Improving perceptions of empathy in patients undergoing low-yield computerized tomographic imaging in the emergency department. Issue 4 (April 2018) - Lin, Michelle P.
Highlights: Patient perceptions of physician empathy may affect imaging rates but are unknown. A majority of ED patients value phrases to enhance physician empathy. Phrases conveying reassurance, medical knowledge and risks of testing are preferred. Further study of phrases to enhance empathy and effect on imaging rates is needed. Abstract: Objective: We assessed emergency department (ED) patient perceptions of how physicians can improve their language to determine patient preferences for 11 phrases to enhance physician empathy toward the goal of reducing low-value advanced imaging. Methods: Multi-center survey study of low-risk ED patients undergoing computerized tomography (CT) scanning. Results: We enroled 305 participants across nine sites. The statement "I have carefully considered what you told me about what brought you here today" was most frequently rated as important (88%). The statement "I have thought about the cost of your medical care to you today" was least frequently rated as important (59%). Participants preferred statements indicating physicians had considered their "vital signs and physical examination" (86%), "past medical history" (84%), and "what prior research tells me about your condition" (79%). Participants also valued statements conveying risks of testing, including potential kidney injury (78%) and radiation (77%). Conclusion: The majority of phrases were identified as important. Participants preferred statements conveying cognitive reassurance, medical knowledge and risks of testing. Practice implications: Our findings suggest specific phrases have the potential to enhance ED patient perceptions of physician empathy. Further research is needed to determine whether statements to convey empathy affect diagnostic testing rates.