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Gertsman S, Ene IC, Palmert S, Liu A, Makkar M, Shao I, Shapiro J, Williams C. Clinical empathy as perceived by patients with chronic illness in Canada: a qualitative focus group study. CMAJ Open 2023; 11:E859-E868. [PMID: 37751921 PMCID: PMC10521922 DOI: 10.9778/cmajo.20220211] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND Although clinical empathy - the ability of a physician to understand a patient's illness experience, communicate this understanding and act collaboratively to create a treatment plan - provides substantial benefits to both physicians and patients, medical students typically experience a decline in empathy during training. The primary objective of this study was to generate a model of clinical empathy grounded in the perspectives of people with chronic illness living in Canada, to promote empathy-focused curricular development in Canadian medical education. METHODS We conducted a qualitative focus group study using a constructivist grounded theory approach. We recruited adults (age ≥ 18 yr) with chronic illness who had recently seen a physician in Canada from virtual support groups. Six semistructured virtual focus groups with 3-5 participants each were scheduled between June and September 2021. We coded the transcripts using the constant comparative method, allowing for the construction of an overarching theory. RESULTS Twenty patients (17 women and 3 men) participated in the focus groups; 1 group had 2 participants because 1 participant failed to appear. The majority of participants (14 [70%]) had at least a college degree. The mean rating for overall satisfaction with the Canadian health care system was 5.4/10.0 (median 5.0). The emergent theory showed that the perceived presence of physician empathy engendered positive internal processing by patients, leading to increased health care efficacy and enhanced mental health outcomes. Negative patient processing in response to the perceived absence of empathy led to reduced quality of health care delivery (e.g., ineffective referrals and more appointments), increased use of health care resources, disruptions in patients' personal lives, and negative physical and mental health outcomes. INTERPRETATION Clinical empathy can have life-altering impacts on patients, and its absence may increase resource use. As empathy involves understanding patients' lived experiences, any valid intervention to improve clinical empathy must be informed by patient perspectives.
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Affiliation(s)
- Shira Gertsman
- Michael G. DeGroote School of Medicine (Gertsman, Ene, Palmert, Liu, Makkar, Shao), McMaster University, Hamilton, Ont.; Department of Family Medicine (Shapiro), UC Irvine School of Medicine, University of California Irvine, Irvine, Calif.; Department of Pediatrics (Williams), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Dalla Lana School of Public Health (Williams), University of Toronto, Toronto, Ont.
| | - Ioana Cezara Ene
- Michael G. DeGroote School of Medicine (Gertsman, Ene, Palmert, Liu, Makkar, Shao), McMaster University, Hamilton, Ont.; Department of Family Medicine (Shapiro), UC Irvine School of Medicine, University of California Irvine, Irvine, Calif.; Department of Pediatrics (Williams), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Dalla Lana School of Public Health (Williams), University of Toronto, Toronto, Ont
| | - Sasha Palmert
- Michael G. DeGroote School of Medicine (Gertsman, Ene, Palmert, Liu, Makkar, Shao), McMaster University, Hamilton, Ont.; Department of Family Medicine (Shapiro), UC Irvine School of Medicine, University of California Irvine, Irvine, Calif.; Department of Pediatrics (Williams), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Dalla Lana School of Public Health (Williams), University of Toronto, Toronto, Ont
| | - Amy Liu
- Michael G. DeGroote School of Medicine (Gertsman, Ene, Palmert, Liu, Makkar, Shao), McMaster University, Hamilton, Ont.; Department of Family Medicine (Shapiro), UC Irvine School of Medicine, University of California Irvine, Irvine, Calif.; Department of Pediatrics (Williams), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Dalla Lana School of Public Health (Williams), University of Toronto, Toronto, Ont
| | - Mallika Makkar
- Michael G. DeGroote School of Medicine (Gertsman, Ene, Palmert, Liu, Makkar, Shao), McMaster University, Hamilton, Ont.; Department of Family Medicine (Shapiro), UC Irvine School of Medicine, University of California Irvine, Irvine, Calif.; Department of Pediatrics (Williams), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Dalla Lana School of Public Health (Williams), University of Toronto, Toronto, Ont
| | - Ian Shao
- Michael G. DeGroote School of Medicine (Gertsman, Ene, Palmert, Liu, Makkar, Shao), McMaster University, Hamilton, Ont.; Department of Family Medicine (Shapiro), UC Irvine School of Medicine, University of California Irvine, Irvine, Calif.; Department of Pediatrics (Williams), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Dalla Lana School of Public Health (Williams), University of Toronto, Toronto, Ont
| | - Johanna Shapiro
- Michael G. DeGroote School of Medicine (Gertsman, Ene, Palmert, Liu, Makkar, Shao), McMaster University, Hamilton, Ont.; Department of Family Medicine (Shapiro), UC Irvine School of Medicine, University of California Irvine, Irvine, Calif.; Department of Pediatrics (Williams), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Dalla Lana School of Public Health (Williams), University of Toronto, Toronto, Ont
| | - Connie Williams
- Michael G. DeGroote School of Medicine (Gertsman, Ene, Palmert, Liu, Makkar, Shao), McMaster University, Hamilton, Ont.; Department of Family Medicine (Shapiro), UC Irvine School of Medicine, University of California Irvine, Irvine, Calif.; Department of Pediatrics (Williams), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; Dalla Lana School of Public Health (Williams), University of Toronto, Toronto, Ont
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Gabay G, Gere A, Zemel G, Moskowitz H. Personalized Communication with Patients at the Emergency Department—An Experimental Design Study. J Pers Med 2022; 12:jpm12101542. [PMID: 36294684 PMCID: PMC9605307 DOI: 10.3390/jpm12101542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 09/05/2022] [Accepted: 09/15/2022] [Indexed: 11/16/2022] Open
Abstract
Communication of clinicians at the emergency department is a barrier to patient satisfaction due to lack of human connection, lack of control over the situation, low health literacy, deficient information, poor support at a time of uncertainty all affecting perceived quality of care. This explorative study tests drivers of patient satisfaction with communication of clinicians at the emergency department. The sample comprises 112 Americans from the New York greater area, who visited an emergency department in the past year. A conjoint-based experimental design was performed testing six messages in six categories. The categories encompass acknowledged aspects of communication with health providers enabling to compare among them when exploring communication at the ED by patient preferences. Respondents rated messages by the extent to which it drives their satisfaction with communication of clinicians at the emergency department. Based on the similarity of patients’ response patterns to each message, three significantly distinct mindsets of patient preferences regarding communication exchanges with clinicians at the emergency department emerged. Different conduct and communication messages drive the satisfaction of members of each mindset with the communication of clinicians at the emergency department. The strong performing messages for one mindset are irrelevant for members of other mindsets. Clinicians may identify the patient-belonging to a mindset and communicate using mindset-tailored messages. This novel strategy may enable clinicians to implement patient-centered communication, by mindset, promoting patient satisfaction and enabling clinicians to better cope with patients in the chaotic emergency department environment.
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Affiliation(s)
| | - Attila Gere
- Institute of Food Science and Technology, Department of Postharvest, Supply Chain, Commerce and Sensory Science, Hungarian University of Agriculture and Life Sciences, 1118 Budapest, Hungary
- Correspondence:
| | - Glenn Zemel
- Dupage Valley Anesthesiologists, Inc., Naperville, IL 60101, USA
| | - Howard Moskowitz
- Mind-Genomics Associates, White Plains, White Plains, NY 10617, USA
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