Sympathy, empathy, and physician resource utilization

Abstract

Objective: To test the hypothesis that physicians preferring a sympathetic over an empathetic response to a hypothetical patient’s misfortune will utilize more health care resources in the care of their patients. Design: Physicians were asked to select either the sympathetic response or the empathetic response to a hypothetical patient’s misfortune (death of a spouse) and to state their preferences for intubation of a hypothetical end-stage lung-disease patient. For each physician, hospital records were retrospectively reviewed to assess the mean number of laboratory tests ordered per clinic patient and the mean duration of cardiopulmonary resuscitations he or she performed before declaring his or her efforts unsuccessful. Setting: General medicine clinic at a large urban hospital. Participants: 101 physicians above the postgraduate year-1 level who attended the general medicine clinic. Measurements and main results: As hypothesized, physicians selecting the sympathetic option (n= 58) had a greater mean preference for intubation (p<0.02), ordered more laboratory tests per patient in clinic (p<0.03), and performed cardiopulmonary resuscitation for longer periods of time before declaring their efforts unsuccessful (p<0.06) than did physicians selecting the empathetic option (n= 38). Conclusions: These data suggest that the constructs of sympathy and empathy reflect psychological aspects of physicians that have a measurable influence on their practice behaviors. © 1991, Society of General Internal Medicine. All rights reserved.