Empathic care in medicine is associated with greater patient satisfaction, a new review has found.
“Patient satisfaction” is more than a fluffy metric that measures how satisfied “customers” are. Increased patient satisfaction is associated with, among other things, improved survival after heart attacks, a lower risk of being readmitted to hospital, higher general quality of care and better patient safety.
Empathic care is also associated with patients taking their drugs as prescribed, which itself improves patient outcomes.
Unfortunately, patient satisfaction is often lacking.
In 2022, only 36% of surveyed UK patients were satisfied with their care in the NHS – the lowest since it was first measured in 1997. The COVID pandemic has exacerbated the decline in patient satisfaction.
Between 2020 and 2021, patient satisfaction dropped by 17% in the UK, the largest one-year drop ever recorded. This fall in satisfaction was reflected across all services, including hospital treatment (inpatient and outpatient), general practice and dentistry. Similar trends have been seen in the US, where a 2022 poll found that less than half of Americans are satisfied with their healthcare.
Several interventions have been used to raise patient satisfaction including real-time patient experience surveys, improved cleanliness and better communication. But a review of these interventions in hospitals found that the results were mixed.
A cure for poor patient satisfaction remains elusive.
Empathy is key
Showing increased empathy helps patients to be more forthcoming about their concerns, creating a better understanding of their health issues. When doctors spend a bit more time doing this, patients appear to be more satisfied with their care.
Empathy and satisfaction also appear to work together to help patients. Both patient satisfaction and increased empathy seem to improve adherence to medication, so patients are more likely to listen to and follow advice on medicine or lifestyle prescriptions.
Beyond improving patient satisfaction, increased empathy has the “side-effect” of improving other patient outcomes (such as reducing their pain) and improving the wellbeing of the medical professionals providing the care.
However, the evidence linking more empathic doctors and nurses with improved patient satisfaction had not been recently summarised. To overcome this gap, my colleagues and I reviewed 14 randomised trials comprising 80 healthcare professionals and nearly 2,000 patients across several countries, settings (hospital and general practice), and practitioner types (doctors and nurses) to evaluate the effect of empathy on patient satisfaction.
All 14 studies found that healthcare professional empathy was associated with an improvement in patient satisfaction. However, there were several problems with the evidence that prevented us from drawing firm conclusions about how big an effect empathy has on patient satisfaction.
Limitations included high variation in how empathy was defined and enacted in the studies, as well as differences in the way patient satisfaction was measured. This is a barrier to implementing the science because doctors are left wondering exactly how they can increase empathy so that it improves patient satisfaction.
An exception to this variation was that several of the included studies involved an intervention called Bathe. This intervention takes doctors and nurses through several steps to gather relevant information, respond to patients’ emotions and offer help. This well-described intervention can be used off the shelf by doctors who wish to improve their patients’ satisfaction with care.
We hope our study will motivate healthcare professionals to find ways to improve the way they express empathy. Patient satisfaction is clearly in everyone’s best interests.
Jeremy Howick receives funding from the Medical Research Council (MRC), the Economics and Social Science Research Council (ESRC), the National Institute for Health and Care Research (NIHR), and the General Medical Council (GMC).