No matter which quality improvement philosophy your organization subscribes to—accountable care, medical home or Lean, the end goal is the same: better care for the patient. And beneath all those clinical integration frameworks, improved processes and hand-washing protocols are the personal relationships patients have with their doctors and nurses, for better or worse. An intriguing new study on diabetic patients, to be published this month in Academic Medicine, suggests that the relative empathy of a given doctor can play a substantial role on clinical outcomes.

Researchers asked physicians to take a 20-question empathy assessment, and then compared their scores with the progression of their patients on key indicators for diabetics. The researchers found that the rate of good control for patients' hemoglobin and cholesterol levels—indicators of improvement for diabetics—was significantly higher for patients whose doctors scored high on the empathy assessments. Anecdotally, this study makes sense. The only time I've ever been hospitalized, when I was 8, the situation was made much worse by a physician who thought I was complaining too much about the pain I was in. Conversely, the times I've encountered doctors with good communications skills are when I've been most engaged in my care, and comfortable divulging exactly what's bothering me.

But what can hospitals, medical schools and other health care institutions do to foster empathy in clinicians? Mohammadreza Hojat, director of the Jefferson Longitudinal Study of Medical Education—which conducted the survey on behalf of Jefferson Medical College at Thomas Jefferson University—suggests making empathy "an integral component of a physician's competence."

"This study supports the recommendations of such professional organizations as the Association of American Medical Colleges and the American Board of Internal Medicine of the importance of assessing and enhancing empathetic skills in undergraduate and graduate medical education," Hojat stated in a release accompanying the survey.

None of this should be surprising—I've sat through enough conference seminars on dealing with difficult or abusive physicians to know that managing physicians' demeanor is a fairly central HR concern for most hospitals. But instead of dealing with the problems that arise from difficult docs on the back end, this study suggests that finding physicians who already possess strong interpersonal skills should be more of a priority for hospitals.

"These findings, if confirmed by larger scale research, suggest that empathy should be viewed as an integral component of a physician's competence," Hojat added.

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