The DOI matches its Crossref record; 46 of the 46 references it cites were found in a registry or an index.
The Relationship Between Physician Empathy and Disease Complications: An Empirical Study of Primary Care Physicians and Their Diabetic Patients in Parma, Italy
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.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“Empathy skills of healthcare providers have been shown to positively influence patient outcomes.38”
From Artificial intelligence: opportunities and implications for the health workforce (2020) · cites this paper as [38]
Citations
Cites
How does communication heal? Pathways linking clinician–patient communication to health outcomes
Street, R. L., Makoul, G. T., Arora, N. K., & Epstein, R. M. (2009) · Patient Education and Counseling · doi:10.1016/j.pec.2008.11.015 · Cited by 2,702
Levinson, W. S. (1997) · JAMA · doi:10.1001/jama.277.7.553 · Cited by 1,794
Physician Empathy: Definition, Components, Measurement, and Relationship to Gender and Specialty
Hojat, M., Gonnella, J. S., Nasca, T. J., Mangione, S., Vergare, M. J., & Magee, M. M. (2002) · American Journal of Psychiatry · doi:10.1176/appi.ajp.159.9.1563 · Cited by 1,318
Physiciansʼ Empathy and Clinical Outcomes for Diabetic Patients
Hojat, M., Louis, D. Z., Markham, F. W., Wender, R. C., Rabinowitz, C., & Gonnella, J. S. (2011) · Academic Medicine · doi:10.1097/acm.0b013e3182086fe1 · Cited by 1,253
Psychotherapy relationships that work : therapist contributions and responsiveness to patients
Norcross, J. C. (2002) · Cited by 1,197
The Effects of Physician Empathy on Patient Satisfaction and Compliance
Kim, S. S., Kaplowitz, S., & Johnston, M. V. (2004) · Evaluation & the Health Professions · doi:10.1177/0163278704267037 · Cited by 1,063
The Jefferson Scale of Physician Empathy: Development and Preliminary Psychometric Data
Hojat, M., Mangione, S., Nasca, T. J., Cohen, M. J. M., Gonnella, J. S., Erdmann, J. B., Veloski, J. J., & Magee, M. (2001) · Educational and Psychological Measurement · doi:10.1177/00131640121971158 · Cited by 1,052
Association of resident fatigue and distress with perceived medical errors
West, C. P. (2009) · JAMA · doi:10.1001/jama.2009.1389 · Cited by 999
Effectiveness of Interventions to Improve Patient Compliance
ROTER, D. L., Hall, J. A., Merisca, R., Nordstrom, B. L., Cretin, D., & Svarstad, B. L. (1998) · Medical Care · doi:10.1097/00005650-199808000-00004 · Cited by 998
Dimatteo, M., Sherbourne, C., Hays, R., Ordway, L., Kravitz, R., McGlynn, E., Kaplan, S., & Rogers, W. (1993) · Health Psychology · doi:10.1037/0278-6133.12.2.93 · Cited by 867
The Doctor-Patient Relationship and Malpractice
Beckman, H. (1994) · Archives of Internal Medicine · doi:10.1001/archinte.1994.00420120093010 · Cited by 762
Empathy in medical students as related to academic performance, clinical competence and gender
Hojat, M., Gonnella, J. S., Mangione, S., Nasca, T. J., Veloski, J. J., Erdmann, J. B., Callahan, C. A., & Magee, M. M. (2002) · Medical Education · doi:10.1046/j.1365-2923.2002.01234.x · Cited by 671
Zachariae, R., Pedersen, C. G., Jensen, A. B., Ehrnrooth, E., Rossen, P. B., & von der Maase, H. (2003) · British Journal of Cancer · doi:10.1038/sj.bjc.6600798 · Cited by 601
de Belvis, A. G., Meregaglia, M., Morsella, A., Adduci, A., Perilli, A., Cascini, F., Solipaca, A., Fattore, G., Ricciardi, W., Maresso, A., et al. (2014) · PubMed · Cited by 462
The Jefferson Scale of Physician Empathy
Hojat, M., Gonnella, J. S., Nasca, T. J., Mangione, S., Veloski, J. J., & Magee, M. M. (2002) · Academic Medicine · doi:10.1097/00001888-200210001-00019 · Cited by 426
Empathy in patient care: antecedents, development, measurement, and outcomes
(2007) · Choice Reviews Online · doi:10.5860/choice.44-5086 · Cited by 419
Kataoka, H. U., Koide, N., Ochi, K., Hojat, M., & Gonnella, J. S. (2009) · Academic Medicine · doi:10.1097/acm.0b013e3181b180d4 · Cited by 381
Wensing, M., Jung, H. P., Mainz, J., Olesen, F., & Grol, R. P. T. M. (1998) · Social Science & Medicine · doi:10.1016/s0277-9536(98)00222-6 · Cited by 369
The Italian health-care system
France, G., Taroni, F., & Donatini, A. (2005) · Health Economics · doi:10.1002/hec.1035 · Cited by 327
Staging of disease. A case-mix measurement
Gonnella, J. S. (1984) · JAMA · doi:10.1001/jama.251.5.637 · Cited by 319
Squier, R. W. (1990) · Social Science & Medicine · doi:10.1016/0277-9536(90)90188-x · Cited by 305
Measurement of Changes in Empathy During Dental School
Sherman, J. J., & Cramer, A. P. (2005) · Journal of Dental Education · doi:10.1002/j.0022-0337.2005.69.3.tb03920.x · Cited by 269
Hidden Reasons Some Patients Visit Doctors
BARSKY, A. J. (1981) · Annals of Internal Medicine · doi:10.7326/0003-4819-94-4-492 · Cited by 240
Practitioner empathy and the duration of the common cold.
Rakel, D. P., Hoeft, T. J., Barrett, B. P., Chewning, B. A., Craig, B. M., & Niu, M. Y. (2009) · PubMed · Cited by 224
Gonnella, J. S. (1984) · JAMA · doi:10.1001/jama.1984.03340290051021 · Cited by 222
'Adherence' and the Negotiated Approach to Patienthood
Eisenthal, S. (1979) · Archives of General Psychiatry · doi:10.1001/archpsyc.1979.01780040035003 · Cited by 211
Reliability and Validity of the Jefferson Scale of Empathy in Undergraduate Nursing Students
Ward, J., Schaal, M., Sullivan, J., Bowen, M. E., Erdmann, J. B., & Hojat, M. (2009) · Journal of Nursing Measurement · doi:10.1891/1061-3749.17.1.73 · Cited by 186
Hojat, M., Mangione, S., Nasca, T. J., Gonnella, J. S., & Magee, M. (2005) · The Journal of Social Psychology · doi:10.3200/socp.145.6.663-672 · Cited by 182
Lillo, M. D., Cicchetti, A., Scalzo, A. L., Taroni, F., & Hojat, M. (2009) · Academic Medicine · doi:10.1097/acm.0b013e3181b17b3f · Cited by 175
Roh, M., Hahm, B., Lee, D. H., & Suh, D. H. (2010) · Teaching and Learning in Medicine · doi:10.1080/10401334.2010.488191 · Cited by 167
Carmel, S., & Glick, S. M. (1996) · Social Science & Medicine · doi:10.1016/0277-9536(95)00445-9 · Cited by 111
Greenberg, L. S., Elliott, R., Watson, J. C., & Bohart, A. C. (2001) · Psychotherapy: Theory, Research, Practice, Training · doi:10.1037/0033-3204.38.4.380 · Cited by 106
Association of Resident Fatigue and Distress With Perceived Medical Errors
West, C. P., Tan, A. D., Habermann, T. M., Sloan, J. A., & Shanafelt, T. D. (2010) · Obstetric Anesthesia Digest · doi:10.1097/01.aoa.0000389590.11106.13 · Cited by 96
Assessment of Empathy in a Standardized-Patient Examination
Colliver, J. A., Willis, M. S., ROBBS, R. S., Cohen, D., & Swartz, M. H. (1998) · Teaching and Learning in Medicine · doi:10.1207/s15328015tlm1001_2 · Cited by 93
Potentially Inappropriate Medication Prescribing for Elderly Outpatients in Emilia Romagna, Italy
Maio, V., Yuen, E. J., Novielli, K. D., Smith, K. D., & Louis, D. Z. (2006) · Drugs & Aging · doi:10.2165/00002512-200623110-00006 · Cited by 80
Using pharmacy data to identify those with chronic conditions in Emilia Romagna, Italy
Maio, V., Yuen, E. J., Rabinowitz, C., Louis, D. Z., Jimbo, M., Donatini, A., Mall, S., & Taroni, F. (2005) · Journal of Health Services Research & Policy · doi:10.1258/135581905774414259 · Cited by 73
Petronis, V. M., Carver, C. S., Antoni, M. H., & Weiss, S. M. (2003) · Psychology and Health · doi:10.1080/0887044021000020941 · Cited by 71
Goodchild, C. E., Skinner, T. C., & Parkin, T. (2005) · Journal of Human Nutrition and Dietetics · doi:10.1111/j.1365-277x.2005.00606.x · Cited by 62
Determinants of patient satisfaction with the medical consultation
Kenny, D. (1995) · Psychology and Health · doi:10.1080/08870449508401961 · Cited by 56
Association between patients’ recommendation of their GP and their evaluation of the GP
Vedsted, P., & Heje, H. N. (2008) · Scandinavian Journal of Primary Health Care · doi:10.1080/02813430802294886 · Cited by 51
Sultan, S., Attali, C., Gilberg, S., Zenasni, F., & Hartemann, A. (2011) · Psychology and Health · doi:10.1080/08870441003703226 · Cited by 40
Relationships among therapist empathy and authoritarianism and a therapist's prognosis.
Dubnicki, C. (1977) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.45.5.958 · Cited by 18
Beta-blocker initiation and adherence after hospitalization for acute myocardial infarction
Maio, V., Marino, M., Robeson, M., & Gagne, J. J. (2011) · European Journal of Cardiovascular Prevention & Rehabilitation · doi:10.1177/1741826710389401 · Cited by 17
Relationships among therapist empathy and authoritarianism and a therapist's prognosis.
Dubnicki, C. (1977) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.45.5.958 · Cited by 16
Increasing appropriateness of hospital admissions in the Emilia-Romagna region of Italy
Louis, D. Z., Taroni, F., Melotti, R. M., Rabinowitz, C., Vizioli, M. G., Fiorini, M., & Gonnella, J. S. (2008) · Journal of Health Services Research & Policy · doi:10.1258/jhsrp.2008.007157 · Cited by 13
Louis, D. Z., Yuen, E. J., Maio, V., Rabinowitz, C., Robeson, M., Smith, K. D., & Gonnella, J. S. (2005) · The Medicine Forum · Cited by 12
Flagged first, then by citations
Research works printed but not linked: 6
- Levinson, 1997, JAMA, 277, 553, 10.1001/jama.1997.03540310051034 · DOI
- Sultan, 2011, Psychol Health, 18, 1
- Lo Scalzo, 2009, Health Syst Transit, 11:, 1
- Louis, 2005, Health Policy Newsletter, 18(2), 6
- Alcorta-Garza, 2005, Salud Ment (Mex, 28, 57
- Rakel, 2009, Fam Med, 41, 494
Cited by
Sorted by citations
How phenomenology can help us learn from the experiences of others
Neubauer, B. E., Witkop, C. T., & Varpio, L. (2019) · Perspectives on Medical Education · doi:10.1007/s40037-019-0509-2 · Cited by 2,097
Digital health is a cultural transformation of traditional healthcare
Meskó, B., Drobni, Z. D., Bényei, É., Gergely, B., & Győrffy, Z. (2017) · mHealth · doi:10.21037/mhealth.2017.08.07 · Cited by 734
“The well-functioning patient-physician relationship is still an essential part of healing: a decisive study revealed that the empathy skills of physicians can influence diabetic patients’ objective laboratory parameters, development of complications and subjective well-being (44).”
BackgroundThe Role of Empathy in Health and Social Care Professionals
Moudatsou, M., Stavropoulou, A., Philalithis, A., & Koukouli, S. (2020) · Healthcare · doi:10.3390/healthcare8010026 · Cited by 645
Pfattheicher, S., Nockur, L., BOHM, R. M., Sassenrath, C., & Petersen, M. B. (2020) · Psychological Science · doi:10.1177/0956797620964422 · Cited by 576
Han, E.-R., Yeo, S., Kim, M.-J., Lee, Y.-H., Park, K.-H., & Roh, H. (2019) · BMC Medical Education · doi:10.1186/s12909-019-1891-5 · Cited by 393
Metadata
- 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.
- Venue
- Academic Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 2012-09
- Volume
- 87
- Issue
- 9
- Pages
- 1243-1249
- ISSN
- 1040-2446 (ISSN-L)
- 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
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review