title: Does emergency physician empathy reduce thoughts of litigation? A randomised trial.
abstract: BACKGROUND
  We hypothesised the addition of brief empathetic statements to physician-patient interaction might decrease thoughts regarding litigation.
  
  
  METHODS
  We enrolled a convenience sample of adults in our emergency department (ED) waiting room into a randomised, double-blind controlled trial. Subjects watched videos of simulated discharge conversations between physicians and patient actors; half of the videos differed only by the inclusion of two brief empathetic statements: verbalisations that (1) the physician recognises that the patient is concerned about their symptoms and (2) the patient knows their typical state of health better than a physician seeing them for the first time and did the right thing by seeking evaluation. After watching the video subjects were asked to score a five-point Likert scale their thoughts regarding suing this physician in the event of a missed outcome leading to lost work (primary outcome), and four measures of satisfaction with the physician encounter (secondary outcomes).
  
  
  RESULTS
  We enrolled and randomised 437 subjects. 213 in the empathy group and 208 in the non-empathy group completed the trial. Sixteen subjects did not complete the trial due to computer malfunction or incomplete data sheets. Empathy group subjects reported statistically significant less thoughts of litigation than the non-empathy group (mean Likert scale 2.66 vs 2.95, difference -0.29, 95% CI -0.04 to -0.54, p=0.0176). All four secondary measures of satisfaction with the physician encounter were better in the empathy group.
  
  
  CONCLUSIONS
  In this study, the addition of brief empathetic statements to ED discharge scenarios was associated with a statistically significant reduction in thoughts regarding litigation.
  
  
  BACKGROUND
  NCT01837706.
authors.affiliation: Department of Emergency Medicine, Loma Linda University Medical Center and Children's Hospital, Loma Linda, California, USA.
authors.forename: Dustin D
authors.initials: DD
authors.lastname: Smith
authors.affiliation: Department of Emergency Medicine, Loma Linda University Medical Center and Children's Hospital, Loma Linda, California, USA Department of Emergency Medicine, Lakeland Health, St Joseph, Michigan, USA.
authors.forename: Jesse
authors.initials: J
authors.lastname: Kellar
authors.affiliation: Department of Emergency Medicine, Loma Linda University Medical Center and Children's Hospital, Loma Linda, California, USA.
authors.forename: Elizabeth L
authors.initials: EL
authors.lastname: Walters
authors.affiliation: Department of Emergency Medicine, Loma Linda University Medical Center and Children's Hospital, Loma Linda, California, USA.
authors.forename: Ellen T
authors.initials: ET
authors.lastname: Reibling
authors.affiliation: Department of Emergency Medicine, Loma Linda University Medical Center and Children's Hospital, Loma Linda, California, USA.
authors.forename: Tammy
authors.initials: T
authors.lastname: Phan
authors.affiliation: Department of Emergency Medicine, Loma Linda University Medical Center and Children's Hospital, Loma Linda, California, USA.
authors.forename: Steven M
authors.initials: SM
authors.lastname: Green
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004311:Double-Blind Method; D004636:Emergency Service, Hospital; D004645:Empathy; D005260:Female; D006801:Humans; D007603:Jurisprudence; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010361:Patients / Q000523:psychology*; D010817:Physician-Patient Relations; D011446:Prospective Studies; D014741:Video Recording
keywords: interpersonal; law; medico-legal; risk management