General practitioners’ patient-centredness and responses to patients’ emotional cues and concerns: relationships with perceived empathy in areas of high and low socioeconomic deprivation

Jenna-Marie Lundy,Graham C Watt,Maria Higgins,Annemieke Bikker,Paul Little,Gerry M Humphries,Stewart W Mercer

doi:10.1186/s40639-015-0011-6

Jenna-Marie Lundy, Graham C Watt + Show 5 more

Open Access

https://doi.org/10.1186/s40639-015-0011-6

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Abstract

Physician empathy is important to patients across the socio-economic spectrum. However, whether socioeconomic status (SES) influences how patients’ judge physician empathy is not known. We investigated how patients’ perceptions of their general practitioners’ (GPs) empathy related to objectively measured patient-centeredness of the GPs and their detection and response to emotional cues. Secondary analysis of 112 videoed consultations of 8 GPs with the high and low empathy scores as rated by patients using the Consultation and Relational Empathy (CARE) Measure working in high or low deprivation settings in Scotland. Objective assessment involved the Measure of Patient-Centredness (MPCC) which has 3 components (exploring disease and illness experience, understanding the whole person, and finding common ground) and the Verona coding system (which measures emotional cues, concerns and responses). GPs rated by patients as being empathic were more patient-centred overall than those rated as less empathic, in both high (p = 0.03) and low deprivation areas (p = 0.05). In high deprivation areas, perceived empathy was related to finding common ground (p = 0.02) whereas in low deprivation areas it was related to understanding the whole person (p= 0.01). In high deprivation areas, empathic GPs also had significantly different responses to emotional cues and concerns than GPs perceived as having low empathy. Socioeconomic status appears to affect how patients judge practitioner empathy. This study emphasises the importance of finding common ground and detecting and responding actively to emotional cues in consultations in high deprivation areas. Further research on a larger sample is warranted.

Highlights

Physician empathy is important to patients across the socio-economic spectrum
Patient and consultations characteristics Patients in the high and low general practitioners’ (GPs) empathy (CARE measure) groups showed no significant difference in the mean ages in the low deprivation group but in the high deprivation group the mean age of patients in the low Consultation and Relational Empathy (CARE) group was significantly lower than in the high CARE group (Table 1)
Component 3, was significantly higher in the high empathy GPs in the deprived areas compared with low empathy GPs, but this was not found in the affluent areas (Table 2)

Summary

Introduction

Physician empathy is important to patients across the socio-economic spectrum. whether socioeconomic status (SES) influences how patients’ judge physician empathy is not known. Empathy is widely regarded as a crucial attribute of healthcare professionals, and research has shown the importance of empathy in general practice consultations in achieving higher patient satisfaction, enablement, and improvement in some health outcomes [1,2,3,4,5]. The Consultation and Relational Empathy (CARE) Measure is one widely used measure which was developed and validated in general practice in areas of both high and low socioeconomic deprivation [8,9]. Such an inclusive approach is important given the wide differences in health and healthcare needs that exist between affluent and poor areas [10]. Because general practitioners (GPs) are not distributed in the UK according to population need, GPs working in deprived areas face higher demands, and more stress [11]

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