Cited by 512Empathy and Medical EducationDiabetes Management and EducationPatient-Provider Communication in Healthcare

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The Relationship Between Physician Empathy and Disease Complications: An Empirical Study of Primary Care Physicians and Their Diabetic Patients in Parma, Italy

Canale, Stefano Del, Louis, Daniel Z., Maio, Vittorio, Wang, Xiaohong, Rossi, Giuseppina, Hojat, Mohammadreza, Gonnella, Joseph S.·2012·Academic Medicine

DOI 10.1097/acm.0b013e3182628fbf

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Abstract

PURPOSE: To test the hypothesis that scores of a validated measure of physician empathy are associated with clinical outcomes for patients with diabetes mellitus. METHOD: This retrospective correlational study included 20,961 patients with type 1 or type 2 diabetes mellitus from a population of 284,298 adult patients in the Local Health Authority, Parma, Italy, enrolled with one of 242 primary care physicians for the entire year of 2009. Participating physicians' Jefferson Scale of Empathy scores were compared with occurrence of acute metabolic complications (hyperosmolar state, diabetic ketoacidosis, coma) in diabetes patients hospitalized in 2009. RESULTS: Patients of physicians with high empathy scores, compared with patients of physicians with moderate and low empathy scores, had a significantly lower rate of acute metabolic complications (4.0, 7.1, and 6.5 per 1,000 patients, respectively, P < .05). Logistic regression analysis showed physicians' empathy scores were associated with acute metabolic complications: odds ratio (OR) = 0.59 (95% confidence interval [CI], 0.37-0.95, contrasting physicians with high and low empathy scores). Patients' age (≥69 years) also contributed to the prediction of acute metabolic complications: OR = 1.7 (95% CI, 1.2-1.4). Physicians' gender and age, patients' gender, type of practice (solo, association), geographical location of practice (mountain, hills, plain), and length of time the patient had been enrolled with the physician were not associated with acute metabolic complications. CONCLUSIONS: These results suggest that physician empathy is significantly associated with clinical outcome for patients with diabetes mellitus and should be considered an important component of clinical competence.

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Fatima, S. (2016) · Journal of Medical Humanities · doi:10.1007/s10912-016-9385-5 · Cited by 2
Wunderdroge Empathie
Gross, H. (2013) · Uro-News · doi:10.1007/s00092-013-0443-2 · Cited by 2
The Fakebetes Challenge: A Pilot Study of the Patient as Educator
Litchman, M. L. (2016) · PLAID People Living with And Inspired by Diabetes · doi:10.17125/plaid.2016.64 · Cited by 2
“Research indicates healthcare providers who have empathy for their patients with diabetes build stronger relationships with their patients [17], and have better clinical outcomes [18, 19].”
Background
Measuring medical students’ empathy using direct verbal expressions
Hur, Y., Cho, A.-R., & Kim, S. (2016) · Korean journal of medical education · doi:10.3946/kjme.2016.35 · Cited by 2
What You Need to Know—A Primer for Radiologists Entering Breast Imaging
Margolis, N. E., & Gao, Y. (2016) · Journal of the American College of Radiology · doi:10.1016/j.jacr.2016.10.008 · Cited by 2
Suffering and hope: Helen Lester Memorial Lecture 2016
Dowrick, C. F. (2017) · BJGP Open · doi:10.3399/bjgpopen17x100605 · Cited by 2
“GP empathy is also associated with greater effectiveness of antidepressant medication(21) and with lower rates of acute metabolic complications in diabetic patients.(22)”
Background
A closer look into empathy among medical students: The career eulogy as a lens
Crump, W. J., Fricker, R. S., & Ziegler, C. H. (2021) · Marshall Journal of Medicine · doi:10.33470/2379-9536.1317 · Cited by 2
“Those who would like to promote this skill in future physicians have attempted to measure empathy to both assess the effect of current medical education as well as design better methods to prepare doctors for practice.(1-5) Different authors have considered empathy as more of an affective domain or alternatively rathe…”
Method
A Longitudinal Measure of Medical Student Empathy at a Regional Campus
Crump, W. J., Ziegler, C. H., & Fricker, R. S. (2021) · Journal of Regional Medical Campuses · doi:10.24926/jrmc.v4i1.3475 · Cited by 3
Does empathy really decline during residency training? A longitudinal look at changes in measured empathy in a community program
Crump, W. J., Ziegler, C. H., & Fricker, S. (2021) · Journal of Regional Medical Campuses · doi:10.24926/jrmc.v4i4.4206 · Cited by 2
Assessment of the emotional intelligence and its dimensions of students at beginning of their medical profession education
Singh, H., Singh, I., & Soni, R. K. (2022) · International Journal of Contemporary Pediatrics · doi:10.18203/2349-3291.ijcp20220758 · Cited by 2
Affective Error
Howard, J. (2018) · Springer eBooks · doi:10.1007/978-3-319-93224-8_11 · Cited by 2
Cognitive empathy of osteopathic students: a longitudinal study with data comparisons to the Project in Osteopathic Medical Education and Empathy (POMEE)
Newton, B. W., & Vaskalis, Z. T. (2023) · Journal of Osteopathic Medicine · doi:10.1515/jom-2023-0014 · Cited by 2
The Art of Empathy: Visual Art Interpretation and Creation to Enhance Empathy in DPT Students
Collier, N. B., & Taylor, L. F. (2024) · Internet Journal of Allied Health Sciences and Practice · doi:10.46743/1540-580x/2024.2385 · Cited by 2
“12 This decline might be due in part to the pedagogical approach.”
Background
So meistern Sie schwierige Gesprächssituationen
Klein, F. (2014) · Pädiatrie · doi:10.1007/s15014-014-0468-3 · Cited by 2
Does compassion matter in the fast‐paced environment of emergency medicine?
Scott, J. F. (2021) · Emergency Medicine Australasia · doi:10.1111/1742-6723.13896 · Cited by 2
Injection Drug Users’ Perceptions of Received Nursing Care: A Case Study
Dion, K. A. (2021) · Scholarworks (University of Massachusetts Amherst) · doi:10.7275/6945435.0 · Cited by 2
Empathy: A Vital Sign for the Osteopathic Medical Profession
Calabrese, L. H. (2016) · Journal of Osteopathic Medicine · doi:10.7556/jaoa.2016.125 · Cited by 2
Analyzing The Construct Validity of the Indonesian Basic Empathy Scale using the Rasch modelPreprint
Diswantika, N., Suherman, U., Rusmana, N., Suryana, D., Qurbi, A., & Noor, A. M. (2023) · Research Square · doi:10.21203/rs.3.rs-3364544/v1 · Cited by 2
Correlation Between Attending Physicians’ Empathy and Readmission Rate in Internal Medicine
Bruggi, F., Falaschi, F., Sabatino, A. D., Preti, P., Tinelli, C., Dell'Aera, D., Martignoni, A., & Perlini, S. (2022) · American Journal of Biomedical Science & Research · doi:10.34297/ajbsr.2022.16.002254 · Cited by 1
Use of the arts in pharmacy education to develop self-perceived empathy
Allinson, M., Archer, N., Montero-Diaz, F., Jacklin, S., & Thompson, J. (2023) · Pharmacy Education · doi:10.46542/pe.2023.231.732740 · Cited by 1
Changes in the Affective Empathy of Osteopathic Students: a Longitudinal Study
Newton, B. W., & Vaskalis, Z. T. (2024) · Medical Science Educator · doi:10.1007/s40670-024-02139-0 · Cited by 1
“Patient satisfaction, compliance and outcomes are enhanced [3–9], and if a medical error occurs there is a lesser chance of being sued [10, 11].”
Empathy as a Psychometric Property in Dental Undergraduate Students
Anishchuk, S., & Seery, A. (2024) · International Journal of Dental Hygiene · doi:10.1111/idh.12891 · Cited by 1
A longitudinal curriculum to teach and assess empathy within the doctor of pharmacy curriculum
Munjy, L., Besinque, K., Beuttler, R., Taheri, R., Won, K. J., & Bethishou, L. (2025) · Currents in Pharmacy Teaching and Learning · doi:10.1016/j.cptl.2024.102279 · Cited by 1
Required Art-Based Curriculum Improves Essential Qualities in Medical Students: A Three-Year Study With In-Person and Remote Art Observation Experiences
Kruse, S. W., Getch, S. E., Kumar, A., & Roffler, M. (2025) · Cureus · doi:10.7759/cureus.82022 · Cited by 1
Factors Influencing Emergency Empathy Towards Patients and Their Relatives: A National Survey Study in Türkiye
Vişneci, E. F., & Demirci, O. (2025) · Healthcare · doi:10.3390/healthcare13131559 · Cited by 1
“Similarly, patient satisfaction and clinical outcomes are associated with higher levels of physician empathy [10].”

Authors: Canale, S. D., Louis, D. Z., Maio, V., Wang, X., Rossi, G., Hojat, M., & Gonnella, J. S.
Affiliations: Thomas Jefferson University (US)
Corresponding author: Louis, Daniel Z.
ORCID: Maio, Vittorio
Wang, Xiaohong
Hojat, Mohammadreza
Venue: Academic Medicine
Publisher: Oxford University Press (OUP)
Published: 2012-09
Volume: 87
Issue: 9
Pages: 1243-1249
ISSN: 1040-2446 (ISSN-L)
DOI: 10.1097/acm.0b013e3182628fbf
OpenAlex: W2114067207
Cited by: 512
References: 46
Citations by year: 2026: 9 · 2025: 31 · 2024: 33 · 2023: 38 · 2022: 44 · 2021: 53 · 2020: 46 · 2019: 51 · 2018: 45 · 2017: 34 · 2016: 47 · 2015: 25 · 2014: 31 · 2013: 21 · 2012: 1
FWCI: 17.76
Type: journal article
Language: en
Open access: closed
Locations: Academic Medicine (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Empathy and Medical Education
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
Keywords: physician empathy, diabetes mellitus, diabetic ketoacidosis, hyperosmolar hyperglycemic state, diabetic coma, Jefferson Scale of Physician Empathy, clinical outcomes, primary care physicians, elderly patients, clinical competence
MeSH terms: Age Factors, Aged, Diabetes Mellitus, Empathy, Female, Hospitalization, Humans, Italy, Male, Physician-Patient Relations, Retrospective Studies, Logistic Models, Diabetes Complications, Physicians, Primary Care

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The Relationship Between Physician Empathy and Disease Complications: An Empirical Study of Primary Care Physicians and Their Diabetic Patients in Parma, Italy

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