Empathy may reduce malpractice suits

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Malpractice insurance = empathy?
Are empathetic doctors less likely to get sued?  This RCT showed a video of a simulated discharge encounter, one in which the doctor included a couple of empathetic remarks and one without such remarks.  Specifically, the empathetic statements were: "(1) the physician recognizes that the patient is concerned about their symptoms and (2) the patient knows their typical state of health better than a physician seeing them for the first time and did the right thing by seeking evaluation."  Patients were asked to rate on a Likert scale the likelihood they would sue the doctor giving the discharge instructions if there was a bad outcome leading to lost work.  They found a statistically significant reduction in the empathy group.  Four additional patient satisfaction outcomes (the study's secondary outcome) were better in the empathy group.

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Very brief words that show you care and that you don't think patients are stupid for coming in to the ED could make a difference in the chances of you being named in a malpractice suit and could improve your patient satisfaction scores. The Atlantic has an excellent article on physician empathy.

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Abstract

Emerg Med J. 2016 Aug;33(8):548-52. doi: 10.1136/emermed-2015-205312. Epub 2016 Mar 21.

Does emergency physician empathy reduce thoughts of litigation? A randomised trial.

Smith DD1, Kellar J2, Walters EL1, Reibling ET1, Phan T1, Green SM1.

Author information:

1Department of Emergency Medicine, Loma Linda University Medical Center and Children's Hospital, Loma Linda, California, USA.

2Department of Emergency Medicine, Loma Linda University Medical Center and Children's Hospital, Loma Linda, California, USA Department of Emergency Medicine, Lakeland Health, St Joseph, Michigan, USA.

Abstract

BACKGROUND:

We hypothesised the addition of brief empathetic statements to physician-patient interaction might decrease thoughts regarding litigation.

METHODS:

We enrolled a convenience sample of adults in our emergency department (ED) waiting room into a randomised, double-blind controlled trial. Subjects watched videos of simulated discharge conversations between physicians and patient actors; half of the videos differed only by the inclusion of two brief empathetic statements: verbalisations that (1) the physician recognises that the patient is concerned about their symptoms and (2) the patient knows their typical state of health better than a physician seeing them for the first time and did the right thing by seeking evaluation. After watching the video subjects were asked to score a five-point Likert scale their thoughts regarding suing this physician in the event of a missed outcome leading to lost work (primary outcome), and four measures of satisfaction with the physician encounter (secondary outcomes).

RESULTS:

We enrolled and randomised 437 subjects. 213 in the empathy group and 208 in the non-empathy group completed the trial. Sixteen subjects did not complete the trial due to computer malfunction or incomplete data sheets. Empathy group subjects reported statistically significant less thoughts of litigation than the non-empathy group (mean Likert scale 2.66 vs 2.95, difference -0.29, 95% CI -0.04 to -0.54, p=0.0176). All four secondary measures of satisfaction with the physician encounter were better in the empathy group.

CONCLUSIONS:

In this study, the addition of brief empathetic statements to ED discharge scenarios was associated with a statistically significant reduction in thoughts regarding litigation.

CLINICAL TRIAL REGISTRATION:

NCT01837706.

Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

PMID: 27002161 [PubMed - in process]