What makes an interaction with your doctor helpful to you? What inspires you to follow through with what she or he recommends? Is it the information or the prescription given to you, or the way you’re treated?
As a practicing psychiatrist, I have a unique window into patients’ perceptions of their medical and surgical visits. I often see patients express immense gratitude for a caring physician who conveyed genuine concern about their illness or injury.
But I also hear about interactions that have caused patients to feel unheard, dismissed, or treated like a number on an assembly line. These types of interactions have lasting and devastating effects, sometimes leading patients to stop adhering to treatments. Yet our medical colleagues rarely get the honest feedback that could move things in a more positive direction.
That’s why my team and I founded the Empathy and Relational Science Research Program. For almost a decade, we’ve been researching how empathic skills can be taught, how to implement them in culturally appropriate ways, and how they might improve medical care. Our mission is to ensure that practicing clinicians, health care workers, and physicians-in-training are using their hardwired neurobiological abilities to create heartfelt connections with their patients.
Studies have shown that when physicians behave empathically, patients are more satisfied, trust them more, adhere better to treatment recommendations, file fewer malpractice claims, and end up healthier. Meanwhile, the physicians make fewer medical errors and have higher job satisfaction—all positives, for sure.
But could there be any downsides to physician empathy? Is there a “warmth-competence tradeoff” in medical contexts, where doctors who are warm and empathic could be perceived as less competent by patients?
Does empathy undermine credibility?
This is not an idle question. Based on Susan Fiske’s and others’ research, a warmth-competence tradeoff has been observed in other professional settings. To investigate this issue in a medical context, we designed a research project to gauge how patients perceive empathic physicians.
The study involved volunteer participants who were told to imagine themselves as patients receiving some bad news: The treatment for their disease had failed and they needed surgery. Approximately half of the participants were randomly assigned to receive this news while looking at still photos of a physician displaying “nonverbal empathy”: seated at eye level with good eye contact, no desk or computer screen between them, open body posture, and a warm facial expression. The other half observed the physician displaying “non-empathic nonverbal behaviors”: standing up with little eye contact, a computer or a desk between them, crossed arms, and a neutral facial expression. Participants only saw one of the two images, so they couldn’t make comparisons.
Afterwards, they were asked to rate the physician on perceived warmth (how tolerant, sincere, and good-natured they were) and competence (how intelligent and confident). Results showed that the physicians who displayed nonverbal empathy were judged to be both warmer and more competent than the non-empathic physicians. A participant’s mood had no effect on these results.
Interestingly, whether or not the physician in the photos wore a white coat—a traditional symbol of professionalism—had no impact on perceived competence. This suggests that improving patient-health provider relations will take a bit more effort than just donning a certain uniform.
The case for empathic leaders
By demonstrating that nonverbal empathy improves ratings of physician warmth and competence, we show that there is no tradeoff when physicians use their empathy skills with patients. This suggests that education in empathy would be an important addition to their training, and, luckily, prior research suggests empathy skills can indeed be taught.
Medicine has a long tradition of promoting physicians as authority figures whose expertise cannot be challenged and whose warmth, if it exists, is merely a bonus. But today’s patients are more informed than ever before—with vast amounts of information readily available to them on the Internet—and they expect more from health care providers. Interpersonal skills have become a crucial factor in providing quality care.
Our research dovetails with the work of other social scientists who’ve found that strong interpersonal skills like empathy are highly valued in many professions. For example, business leaders are now expected to have emotional intelligence skills, because these are tied to better work morale, retention, and overall well-being in organizations. Our work helps support the theory, now increasingly accepted in the business world, that emotional intelligence and empathy (one of its key subcomponents) generally go hand in hand with competence.
We need only look at recent news events to see how this plays out in real life. After President Trump first visited Texas in the wake of the devastation wrought by Hurricane Harvey, there was public outcry over his perceived lack of empathy regarding the victims and their families. The fact that he did not set foot in the flooded areas, nor meet with any of the victims, look them in the eye, or give them a hug, was seen as a colossal failure of empathy. And this perceived lack of empathy led to decreases in approval ratings and comments on television that he is “unfit” for the office.
The above is just one of countless examples showing that people expect empathy from their leaders and are bitterly disappointed when it is lacking. Whether we are doctors, teachers, business executives, or the leader of the free world, displaying empathy clearly helps to make our society a warmer, more compassionate place.
And it may boost our credibility, as well.