Central to the patient-provider relationship is the ability for the provider to show empathy. However, the opportunity for empathetic responses may be missed 70 to 90 percent of the time when the provider is uncomfortable showing emotion, has their mind on other tasks, or doesn’t have enough time. A new study found many missed opportunities for primary care providers to display empathy. In many of these cases, the provider’s preoccupation with problem solving got in the way of showing empathy for the patient.
The researchers evaluated 47 visits with HIV-infected individuals and their primary care providers, including physicians, nurse practitioners, and physician assistants. Sessions were audiorecorded and transcribed. An empathic opportunity was defined as an instance where the patient expressed a strong negative emotion.
The researchers identified 29 missed opportunities for provider empathy during 21 patient visits. The rate of an empathic statement being said at some point during the response sequence was 45 percent. Five distinct types of provider responses were identified: ignore/change the subject, dismiss/minimize, elicit information, problem-solving, and empathic response. Eliciting information was the most common response type among providers, followed by problem-solving. When the providers started off the encounter with problem-solving, empathic statements rarely followed afterwards. In half of all instances where there were no empathic responses, the providers engaged in problem solving.
The researchers suggest that providers respond by solving the problem underlying the patient’s emotional experience when empathic opportunities are missed. This type of support can still be constructive and helpful to the patient. However, the researchers suggest that providers need to strike a balance between problem solving and giving empathic responses during the clinical encounter.
The study was supported in part by AHRQ (HS13903, Contract No. 290-01-0012). See "Providing support to patients in emotional encounters: A new perspective on missed empathic opportunities," by Ian Hsu, Somnath Saha, M.D., M.P.H., Phillip Todd Korthuis, M.D., M.P.H., and others in Patient Education and Counseling 88, pp. 436-442, 2012.