Study: VA Doctors Offer Veteran Patients Scant Empathy During Exams


September 22, 2008 – During an appointment with his doctor, a man diagnosed with lung cancer sounded dispirited when talking about what cigarettes had done to him.

“I was always told I had a good strong heart and lungs. But the lungs couldn’t withstand all (those) cigarettes … asbestos and pollution and second-hand smoke and all these other things, I guess,” the man told his doctor.

“Do you have glaucoma?” the doctor responded, abruptly changing the subject.

U.S. researchers who assessed interactions between a small group of people with lung cancer and their doctors found physicians provided little emotional support even when patients seemed to be searching for it.

When patients made comments on topics like the personal impact of cancer, their diagnosis and treatment and struggles with the health care system, doctors responded with words of empathy only 10 percent of the time, the researchers said.

This was a small study — appointments between doctors and 10 patients at a Veterans Affairs hospital in Houston were audiotaped and analyzed for whether the physicians provided empathy for the plight of these people with a deadly illness.

But Dr. Diane Morse of the University of Rochester Medical Center in Rochester, New York said the findings reinforce other research showing doctors fall short in the simple act of acknowledging the emotional difficulties of their patients’ predicament.

“When doctors do provide empathy, it doesn’t make the interaction take longer. All that we’re asking physicians to think about doing is to acknowledge what they hear,” Morse, whose findings appear in the journal Archives of Internal Medicine, said in a telephone interview. 

She said words of empathy can be succinct and spoken early in an appointment. In answering how long a patient has left to live, a doctor might say “that’s a really scary question” and acknowledge the patient’s misfortune.

Few studies have involved a word-by-word analysis of doctor-patient meetings to assess how doctors respond to patients’ worries about their own mortality, possible mistrust of medical care and the emotions arising from a deadly diagnosis.

In this study, the doctors and patients knew the sessions were being recorded. They were not identified by name.

Researchers identified 384 times during these appointments when patients mentioned such concerns or emotions. Doctors responded with empathy in just 39 of these instances, they said.

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