Mohammadreza Hojat, PhD, on the Importance of Physician Empathy

Dr. Mohammadreza Hojat, a research professor in the Department of Psychiatry and Human Behavior and Thomas Jefferson University, talks with DocWire News about a nationwide study he conducted regarding empathy in medical students.

5 questions: How doctors’ empathy improves patient care
by Sandy Bauers, October 10, 2019

"The difference is empathy, and researchers such as Thomas Jefferson University’s Mohammadreza Hojat, a research professor of psychiatry and human behavior in the Center for Research in Medical Education & Health Care, are gaining a new understanding of how important it can be, and how to measure it. He spoke to us recently about empathy."

"The concept of empathy is a bit vague. Different researchers offer different definitions. But in the context of patient care, we define empathy as a personality attribute that involves three concepts. One involves understanding of a patient’s experiences, concerns, and suffering. Second is the ability to communicate this understanding. And third, the intention to help."

Researchers suggest empathy be a factor in medical school admissions
by American Osteopathic Association
JULY 25, 2019
"The study gauged empathy levels of 16,149 new matriculants and first- through fourth-year medical students, establishing a set of national norms, which serve as a bench mark for assessing future applicants' suitability to the profession. Researchers say the national norms can help to distinguish between two applicants with similar academic qualifications, and identify students who might need additional educational remedies to bolster their level of empathy.  "Testing for empathy should not replace the traditional admissions process," says Mohammedreza Hojat, Ph.D., a research professor of psychiatry and human behavior at Sidney Kimmel Medical College of Thomas Jefferson University and lead author on this study."
 

Dispelling the Myth of Empathy in Patient Care  Apr 18, 2014 by Mohammadreza Hojat
"Empathy in patient care would be a myth if it could not be operationally defined, if it could not be quantitatively measured, if it could not be taught, and if it could not predict clinical outcomes. In this blog I provide evidence to dispel the myth.
Definition: Empathic engagement is the pillar of the patient-doctor relationship, which is not only beneficial to the patient, but also to the doctor."
 

Empathy in Patient Care -Antecedents, Developments, Measurement, and Outcomes.
"Dr. Hojat's comprehensive survey of empathy in medicine is subtitled "Antecedents, Developments, Measurement, and Outcomes." He begins by carefully distinguishing empathy from related concepts or qualities, like sympathy and compassion; and by clarifying the cognitive, as opposed to affective, nature of empathy. Essentially, empathy creates our sense of connectedness with other human beings and, to a limited extent, with some animals. After sketching its evolutionaly and neurological substrates, Hojat then summarizes research in measuring empathy, with particular emphasis on empathy in the clinical setting."

AAMC Reporter_June 2012:
https://www.aamc.org/newsroom/reporter/june2012/285314/viewpoint.html

Academic Medicine, September 2012:
http://journals.lww.com/academicmedicine/Fulltext/2012/09000/The_Relationship_Between_Physician_Empathy_and.26.aspx
 

2009-01-22 - Ten approaches for enhancing empathy in health and human services cultures.

• Improving Interpersonal Skills:

• Audio- or Video-Taping of Encounters with Patients:

• Exposure to Role Models:

• Role Playing (Aging Games):

• Shadowing a Patient (Patient Navigator):

• Hospitalization Experiences:

• The Study of Literature and the Arts:

• Improving Narrative Skills:

• Theatrical Performances:

• Balint Method:

"Empathy has been considered as far too important to be taught only to health professionals (Ivey, 1971; 1974). Others have suggested that the capacity for empathy in people in general can serve as a foundation for building interpersonal relationships that have a buffering effect against stress and can be an essential step in conflict resolution (Kremer & Dietzen, 1991). As the author has noted "empathy can be viewed as a remedy for the psyche and soul of human kind...And may be it can serve as a means of achieving a global peace here, there, everywhere on earth." (Hojat, 2007, p. 214).

To enhance empathic understanding in health and human services, we need not only a broad reform in the health and human services education at undergraduate and graduate levels, but also in training the hospital staff, staff of the assisted-living environment, as well as health services administrators and executives. Clinical and organizational managers in health care institutions and human services organizations should develop well-designed and effective institutional-wide programs to retain, cultivate, and enhance a culture of empathic understanding based on approaches described in this article and other innovative approaches."

Video Clips

Office Interview 1 – “Professionalism in Medicine”
Office Interview 2 – “The Science and the Art of Medicine”

Television Interview 1 – “Teaching Empathy to Medical Students”
Television Interview 2 – “Medical Student’s Perspective on Learning Empathy”

Physician Empathy PowerPoint Presentation

Dawn Episode 127 - Seg #2 PATIENT EMPATHY

Show Description: Dawn is joined by Thomas Jefferson University Hospital to learn just how
important empathy is in the doctor-patient relationship.
Guest: Mohammadrezqa Hojat, Ph.D., Professor in the Department of Psychiatry & Human Behavior and
 Jesse Edwards, Medical Student at Thomas Jefferson University

Dawn Episode 127 - Seg #3/4 Close PATIENT EMPATHY

2012-03-14 - Medical students show gains in empathy are short-lived after training
"An exercise on the challenges of aging helps students feel more compassion for patients, but researchers say repetition is needed for lasting results.
 The link of outcomes and empathy
Previous research has shown a positive relationship between physician empathy and patient outcomes. In a March 2011 Academic Medicine study, Hojat and his colleagues found that physicians with high empathy had patients with significantly greater control over their diabetes than patients of physicians with low empathy"
 

2012-03-14 - Jefferson researcher seeks ways to make doctors more empathetic
"Mohammadreza Hojat is trying to figure out how to make doctors more empathetic.

 His study, published in this month's American Journal of Pharmaceutical Education, found that medical students who watched a skit about a senior citizen's introduction to an assisted-living facility became more empathetic, but it didn't last. His most recent work, not yet published, looks more promising. In that one, he combined discussions of short film clips with lessons on why empathy matters."

Alliance 2012: Physician Empathy Presentation Slide show and video

2012-02-24 - Workshop increases pharmacy and medical students' empathy
One year ago, a landmark study led by Mohammadreza Hojat, Ph.D., research professor, Department of Psychiatry and Human Behavior at Thomas Jefferson University, quantified a relationship between physicians' empathy and their patients' positive clinical outcomes, suggesting that a physician's empathy is an important factor associated with clinical competence. The study was published in the journal Academic Medicine .
 

2012-02-24 - Empathy Difficult for Medical Students to Maintain; Creates Model to Improve and Sustain Students’ Empathy
Dr. Hojat’s team found that empathy can indeed be improved. In an article called, “Impact of a Workshop about Aging on the Empathy Scores of Pharmacy and Medical Students,” which was published in the current issue of the American Journal of Pharmaceutical Education

2011-03-08 - Study: Physicians' empathy can improve patients' positive clinical outcomes
It has been thought that the quality of the physician-patient relationship is integral to positive outcomes but until now, data to confirm such beliefs has been hard to find. Through a landmark study, a research team from Jefferson Medical College (JMC) of Thomas Jefferson University has been able to quantify a relationship between physicians' empathy and their patients' positive clinical outcomes, suggesting that a physician's empathy is an important factor associated with clinical competence. The study is available in the March 2011 issue of Academic Medicine.

"The purpose of this study was to provide an evidence-based scientific foundation for the study of empathy as a clinically important factor in patient outcomes," said Mohammadreza Hojat, Ph.D., research professor, Department of Psychiatry and Human Behavior; and director, Jefferson Longitudinal Study of Medical Education in the Center for Research in Medical Education and Health Care at JMC. "Our results show that physicians with high empathy scores had better clinical outcomes than other physicians with lower scores."
 

Empathy Publications by Chronological Order

1. Hojat, M., Mangione, S., Gonnella, J.S., Nasca, T., Veloski, J. J., Kane, G. (2001). Empathy in medical education and patient care (letter to the editor). Academic Medicine, 76, 669.

2. Hojat, M., Mangione, S., Nasca, T. J., Cohen, M J. M., Gonnella, J. S., Erdmann, J. B., Veloski, J. J., & Magee, M. (2001). The Jefferson scale of physician empathy: Development and Preliminary psychometric data. Educational and Psychological Measurement, 61, 349-365.

3. Hojat, M. Gonnella, J.S. Nasca, T.J., Mangione, S., Veloski, J.J., & Magee, M. (2002). The Jefferson Scale of Physician Empathy: Further psychometric data and differences by gender and specialty at item level. Academic Medicine (supplement), 77, S58-S60.

4. Hojat, M. Gonnella, J.S., Nasca, T.J., Mangione, S., Vergare, M., & Magee, M. (2002). Physician empathy: Definition, measurement, and relationship to gender and specialty. American Journal of Psychiatry, 159, 1563-1569.

5. Hojat, M., Gonnella, J.S., Mangione, S., Nasca, T. J., Veloski, J. J., Erdmann, J. B., Callahan, C. A., & Magee, M. (2002). Empathy in medical students as related to academic performance, clinical competence, and gender. Medical Education, 36,522-527.

6. Mangione, S. Kane, G.C., Caruso, J.W., Gonnella, J.S., Nasca, T.J., & Hojat, M. (2002). Assessment of empathy in different years of internal medicine training. Medical Teacher, 24, 371-374.

7. Hojat, M., Fields, S.K., Gonnella, J.S. (2003). Comparisons of nurse practitioners with physicians on the Jefferson Scale of Physician Empathy. The Nurse Practitioner, 28, 45-47.

8. Hojat, M., Gonnella, J.S., Mangione, S., Nasca, T.J., & Magee, M. (2003). Physician empathy in medical education and practice: Experience with the Jefferson Scale of Physician Empathy. Seminars in Integrative Medicine, 1, 25-41.

9. Fields S.K., Hojat, M., Gonnella, J.S., Mangione, S., Kane, G., & Magee, M. (2004). Comparisons of nurses and physicians on an operational measure of empathy Evaluation & The Health Professions, 27, 80-94.

10. Hojat, M., Mangione, S., Nasca, T.J., Rattner, S., Erdmann, J.B., Gonnella, J.S., & Magee, M. (2004). An empirical study of decline in empathy in medical school. Medical Education, 38, 934-941.

11. Gonnella, J.S., Mangione, S. Nasca, T.J. & Hojat, M. (2005). Empathy scores in medical school and ratings of empathic behavior in residency training three years later. Journal of Social Psychology, 145, 663-672.

12. Hojat, M., Gonnella, J.S., Mangione, S. Nasca, T.J. & Magee, M. (2005). Empathy scores in medical school and ratings of empathic behavior Three years later. Journal of Social Psychology, 145, 663-672.

13. Hojat, M. Mangione, S., Kane, G., Gonnella, J.S. (2005). Relationships between scores of the Jefferson Scale of Physician Empathy (JSPE) and the Interpersonal Reactivity Index (IRI). Medical Teacher, 27, 625-628.


14. Hojat, M., Zuckerman, M., Gonnella, J.S., Mangione, S., Nasca, T.J., Vergare, M., & Magee, M. (2005). Empathy in medical students as related to specialty interest, personality, and perceptions of mother and father. Journal of Personality and Individual Difference, 39, 1205-1215.

15. Glaser, K., Markham, F.W., Adler, H.M., McManus, P.R., & Hojat, M. (2007). Relationship between scores on the Jefferson Scale of Physician Empathy, patients’ perceptions of physician empathy and humanistic approaches to patient care: A validity study. Medical Science Monitor, 13, 291-294.

16. Kane, G.C., Gotto, J.L., Mangione, S., West, S., & Hojat, M. (2007). The Jefferson Scale of Patient’s Perceptions of Physician Empathy: Preliminary psychometric data. Croatian Journal of Medicine, 48, 81-86.

17. Di Lillo, M., Cicchetti, A., Lo Scalzo, A., Taroni, F., & Hojat, M. (2009). Jefferson Scale of Physician Empathy: Preliminary psychometrics and group comparisons in Italian physicians. Academic Medicine, 84, 1198-1202.

18. Hojat, M. (2009). Ten approaches for enhancing empathy in health and human services cultures. Journal of Health and Human Services Administration, 31, 412-450.

19. Kataoka, H., Koide, N., Ochi, K., Hojat, M., & Gonnella, J. S. (2009). Measurement of empathy among Japanese medical students: Psychometrics and score differences by gender and level of medical education. Academic Medicine, 84, 1192-1197.

20. Ward, J., Schaal, M., Sullivan, J., Bowen, M. E., Erdmann, J. B., & Hojat, M. (2009). Reliability and validity of the Jefferson scale of empathy in undergraduate nursing students. Journal of Nursing Measurement, 17, 73-88.

21. Hojat, M., Vergare, M., Maxwell, K., Brainard, G., Herrine, S. K., Isenberg, G. A., Veloski, J. J., & Gonnella, J. S. (2009). The devil is in the third year: A longitudinal study of erosion of empathy in medical school. Academic Medicine, 84, 1182-1191.

22. Hojat, M., Gonnella, J.S., Veloski, J.J. (2010). A rebuttal on critics on decline of empathy [letter to the editor]. Academic Medicine. 85, 1812.

23. Hojat, M., Louis, D.Z., Maxwell, K., Markham, F., Wender, R., Gonnella, J.S. (2010). Patient perceptions of physician empathy, satisfaction with physician, interpersonal trust, and compliance. International Journal of Medical Education, 1, 83-88.

24. Magee, M., Hojat, M. (2010). Rocking chair and empathy (letter to the editor), Family Medicine, 7,465-466.

25. Berg, K., Berg, D., Majdan, J., Veloski, J., Hojat, M. (2011). Medical Students' Self-Reported Empathy and Simulated Patients' Assessments of Student Empathy: An Analysis by Gender and Ethnicity. Academic Medicine, 86, 984-988.

26. Berg, K., Majdan, J.F., Berg, D., Veloski, J, Hojat, M. (2011). A comparison of students’ self-reported empathy with simulated patients’ assessment of the student empathy. Medical Teacher, 33, 388-391.

27. Fields, S.K., Mahan, P. Hojat, M., Tillman, P. Maxwell, K. (2011). Measuring empathy in healthcare profession students using the Jefferson Scale of Physician Empathy: Health Provider-Student Version. Journal of Interprofessional Care, 25, 287-293.

28. Fjortoft, N., Van Winkle, L.J., Hojat, M. (2011). Measuring empathy in pharmacy students. American Journal of Pharmaceutical Education, 75(6), Article 109.

29. Forstater, A. T., Chauhan, N., Allen, A., Hojat, M., Lopez, B.L. (2011). An emergency department shadowing experiences for emergency medicine residents: Can it prevent erosion of empathy? (Abstract). Academic Emergency Medicine, 18(10), s2.

30. Hojat, M., Louis, D.Z., Markham, F.W., Wender, R., Rabinowitz, C., Gonnella, J.S. (2011). Physicians’ empathy and clinical outcomes in diabetic patients. Academic Medicine, 86, 359-364.

31. Pohl C.A., Hojat. M., Arnold, L. (2011). Peer nominations as related to academic attainment, empathy, and specialty interest. Academic Medicine, 86, 747-751.

32. Hojat, M., Spandorfer, J., Louis, D.Z., Gonnella, J.S. (2011). Empathic and sympathetic orientations toward patient care: Conceptualization, measurement, and psychometrics. Academic Medicine, 86, 989-995.

33. Van Winkle, L.J., Fjortoft, N., Hojat, M. (2012). Impact of a workshop about aging on the empathy scores of pharmacy and medical students. American Journal of Pharmaceutical Education, 7 (1), Article 9.

34. Ward, J., Cody, J., Schaal, M., Hojat, M. (2012). The empathy enigma: An empirical study of decline in empathy among undergraduate nursing students. Journal of Professional Nursing, 28, 34-40.

35. Del Canale, S., Louis, D. Z., Maio, V., Wang, X., Rossi, G., Hojat, M., Gonnella, J. S. (in press). Physicians’ empathy and disease complications: An empirical study of primary care physicians and their diabetic patients in Parma, Italy. Academic Medicine.