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Does emergency physician empathy reduce thoughts of litigation? A randomised trial
  1. Dustin D Smith1,
  2. Jesse Kellar1,2,
  3. Elizabeth L Walters1,
  4. Ellen T Reibling1,
  5. Tammy Phan1,
  6. Steven M Green1
  1. 1Department of Emergency Medicine, Loma Linda University Medical Center and Children's Hospital, Loma Linda, California, USA
  2. 2Department of Emergency Medicine, Lakeland Health, St Joseph, Michigan, USA
  1. Correspondence to Dr Dustin D Smith, Department of Emergency Medicine, Loma Linda University Medical Center and Children's Hospital, 11234 Anderson Street, Loma Linda CA 92354, USA; ddsmith{at}llu.edu

Abstract

Background We hypothesised the addition of brief empathetic statements to physician–patient interaction might decrease thoughts regarding litigation.

Methods We enrolled a convenience sample of adults in our emergency department (ED) waiting room into a randomised, double-blind controlled trial. Subjects watched videos of simulated discharge conversations between physicians and patient actors; half of the videos differed only by the inclusion of two brief empathetic statements: verbalisations that (1) the physician recognises that the patient is concerned about their symptoms and (2) the patient knows their typical state of health better than a physician seeing them for the first time and did the right thing by seeking evaluation. After watching the video subjects were asked to score a five-point Likert scale their thoughts regarding suing this physician in the event of a missed outcome leading to lost work (primary outcome), and four measures of satisfaction with the physician encounter (secondary outcomes).

Results We enrolled and randomised 437 subjects. 213 in the empathy group and 208 in the non-empathy group completed the trial. Sixteen subjects did not complete the trial due to computer malfunction or incomplete data sheets. Empathy group subjects reported statistically significant less thoughts of litigation than the non-empathy group (mean Likert scale 2.66 vs 2.95, difference −0.29, 95% CI −0.04 to −0.54, p=0.0176). All four secondary measures of satisfaction with the physician encounter were better in the empathy group.

Conclusions In this study, the addition of brief empathetic statements to ED discharge scenarios was associated with a statistically significant reduction in thoughts regarding litigation.

Clinical trial registration NCT01837706.

  • interpersonal
  • law
  • medico-legal
  • risk management
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