Table 1.

Summary of included articles

AuthorCountryQuality assessment scoreMeasure/empathy levelDesignMethodSample sizeResearch questionKey findings
Hojat et al, 201144US6JSPE/physician rating/cognitive and attitudeQuantitative/RCT with statistical controlsLaboratory results891 patients/31 GPsTo test the hypothesis that physician empathy is associated with positive clinical outcomes for patients with diabetes.Patients of physicians with high empathy scores were significantly more likely to have good control of HbA1c (56%) than were patients of physicians with low empathy scores (40%). Similarly, the proportion of patients with good LDL-C control was significantly higher for physicians with high empathy scores (59%) than for patients of physicians with low scores (44%).
Rakel et al, 201145US5CARE/patient rating/skill and attitudeQuantitative/RCTQuestionnaire and laboratory results348 patients/6 GPsTo evaluate the effects of patient–physician interaction on the severity and duration of the common cold.The ‘physician empathy perfect’ group was associated with the shortest cold duration (5.89 days versus 7.00 days). The amount of change of interleukin-8 and neutrophil level was greater for the ‘physician empathy perfect’ group.
van Dulmen et al, 200441Netherlands4RIAS/observer rating/skillsQuantitativeQuestionnaire and analysis of video consultations698 patients/142 GPsTo examine the physicians’ responses to patients’ concerns in relation to the patient’s empathic preference and perception and the level of anxiety provoked by the medical visit.95% of the patients reported that they have perceived their GP to be empathic. The patients who had perceived a more empathic GP reported lower levels of anxiety.
Mercer et al, 200846Scotland5CARE/patient rating/skill and attitudeQualitative/prospectiveQuestionnaires323 patients/5 GPsTo investigate the relationships between GPs’ empathy, patient enablement and patient-assessed outcomes in primary care consultations in an area of high socioeconomic deprivation in Scotland.There is a direct relationship between physician empathy and patient enablement.
Hojat et al, 201140US6JSPPPE physician rating cognitive and attitudeQualitative/RCTQuestionnaires535 patientsTo develop and examine an instrument to measure patients’ overall satisfaction with their GP.A large correlation between the perception of physician empathy and patient satisfaction.
Buszewicz et al, 200643UK6TAR/patient rating/long working relationshipsQualitativePatient interviews20 patients/12 GPsTo identify which aspects of GP consultations patients presenting with psychological problems experience as helpful or unhelpful.Genuine interest and empathy, within a continuing relationship, was highly valued both for psychological and non-psychological problems.
Levinson and Roter, 199542US6RIAS/observer rating/skillsQualitativeAnalysis of audiotapes412 patients/29 GPsTo assess the relationship between physicians’ beliefs about the psychosocial aspects of patient care and their routine communication with patients.Physicians who had positive attitudes used more statements of emotions, such as empathy, reassurance, and fewer closed-ended questions than did their colleagues who had less positive attitudes. The patients of these physicians offer more information about psychological and social issues.
  • CARE = the Consultation and Relational Empathy measure. HbA1c = gylcosylated haemoglobin. JSPE = Jefferson scale of Physician Empathy. JSPPPE = Jefferson Scale of Patient Perception of Physician Empathy. LDL-C = low-density lipoprotein cholesterol. RCT = randomised controlled trial. RIAS = Roter Interaction Analysis System. TAR = Tape Assistance Recall method.