The Secret to Quality Doctor-Patient Relationships

March 4, 2021
Kim A. Gorgens, Ph.D., ABPP

Readers may be surprised to hear that a high percentage of health professionals, about 70%, find it difficult to develop empathy with their patients.

Psychologists are masters of using their relationships with patients to promote change and the secret to psychological practice is to listen and reflect. Readers may be surprised to hear that a high percentage of health professionals, about 70%, find it difficult to do that, to develop empathy with their patients. A study of primary care physicians and surgeons reported that physicians responded to patients’ emotional clues in only 21% of primary care and 38% of surgical cases (Levinson, et al., 2000). Another study explored researchers’ intake interviews and found that most of the opportunities to address patients’ emotional cues were missed entirely (Easter & Beach, 2004). One researcher remarked, “these patients are more likely to receive suboptimal pain management, with a more disease centered orientation and less empathic behavior.” The failure to build empathy for patients is partly a consequence of a lack of adequate time, a lack of training in how to cultivate empathy, and is a consequence of the predominant culture in medical schools.

Empathy is defined as “a cognitive attribute involving an understanding of the patient’s experience and perspective, as a separate individual, combined with an ability to communicate that understanding to the patient” (Hojat, et al., 2002). Empathy is related to positive outcomes for patients, especially for patients with chronic disease. Empathy in the patient encounter is related to healthier patients. A researcher argued that, when a physician is empathic, patients heal faster (Trzeciak & Mazzarelli, 2019). Other studies report the physiological benefits of empathic relationships, including better immune function, shorter post-surgery hospital stays, fewer respiratory complications, stronger placebo response, shorter duration of colds, and better outcomes like medication compliance (Beach, 2018; Reiss, 2010).

In rheumatology, of course, the dynamics of the doctor-patient relationship are often more complex. Rheumatology patients have often seen many different doctors before ending up at a rheumatologist and receiving a diagnosis and treatment plan. Patients often arrive frustrated and distrustful. In one study, 41% of rheumatoid arthritis (RA) patients reported feeling uncomfortable raising concerns and fears with their physician and 22% of patients worried that if they ask too many questions, their doctor will see them as a difficult patient and it will affect the quality of their care. These patient concerns can all be easily buffered with the application of straightforward empathic listening techniques.

Empathic listening in medicine includes a commitment to hearing patients’ concerns, admitting when you don’t know an answer, and setting expectations. Leonard Calabrese, a Rheumatologist and Immunologist at the Cleveland Clinic, writes in “How to Practice Empathetic Listening” (2015) to first listen to your patient and give them the opportunity to help you understand their problem, and then validate their suffering.You don’t even have to fix all of their complaints, people want to be heard and feel seen and they’ll work harder to get your attention if they feel otherwise.

Patients turn to rheumatologists when other providers are unable to treat their ailments which means you have to work harder to establish an empathic relationship. Taking the few minutes to listen and agree, promotes patient satisfaction and well-being, in most cases, it is just that simple.