Do patient attributes predict oncologist empathic responses and patient perceptions of empathy?
OBJECTIVE
Most patients with advanced cancer experience negative emotion. When patients express emotions, oncologists rarely respond empathically. Oncologists may respond more empathically to some patients, and patients may perceive different levels of empathy and trust given past documentation of disparities in cancer care.


METHODS
We audio-recorded 264 outpatient encounters between oncologists and patients with advanced cancer at three sites. We examined whether patient gender, age, race, marital status, education, economic security, and length of relationship with oncologist were related to oncologist empathic responses to patient's negative emotion and patient's perceptions of oncologist empathy and trust.


RESULTS
Half (51%) of the patients expressed a negative emotion. Oncologists sometimes responded with empathy (29%). Oncologists were equally empathic with all patients, except they were more empathic with patients with low economic security compared with those reporting high economic security (p = .002). Patients with low economic security viewed oncologists as more empathic (p = .06) compared with those with moderate security. Married patients also viewed oncologists as more empathic (p = .04). Patients who knew their oncologist for more than a year had more trust than patients who knew their oncologists for less time (p = .02).


CONCLUSIONS
Oncologists, in general, did not respond empathically to patient's negative emotion, and did this equally for most patients. Oncologists responded more empathically to patients who were less economically advantaged. In turn, patients with lower economic security perceived more empathy. Although oncologists need more education in responding empathically, they may not need to correct many biases in care.
Duke Comprehensive Cancer Center, Cancer Prevention, Detection and Control Research Program, Duke University School of Medicine, Durham, USA. kathryn.pollak@duke.edu
Kathryn I
KI
Pollak
Robert
R
Arnold
Stewart C
SC
Alexander
Amy S
AS
Jeffreys
Maren K
MK
Olsen
Amy P
AP
Abernethy
Keri L
KL
Rodriguez
James A
JA
Tulsky
D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D004644:Emotions; D004645:Empathy; D005260:Female; D006801:Humans; D008297:Male; D017533:Marital Status; D008495:Medical Oncology / Q000379:methods; D008875:Middle Aged; D009369:Neoplasms / Q000473:pathology / Q000523:psychology*; D010465:Perception; D010817:Physician-Patient Relations; D012959:Socioeconomic Factors; D013637:Tape Recording; D013997:Time Factors