Missed Empathic Opportunities During Hand Surgery Office Visits.
Bastiaan T van HoornMariano E MenendezMichael MackertErin E DonovanMark van HeijlTom Joris CrijnsPublished in: Hand (New York, N.Y.) (2019)
Background: Empathy (conveyance of an understanding of a patient's situation, perspective, and feelings) deepens the therapeutic alliance and leads to better health outcomes. We studied the frequency and nature of empathic opportunities and physician responses in patients visiting a hand surgeon. We also sought patient characteristics associated with the number of patient-initiated-clues and missed opportunities by surgeons. Methods: For this prospective cohort study, we enrolled 83 new, adult patients visiting 1 of 3 hand surgeons during a period of 4 months. All visits were audio-recorded, and empathic opportunities (patient-initiated emotional or social clues) and physician responses were categorized using the model of Levenson et al. Before the visit, patients completed the Newest Vital Sign health literacy test; 3 Patient-Reported Outcomes Measurement Information System-based questionnaires: Upper-Extremity function, Pain Interference, and Depression questionnaires; and a sociodemographic survey. Results: Empathic opportunities were present in 70% of hand surgery office visits. Surgeons responded empathically to about half of the opportunities. Patients with limited health literacy and greater symptoms of depression (small correlation; r = -0.29) were less likely to receive a positive response. Response to an empathic opportunity did not affect visit duration. Conclusions: Hand surgeons often miss empathic opportunities. Future research might address the influence of training physicians to address empathic opportunities on trust, adherence, satisfaction, and outcomes.
Keyphrases
- patient reported outcomes
- end stage renal disease
- primary care
- newly diagnosed
- case report
- ejection fraction
- quality improvement
- emergency department
- minimally invasive
- health information
- chronic kidney disease
- depressive symptoms
- prognostic factors
- chronic pain
- type diabetes
- peritoneal dialysis
- sleep quality
- acute coronary syndrome
- adipose tissue
- physical activity
- atrial fibrillation