaints. Health Professions Education, 4(2), 97-106. https://doi.org/10.1016/j.hpe.2017.03.006
Kim, S. S., Kaplowitz, S., & Johnston, M. V. (2004). The effects of physician empathy on patient satisfaction and compliance. Evaluation & the Health Professions, 27(3), 237–251. https://doi.org/10.1177/0163278704267037
Kimball, C. P. (1973). Medical education as a humanizing process. Journal of Medical Education, 48(1), 71–77. https://doi.org/10.1097/00001888-197301000-00010
Kurtz, J., Steenbergh, K., Kessler, J., Vitous, A., Barrett, M., Sandhu, G., & Suwanabol, P. A. (2020). ‘What I wish my surgeon knew’: A novel approach to promote empathic curiosity in surgery. Journal of Surgical Education, 77(1), 82–87. https://doi.org/10.1016/j.jsurg.2019.07.013
Levinson, W., Roter, D. L., Mullooly, J. P., Dull, V. T., & Frankel, R. M. (1997). Physician-patient communication. The relationship with malpractice claims among primary care physicians and surgeons. Journal of the American Medical Association, 277(7), 553–559. https://doi.org/10.1001/jama.277.7.553
Marcum, J. A. (2008). An introductory philosophy of medicine: Humanizing modern medicine. New York: Springer.
Mercer, S. W., Maxwell, M., Heaney, D., & Watt, G. C. (2004). The consultation and relational empathy (CARE) measure: Development and preliminary validation and reliability of an empathy-based consultation process measure. Family Practice, 21(6), 699–705. https://doi.org/10.1093/fampra/cmh621
Mercer, S. W., & Reynolds, W. J. (2002). Empathy and quality of care. The British Journal of General Practice, 52 Suppl(Suppl), S9–S12.
Miles, S. H. (2005). The Hippocratic oath and the ethics of medicine. Oxford University Press.
Morgan, D. J., Scherer, L. D., & Korenstein, D. (2020). Improving physician communication about treatment decisions: Reconsideration of “risks vs benefits.” Journal of the American Medical Association, 324(10), 937–938. https://doi.org/10.1001/jama.2020.0354
Nicholas, D. (2016). Psychosocial care of the adult cancer patient: Evidence-based practice in psycho-oncology. Oxford University Press.
Ogle, J., Bushnell, J. A., & Caputi, P. (2013). Empathy is related to clinical competence in medical care. Medical Education, 47(8), 824–831. https://doi.org/10.1111/medu.12232
Pan, S., Mao, J., Wang, L., Dai, Y., & Wang, W. (2022). Patient participation in treatment decision-making of prostate cancer: A qualitative study. Supportive Care in Cancer, 30(5), 4189–4200. https://doi.org/10.1007/s00520-021-06753-1
Politi, M. C., Studts, J. L., & Hayslip, J. W. (2012). Shared decision making in oncology practice: What do oncologists need to know? The Oncologist, 17(1), 91–100. https://doi.org/10.1634/theoncologist.2011-0261
Pollak, K. I., Arnold, R. M., Jeffreys, A. S., Alexander, S. C., Olsen, M. K., Abernethy, A. P., Sugg Skinner, C., Rodriguez, K. L., & Tulsky, J. A. (2007). Oncologist communication about emotion during visits with patients with advanced cancer. Journal of clinical Oncology, 25(36), 5748–5752. https://doi.org/10.1200/JCO.2007.12.4180
Rakel, D. P., Hoeft, T. J., Barrett, B. P., Chewning, B. A., Craig, B. M., & Niu, M. (2009). Practitioner empathy and the duration of the common cold. Family Medicine, 41(7), 494–501.
Renter, E. (2015). Why nice doctors are better doctors. U.S. News Health. https://bit.ly/3ObfCO1
Riess, H., Kelley, J. M., Bailey, R. W., Dunn, E. J., & Phillips, M. (2012). Empathy training for resident physicians: A randomized controlled trial of a neuroscience-informed curriculum. Journal of General Internal Medicine, 27(10), 1280–1286. https://doi.org/10.1007/s11606-012-2063-z
Riess, H., & Kraft-Todd, G. (2014). E.M.P.A.T.H.Y.: A tool to enhance nonverbal communication between clinicians and their patients. Academic Medicine, 89(8), 1108–1112. https://doi.org/10.1097/ACM.0000000000000287
Rogers, C. (1980). A way of being. Boston: Houghton Mifflin.
Roter, D. L., Hall, J. A., Merisca, R., Nordstrom, B., Cretin, D., & Svarstad, B. (1998). Effectiveness of interventions to improve patient compliance: A meta-analysis. Medical Care, 36(8), 1138–1161. https://doi.org/10.1097/00005650-199808000-00004
Siminoff, L. A., & Step, M. M. (2005). A communication model of shared decision making: Accounting for cancer treatment decisions. Health Psychology, 24(4, Suppl), S99–S105. https://doi.org/10.1037/0278-6133.24.4.S99
Smith, D. D., Kellar, J., Walters, E. L., Reibling, E. T., Phan, T., & Green, S. M. (2016). Does emergency physician empathy reduce thoughts of litigation? A randomised trial. Emergency Medicine Journal, 33(8), 548–552. https://doi.org/10.1136/emermed-2015-205312
Soltner, C., Giquello, J. A., Monrigal-Martin, C., & Beydon, L. (2011). Continuous care and empathic anesthesiologist attitude in the preoperative period: Impact on patient anxiety and satisfaction. British Journal of Anesthesia, 106(5), 680–686. https://doi.org/10.1093/bja/aer034
Stavropoulou, C. (2011). Non-adherence to medication and doctor-patient relationship: Evidence from a European survey. Patient Education and Counseling, 83(1), 7–13. https://doi.org/10.1016/j.pec.2010.04.039
Steinhausen, S., Ommen, O., Antoine, S. L., Koehler, T., Pfaff, H., & Neugebauer, E. (2014). Short- and long-term subjective medical treatment outcome of trauma surgery patients: The importance of physician empathy. Patient Preference and Adherence, 8, 1239–1253. https://doi.org/10.2147/PPA.S62925
Wang, Y., Wu, Q., Wang, Y., & Wang, P. (2022). The effects of physicians’ communication and empathy ability on physician-patient relationship from physicians’ and patients’ perspectives. Journal of Clinical Psychology in Medical Settings, 1–12. Advance online publication. https://doi.org/10.1007/s10880-022-09844-1
Wu, H., Zhang, Y., Li, S., Liu, Q., & Yang, N. (2020). Care is the doctor’s best prescription: The impact of doctor-patient empathy on the physical and mental health of asthmatic patients in China. Psychology Research and Behavior Management, 13, 141–150. https://doi.org/10.2147/PRBM.S226706
Zachariae, R., Pedersen, C. G., Jensen, A. B., Ehrnrooth, E., Rossen, P. B., & von der Maase, H. (2003). Association of perceived physician communication style with patient satisfaction, distress, cancer-related self-efficacy, and perceived control over the disease. British Journal of Cancer, 88(5), 658–665. https://doi.org/10.1038/sj.bjc.6600798
Zolnierek, K. B., & Dimatteo, M. R. (2009). Physician communication and patient adherence to treatment: A meta-analysis. Medical Care, 47(8), 826–834. https://doi.org/10.1097/MLR.0b013e31819a5acc