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Published in: Journal of General Internal Medicine 5/2007

01-05-2007 | Perspectives

Empathy and Patient–Physician Conflicts

Author: Jodi Halpern, MD, PhD

Published in: Journal of General Internal Medicine | Issue 5/2007

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Abstract

Physicians associate empathy with benevolent emotions and with developing a shared understanding with patients. While there have been many articles on managing “difficult” patients, little attention has been paid to the challenges physicians face during conflicts with patients, especially when both parties are angry and yet empathy is still needed. This topic is especially important in light of recent studies showing that practicing medicine increasingly requires physicians to manage their own feelings of anger and frustration. This article seeks to describe how physicians can learn to empathize with patients even when they are both subject to emotions that lead to interpersonal distancing. Empathy is defined as engaged curiosity about another’s particular emotional perspective. Five specific ways for physicians to foster empathy during conflict are described: recognizing one’s own emotions, attending to negative emotions over time, attuning to patients’ verbal and nonverbal emotional messages, and becoming receptive to negative feedback. Importantly, physicians who learn to empathize with patients during emotionally charged interactions can reduce anger and frustration and also increase their therapeutic impact.
Literature
1.
go back to reference Makadon HJ, Gerson S, Ryback R. Managing the care of the difficult patient in the emergency unit. JAMA. 1984;252:2585–8.PubMed Makadon HJ, Gerson S, Ryback R. Managing the care of the difficult patient in the emergency unit. JAMA. 1984;252:2585–8.PubMed
3.
go back to reference Hahn SR, Thompson KS, Wills TA, Stern V, Budner NS. The difficult doctor–patient relationship: somatization, personality and psychopathology. J Clin Epidemiol. 1994;47(6):647–57.PubMed Hahn SR, Thompson KS, Wills TA, Stern V, Budner NS. The difficult doctor–patient relationship: somatization, personality and psychopathology. J Clin Epidemiol. 1994;47(6):647–57.PubMed
4.
go back to reference Schafer S, Nowlis DP. Personality disorders among difficult patients. Arch Fam Med. 1998;7:126–9.PubMed Schafer S, Nowlis DP. Personality disorders among difficult patients. Arch Fam Med. 1998;7:126–9.PubMed
5.
go back to reference Jellenik MS, Todres ID, Catlin EA, Cassem EH, Slazman A. Pediatric intensive care training: confronting the dark side. Crit Care Med. 1993;21(5):775–9. Jellenik MS, Todres ID, Catlin EA, Cassem EH, Slazman A. Pediatric intensive care training: confronting the dark side. Crit Care Med. 1993;21(5):775–9.
6.
go back to reference Maguire P, Pitceathly C. Managing the difficult consultation. Clin Med. 2003;3(6):532–7.PubMed Maguire P, Pitceathly C. Managing the difficult consultation. Clin Med. 2003;3(6):532–7.PubMed
7.
go back to reference Back AL, Arnold RM. Dealing with conflict in caring for the seriously ill: “it was just out of the question”. JAMA. 2005;293(11):1374–81.PubMed Back AL, Arnold RM. Dealing with conflict in caring for the seriously ill: “it was just out of the question”. JAMA. 2005;293(11):1374–81.PubMed
8.
go back to reference Breen CM, Abernethy AP, Abbott KH, Tulsky JA. Conflict associated with decisions to limit life-sustaining treatment in intensive care units. J Gen Intern Med. 2001;16:283–9.PubMed Breen CM, Abernethy AP, Abbott KH, Tulsky JA. Conflict associated with decisions to limit life-sustaining treatment in intensive care units. J Gen Intern Med. 2001;16:283–9.PubMed
9.
go back to reference Goold SD, Williams B, Arnold RM. Conflicts regarding decisions to limit treatment. JAMA. 2000;283:909–14.PubMed Goold SD, Williams B, Arnold RM. Conflicts regarding decisions to limit treatment. JAMA. 2000;283:909–14.PubMed
10.
go back to reference Kopelman AE. Understanding, avoiding, and resolving end-of-life conflicts in the NICU. Mt Sinai J Med. 2006;73:580–6.PubMed Kopelman AE. Understanding, avoiding, and resolving end-of-life conflicts in the NICU. Mt Sinai J Med. 2006;73:580–6.PubMed
11.
go back to reference Shapiro J, Lie D. Using literature to help physician-learners understand and manage “difficult” patients. Acad Med. 2000;75(7):765–8.PubMedCrossRef Shapiro J, Lie D. Using literature to help physician-learners understand and manage “difficult” patients. Acad Med. 2000;75(7):765–8.PubMedCrossRef
12.
go back to reference Marguiles A. The Empathic Imagination. New York, NY: W.W. Norton & Co; 1989. Marguiles A. The Empathic Imagination. New York, NY: W.W. Norton & Co; 1989.
13.
go back to reference Lipps T. Empathy and aesthetic pleasure. Translated by K. Aschenbrenner. In: Aschenbrenner K, Isenberg A, eds. Aesthetic Theories: Studies in the Philosophy of Art. Engelwood Cliffs, NJ: Prentice Hall; 1965:403–12. Lipps T. Empathy and aesthetic pleasure. Translated by K. Aschenbrenner. In: Aschenbrenner K, Isenberg A, eds. Aesthetic Theories: Studies in the Philosophy of Art. Engelwood Cliffs, NJ: Prentice Hall; 1965:403–12.
14.
go back to reference Mehrabian A, Young AL, Sato S. Emotional empathy and associated individual differences. Curr Psychol Res Rev. 1988;7(3):221–40. Mehrabian A, Young AL, Sato S. Emotional empathy and associated individual differences. Curr Psychol Res Rev. 1988;7(3):221–40.
15.
go back to reference Halpern J. From Detached Concern to Empathy: Humanizing Medical Practice. New York, NY: Oxford University Press; 2001. Halpern J. From Detached Concern to Empathy: Humanizing Medical Practice. New York, NY: Oxford University Press; 2001.
16.
go back to reference Fox R, Lief H. Training for “detached concern.” In: Lief H, ed. The Psychological Basis of Medical Practice. New York, NY: Harper & Row; 1963. Fox R, Lief H. Training for “detached concern.” In: Lief H, ed. The Psychological Basis of Medical Practice. New York, NY: Harper & Row; 1963.
17.
go back to reference Roter D, Stewart S, Putnam N, Lipkin M. Communication patterns of primary care physicians. JAMA. 1997;277:350–6.PubMed Roter D, Stewart S, Putnam N, Lipkin M. Communication patterns of primary care physicians. JAMA. 1997;277:350–6.PubMed
18.
go back to reference Halpern J. What is clinical empathy? J Gen Intern Med. 2003;18:670–4.PubMed Halpern J. What is clinical empathy? J Gen Intern Med. 2003;18:670–4.PubMed
19.
go back to reference Suchman A, Markakis K, Beckman H, Frankel R. A model of empathic communication in the medical interview. JAMA. 1997;277(8):678–82.PubMed Suchman A, Markakis K, Beckman H, Frankel R. A model of empathic communication in the medical interview. JAMA. 1997;277(8):678–82.PubMed
20.
go back to reference Skeff KM, Mutha S. Role models: guiding the future of medicine. N Engl J Med. 1998;339:2017. Skeff KM, Mutha S. Role models: guiding the future of medicine. N Engl J Med. 1998;339:2017.
21.
go back to reference Spencer J. Decline in empathy in medical education: how can we stop the rot? Med Educ. 2004;38:916–8.PubMed Spencer J. Decline in empathy in medical education: how can we stop the rot? Med Educ. 2004;38:916–8.PubMed
22.
go back to reference Feighny KM, Arnold L, Monaco M, Munro S, Earl B. In pursuit of empathy and its relationship to physician communication skills: multidimensional empathy training for medical students. Ann Behav Sci Med Educ. 1998;5:13–21. Feighny KM, Arnold L, Monaco M, Munro S, Earl B. In pursuit of empathy and its relationship to physician communication skills: multidimensional empathy training for medical students. Ann Behav Sci Med Educ. 1998;5:13–21.
23.
go back to reference Marcus ER. Empathy, humanism and the professionalization process of medical education. Acad Med. 1999;74:1211–5.PubMed Marcus ER. Empathy, humanism and the professionalization process of medical education. Acad Med. 1999;74:1211–5.PubMed
24.
go back to reference Roter D, Hall J, Merisca R, Nordstrom B, Cretin D, Svarstad B. Effectiveness of interventions to improve patient compliance: a meta-analysis. Med Care. 1997;36(8):1138–61. Roter D, Hall J, Merisca R, Nordstrom B, Cretin D, Svarstad B. Effectiveness of interventions to improve patient compliance: a meta-analysis. Med Care. 1997;36(8):1138–61.
25.
go back to reference Kim SS, Kaplowitz S, Johnston MV. The effects of physician empathy on patient satisfaction and compliance. Eval Health Prof. 2004;27(3):237–51.PubMed Kim SS, Kaplowitz S, Johnston MV. The effects of physician empathy on patient satisfaction and compliance. Eval Health Prof. 2004;27(3):237–51.PubMed
26.
go back to reference Kerse N, Buetow S, Mainous AG III, Young G, Coster G, Arroll B. Physician–patient relationship and medication compliance: a primary care investigation. Ann Fam Med. 2004;2:455–61.PubMed Kerse N, Buetow S, Mainous AG III, Young G, Coster G, Arroll B. Physician–patient relationship and medication compliance: a primary care investigation. Ann Fam Med. 2004;2:455–61.PubMed
27.
go back to reference Girgis A, Sanson-Fisher RW. Breaking bad news 1: current advice for clinicians. J Behav Med. 1998;24:53–9. Girgis A, Sanson-Fisher RW. Breaking bad news 1: current advice for clinicians. J Behav Med. 1998;24:53–9.
28.
go back to reference Girgis A, Sanson-Fisher RW. Breaking bad news: consensus guidelines for medical practitioners. J Clin Oncol. 1995;13:2449–56.PubMed Girgis A, Sanson-Fisher RW. Breaking bad news: consensus guidelines for medical practitioners. J Clin Oncol. 1995;13:2449–56.PubMed
29.
go back to reference Hojat M, Gonnella JS, Manione S, et al. Empathy in medical students as related to academic performance, clinical competence and gender. Med Educ. 2002;36:522–7.PubMed Hojat M, Gonnella JS, Manione S, et al. Empathy in medical students as related to academic performance, clinical competence and gender. Med Educ. 2002;36:522–7.PubMed
30.
go back to reference Easter DW, Beach W. Competent patient care is dependent upon attending to empathic opportunities presented during interview sessions. Curr Surg. 2004;61(3):313–8.PubMed Easter DW, Beach W. Competent patient care is dependent upon attending to empathic opportunities presented during interview sessions. Curr Surg. 2004;61(3):313–8.PubMed
31.
go back to reference Beck R, Duaghtridge R, Sloane P. Physician–patient communication in the primary care office: a systematic review. J Am Board Fam Pract. 2002;15:25–38.PubMed Beck R, Duaghtridge R, Sloane P. Physician–patient communication in the primary care office: a systematic review. J Am Board Fam Pract. 2002;15:25–38.PubMed
32.
go back to reference Butow P, Maclean M, Dunn S, Tattersall M, Boyer M. The dynamics of change: cancer patients’ preferences for information, involvement and support. Ann Oncol. 1997;8:857–63.PubMed Butow P, Maclean M, Dunn S, Tattersall M, Boyer M. The dynamics of change: cancer patients’ preferences for information, involvement and support. Ann Oncol. 1997;8:857–63.PubMed
33.
go back to reference Frankel RM. Emotion and the physician–patient relationship. Motiv Emotion. 1995;19:163–73. Frankel RM. Emotion and the physician–patient relationship. Motiv Emotion. 1995;19:163–73.
34.
go back to reference Squier RW. A model of empathic understanding and adherence to treatment regimens in practitioner–patient relationships. Soc Sci Med. 1990;30:325–39.PubMed Squier RW. A model of empathic understanding and adherence to treatment regimens in practitioner–patient relationships. Soc Sci Med. 1990;30:325–39.PubMed
35.
go back to reference Rietveld S, Prins P. The relationship between negative emotions and acute subjective and objective symptoms of childhood asthma. Psychol Med. 1998;28:407–15.PubMed Rietveld S, Prins P. The relationship between negative emotions and acute subjective and objective symptoms of childhood asthma. Psychol Med. 1998;28:407–15.PubMed
36.
go back to reference Frasure-Smith N, Lesperance F, Talajic M. The impact of negative emotions on prognosis following myocardial infarction: is it more than depression? Health Psychol. 1995;14:388–98.PubMed Frasure-Smith N, Lesperance F, Talajic M. The impact of negative emotions on prognosis following myocardial infarction: is it more than depression? Health Psychol. 1995;14:388–98.PubMed
37.
go back to reference Ptacek JT, Eberhardt TL. Breaking bad news: a review of the literature. JAMA. 1996;276(6):496–502.PubMed Ptacek JT, Eberhardt TL. Breaking bad news: a review of the literature. JAMA. 1996;276(6):496–502.PubMed
38.
go back to reference Ptacek JT, Fries EA, Eberhardt TL, Ptacek JJ. Breaking bad news to patients: physicians’ perceptions of the process. Support Care Cancer. 1999;7:113–20.PubMed Ptacek JT, Fries EA, Eberhardt TL, Ptacek JJ. Breaking bad news to patients: physicians’ perceptions of the process. Support Care Cancer. 1999;7:113–20.PubMed
39.
go back to reference Levinson W, Gorawara-Bhat R, Lamb J. A study of patient clues and physician responses in primary care and surgical settings. JAMA. 2000;284(8):1021–7.PubMed Levinson W, Gorawara-Bhat R, Lamb J. A study of patient clues and physician responses in primary care and surgical settings. JAMA. 2000;284(8):1021–7.PubMed
40.
go back to reference DiMatteo MR, Taranta A, Friedman HS, Prince LM. Predicting patient satisfaction from physicians’ nonverbal communication skills. Med Care. 1980;18(4):376–87.PubMed DiMatteo MR, Taranta A, Friedman HS, Prince LM. Predicting patient satisfaction from physicians’ nonverbal communication skills. Med Care. 1980;18(4):376–87.PubMed
41.
go back to reference Borrell-Carrio´ F, Suchman AL, Epstein RM. The biopsychosocial model 25 years later: principles, practice, and scientific inquiry. Ann Fam Med. 2004;2:576–82.PubMed Borrell-Carrio´ F, Suchman AL, Epstein RM. The biopsychosocial model 25 years later: principles, practice, and scientific inquiry. Ann Fam Med. 2004;2:576–82.PubMed
42.
go back to reference Ross CA. Childhood sexual abuse and psychosomatic symptoms in irritable bowel syndrome. J Child Sex Abus. 2005;14(1):27–38.PubMed Ross CA. Childhood sexual abuse and psychosomatic symptoms in irritable bowel syndrome. J Child Sex Abus. 2005;14(1):27–38.PubMed
43.
go back to reference Handa M, Nukina H, Ando K, Kubo C. What does pain or discomfort in irritable bowel syndrome mean? Dig Dis Sci. 2004;49(4):575–8.PubMed Handa M, Nukina H, Ando K, Kubo C. What does pain or discomfort in irritable bowel syndrome mean? Dig Dis Sci. 2004;49(4):575–8.PubMed
44.
go back to reference Graugaard PK, Holgersen K, Finset A. Communicating with alexithymic and non-alexithymic patients: an experimental study of the effect of psychosocial communication and empathy on patient satisfaction. Psychother Psychosom. 2004;73(2):92–100.PubMed Graugaard PK, Holgersen K, Finset A. Communicating with alexithymic and non-alexithymic patients: an experimental study of the effect of psychosocial communication and empathy on patient satisfaction. Psychother Psychosom. 2004;73(2):92–100.PubMed
45.
go back to reference Przuntek H, Muller T, Riederer P. Diagnostic staging of Parkinson’s disease: conceptual aspects. J Neural Transm. 2004;111(2):201–16.PubMed Przuntek H, Muller T, Riederer P. Diagnostic staging of Parkinson’s disease: conceptual aspects. J Neural Transm. 2004;111(2):201–16.PubMed
46.
go back to reference Beckman HB, Markakis KM, Suchman AL, Frankel RM. The doctor–patient relationship and malpractice. Lessons from plaintiff depositions. Arch Intern Med. 1994;154:1365–70.PubMed Beckman HB, Markakis KM, Suchman AL, Frankel RM. The doctor–patient relationship and malpractice. Lessons from plaintiff depositions. Arch Intern Med. 1994;154:1365–70.PubMed
47.
go back to reference Frankel RM. Relationship-centered care and the patient–physician relationship. J Gen Intern Med. 2004;19(11):1163–5.PubMed Frankel RM. Relationship-centered care and the patient–physician relationship. J Gen Intern Med. 2004;19(11):1163–5.PubMed
48.
go back to reference Larson E, Yao X. Clinical empathy as emotional labor in the patient–physician relationship. JAMA. 2005;293:1100–6.PubMed Larson E, Yao X. Clinical empathy as emotional labor in the patient–physician relationship. JAMA. 2005;293:1100–6.PubMed
49.
go back to reference Griffin SJ, Kinmonth AL, Veltman M, Gillard S, Grant J, Stewart M. Effect on health-related outcomes of interventions to alter the interaction between patients and practitioners: a systematic review of trials. Ann Fam Med. 2004;2:595–608.PubMed Griffin SJ, Kinmonth AL, Veltman M, Gillard S, Grant J, Stewart M. Effect on health-related outcomes of interventions to alter the interaction between patients and practitioners: a systematic review of trials. Ann Fam Med. 2004;2:595–608.PubMed
50.
go back to reference Vanderford M, Stein T, Sheeler R, Skochelak S. Communication challenges for experienced clinicians: topics for an advanced communication curriculum. Health Commun. 2001;13(3):261–84.PubMed Vanderford M, Stein T, Sheeler R, Skochelak S. Communication challenges for experienced clinicians: topics for an advanced communication curriculum. Health Commun. 2001;13(3):261–84.PubMed
51.
go back to reference Quill T. Recognizing and adjusting to barriers in doctor–patient communication. Ann Intern Med. 1989;111:51–7.PubMed Quill T. Recognizing and adjusting to barriers in doctor–patient communication. Ann Intern Med. 1989;111:51–7.PubMed
52.
go back to reference Hedrick H, Nelson R. Handling ethical conflicts in the clinical setting. Semin Pediatr Surg. 2001;10(4):192–7.PubMed Hedrick H, Nelson R. Handling ethical conflicts in the clinical setting. Semin Pediatr Surg. 2001;10(4):192–7.PubMed
53.
go back to reference Weitzman PF, Weitzman EA. Promoting communication with older adults: protocols for resolving interpersonal conflicts and for enhancing interactions with doctors. Clin Psychol Rev. 2003;23:523–35.PubMed Weitzman PF, Weitzman EA. Promoting communication with older adults: protocols for resolving interpersonal conflicts and for enhancing interactions with doctors. Clin Psychol Rev. 2003;23:523–35.PubMed
54.
go back to reference Adler SR, McGraw SA, McKinlay JB. Patient assertiveness in ethnically diverse older women with breast cancer: challenging stereotypes of the elderly. J Aging Stud. 1998;12(4):331–50. Adler SR, McGraw SA, McKinlay JB. Patient assertiveness in ethnically diverse older women with breast cancer: challenging stereotypes of the elderly. J Aging Stud. 1998;12(4):331–50.
55.
go back to reference Levinson W, Gorawara-Bhat R, Dueck R, et al. Resolving disagreements in the patient–physician relationship. JAMA. 1999;282(15):1477–83.PubMed Levinson W, Gorawara-Bhat R, Dueck R, et al. Resolving disagreements in the patient–physician relationship. JAMA. 1999;282(15):1477–83.PubMed
56.
go back to reference Zuger A. Dissatisfaction with medical practice. N Engl J Med. 2004;350(1):69–75.PubMed Zuger A. Dissatisfaction with medical practice. N Engl J Med. 2004;350(1):69–75.PubMed
57.
go back to reference Rosenberg AJ, Rothbaum PA. Managing anger in a managed care age. Med Econ. 2004;81(9):23–5.PubMed Rosenberg AJ, Rothbaum PA. Managing anger in a managed care age. Med Econ. 2004;81(9):23–5.PubMed
58.
go back to reference Longhurst MF. Angry patient, angry doctor. Can Med Assoc J. 1980;123:597–8.PubMed Longhurst MF. Angry patient, angry doctor. Can Med Assoc J. 1980;123:597–8.PubMed
59.
go back to reference Back AL, Arnold RM, Baile WF, Tulsky JA, Fryer-Edwards K. Approaching difficult communication tasks in oncology. CA Cancer J Clin. 2005;55:164–77.PubMed Back AL, Arnold RM, Baile WF, Tulsky JA, Fryer-Edwards K. Approaching difficult communication tasks in oncology. CA Cancer J Clin. 2005;55:164–77.PubMed
60.
go back to reference Quill TE, Suchman AL. Uncertainty and control: learning to live with medicine’s limitations. Hum Med. 1993;9:109–20. Quill TE, Suchman AL. Uncertainty and control: learning to live with medicine’s limitations. Hum Med. 1993;9:109–20.
61.
go back to reference Jones TS, Bodtker A. Mediating with heart in mind: emotion in mediation practice. Negotiation J. 2001:217–44. Jones TS, Bodtker A. Mediating with heart in mind: emotion in mediation practice. Negotiation J. 2001:217–44.
62.
go back to reference Winnicott D. Hate in the counter-transference. Int J Psychoanal. 1949;30:69–74. Winnicott D. Hate in the counter-transference. Int J Psychoanal. 1949;30:69–74.
63.
go back to reference Stone D, Patton B, Heen S, Fisher R. Difficult Conversations: How to Discuss what Matters Most. New York, NY: Penguin Books; 1999. Stone D, Patton B, Heen S, Fisher R. Difficult Conversations: How to Discuss what Matters Most. New York, NY: Penguin Books; 1999.
64.
go back to reference Wile D. After the Fight: Using Your Disagreements to Build a Stronger Relationship. New York, NY: Guilford Publications; 1995. Wile D. After the Fight: Using Your Disagreements to Build a Stronger Relationship. New York, NY: Guilford Publications; 1995.
65.
go back to reference Thomas SP. Anger: the mismanaged emotion. Dermatol Nurs. 2003;15:351–7.PubMed Thomas SP. Anger: the mismanaged emotion. Dermatol Nurs. 2003;15:351–7.PubMed
66.
go back to reference Duan C. Being empathic: the role of motivation to empathize and the nature of target emotions. Motiv Emotion. 2000;24:29–49. Duan C. Being empathic: the role of motivation to empathize and the nature of target emotions. Motiv Emotion. 2000;24:29–49.
67.
go back to reference Steins G. Motivation in person perception: role of the other’s perspective. J Soc Psychol. 2000;140(6):692–709.PubMedCrossRef Steins G. Motivation in person perception: role of the other’s perspective. J Soc Psychol. 2000;140(6):692–709.PubMedCrossRef
68.
go back to reference Steins G, Wicklund RA. Perspective-taking, conflict, and press: drawing an E on your forehead. Basic Appl Soc Psych. 1996;18:319–46. Steins G, Wicklund RA. Perspective-taking, conflict, and press: drawing an E on your forehead. Basic Appl Soc Psych. 1996;18:319–46.
69.
go back to reference Wicklund RA, Steins G. Person perception under pressure: when motivation brings about egocentrism. In: Gollwitzer PM, Bargh JA, eds. The Psychology of Action: Linking Cognition and Motivation to Behavior. New York, NY: Guilford Press; 1996:511–28. Wicklund RA, Steins G. Person perception under pressure: when motivation brings about egocentrism. In: Gollwitzer PM, Bargh JA, eds. The Psychology of Action: Linking Cognition and Motivation to Behavior. New York, NY: Guilford Press; 1996:511–28.
70.
go back to reference Krauss RM, Morsella E. Communication and conflict. In: Deutsch M, Coleman PT, eds. The Handbook of Conflict Resolution: Theory and Practice. San Francisco, CA: Jossey-Bass; 2000:131–43. Krauss RM, Morsella E. Communication and conflict. In: Deutsch M, Coleman PT, eds. The Handbook of Conflict Resolution: Theory and Practice. San Francisco, CA: Jossey-Bass; 2000:131–43.
71.
go back to reference Betancourt H. Attribution-emotion processes in White’s realistic empathy approach to conflict and negotiation. Peace Confl. 2004;10:369–80. Betancourt H. Attribution-emotion processes in White’s realistic empathy approach to conflict and negotiation. Peace Confl. 2004;10:369–80.
72.
go back to reference Charon R. Narrative medicine: a model for empathy, reflection, profession and trust. JAMA. 2001;286(15):1897–902.PubMed Charon R. Narrative medicine: a model for empathy, reflection, profession and trust. JAMA. 2001;286(15):1897–902.PubMed
73.
go back to reference Marangoni C, Garcia S, Ickes W, Teng G. Empathic accuracy in a clinically relevant setting. J Pers Soc Psychol. 1995;68(5):854–69.PubMed Marangoni C, Garcia S, Ickes W, Teng G. Empathic accuracy in a clinically relevant setting. J Pers Soc Psychol. 1995;68(5):854–69.PubMed
74.
go back to reference Ickes W, Marangoni C, Garcia S. Studying empathic accuracy in a clinically relevant context. In: Ickes W, ed. Empathic Accuracy. New York, NY: Guilford Press; 1997:282–310. Ickes W, Marangoni C, Garcia S. Studying empathic accuracy in a clinically relevant context. In: Ickes W, ed. Empathic Accuracy. New York, NY: Guilford Press; 1997:282–310.
75.
go back to reference Ickes W, Simpson JA. Managing empathic accuracy in close relationships. In: Ickes W, ed. Empathic Accuracy. New York, NY: Guilford Press; 1997:218–50. Ickes W, Simpson JA. Managing empathic accuracy in close relationships. In: Ickes W, ed. Empathic Accuracy. New York, NY: Guilford Press; 1997:218–50.
76.
go back to reference Ickes W. Empathic accuracy. J Pers. 1993;61:587–610. Ickes W. Empathic accuracy. J Pers. 1993;61:587–610.
77.
go back to reference Davis MH, Kraus LA. Personality and empathic accuracy. In: Ickes W, ed. Empathic Accuracy. New York, NY: Guilford Press; 1997:144–68. Davis MH, Kraus LA. Personality and empathic accuracy. In: Ickes W, ed. Empathic Accuracy. New York, NY: Guilford Press; 1997:144–68.
78.
go back to reference Smith M, Hart G. Nurses’ responses to patient anger: from disconnecting to connecting. J Adv Nurs. 1994;20:643–51.PubMed Smith M, Hart G. Nurses’ responses to patient anger: from disconnecting to connecting. J Adv Nurs. 1994;20:643–51.PubMed
79.
80.
go back to reference Shapiro S, Schwartz G, Bonner G. Effects of mindfulness-based stress reduction on medical and premedical students. J Behav Med. 1998;21(6):581–99.PubMed Shapiro S, Schwartz G, Bonner G. Effects of mindfulness-based stress reduction on medical and premedical students. J Behav Med. 1998;21(6):581–99.PubMed
81.
go back to reference Schwarz N, Clore G. Mood, misattribution, and judgments of well-being: informative and directive functions of affective states. J Pers Soc Psychol. 1983;45(3):513–23. Schwarz N, Clore G. Mood, misattribution, and judgments of well-being: informative and directive functions of affective states. J Pers Soc Psychol. 1983;45(3):513–23.
82.
go back to reference Schwarz N. Emotion, cognition, & decision-making. Cogn Emotion. 2000;14(4):433–40. Schwarz N. Emotion, cognition, & decision-making. Cogn Emotion. 2000;14(4):433–40.
83.
go back to reference Novack DH, Suchman AL, Clark W, Epstein RM, Najberg E, Kaplan C. Calibrating the physician: personal awareness and effective patient care. JAMA. 1997;278:502–9.PubMed Novack DH, Suchman AL, Clark W, Epstein RM, Najberg E, Kaplan C. Calibrating the physician: personal awareness and effective patient care. JAMA. 1997;278:502–9.PubMed
84.
go back to reference Meier DE, Back AL, Morrison RS. The inner life of physicians and care of the seriously ill. JAMA. 2001;286:3007–14.PubMed Meier DE, Back AL, Morrison RS. The inner life of physicians and care of the seriously ill. JAMA. 2001;286:3007–14.PubMed
85.
go back to reference Gold JH. Reflections on psychodynamic psychotherapy supervision for psychiatrists in clinical practice. J Psychiatr Pract. 2004;10(3):162–9.PubMed Gold JH. Reflections on psychodynamic psychotherapy supervision for psychiatrists in clinical practice. J Psychiatr Pract. 2004;10(3):162–9.PubMed
86.
go back to reference Buckley P, Karasu TB, Charles E. Common mistakes in psychotherapy. Am J Psychiatry. 1979;136(12):1578–80.PubMed Buckley P, Karasu TB, Charles E. Common mistakes in psychotherapy. Am J Psychiatry. 1979;136(12):1578–80.PubMed
87.
go back to reference Marshall AA, Smith RC. Physicians’ emotional reactions to patients: recognizing and managing countertransference. Am J Gastroenterol. 1995;90(1):4–8.PubMed Marshall AA, Smith RC. Physicians’ emotional reactions to patients: recognizing and managing countertransference. Am J Gastroenterol. 1995;90(1):4–8.PubMed
88.
go back to reference Smith RC. Teaching interviewing skills to medical students: the issue of ‘countertransference’. J Med Educ. 1984;59(7):582–8.PubMed Smith RC. Teaching interviewing skills to medical students: the issue of ‘countertransference’. J Med Educ. 1984;59(7):582–8.PubMed
89.
go back to reference Eide H, Frankel R, Haaversen AC, Vaupel KA, Graugaard PK, Finset A. Listening for feelings: identifying and coding empathic and potential empathic opportunities in medical dialogues. Patient Educ Couns. 2004;54(3):291–7.PubMed Eide H, Frankel R, Haaversen AC, Vaupel KA, Graugaard PK, Finset A. Listening for feelings: identifying and coding empathic and potential empathic opportunities in medical dialogues. Patient Educ Couns. 2004;54(3):291–7.PubMed
90.
go back to reference Wissow LS, Larson S, Anderson J, Hadjiisky E. Pediatric residents’ responses that discourage discussion of psychosocial problems in primary care. Pediatrics. 2005;115(6):1569–79.PubMed Wissow LS, Larson S, Anderson J, Hadjiisky E. Pediatric residents’ responses that discourage discussion of psychosocial problems in primary care. Pediatrics. 2005;115(6):1569–79.PubMed
91.
go back to reference Roter DL, Frankel RM, Hall JA, Sluyter D. The expression of emotion through nonverbal behavior in medical visits: mechanisms and outcomes. J Gen Intern Med. 2006;21:S28–34.PubMed Roter DL, Frankel RM, Hall JA, Sluyter D. The expression of emotion through nonverbal behavior in medical visits: mechanisms and outcomes. J Gen Intern Med. 2006;21:S28–34.PubMed
92.
go back to reference Weissmann PF, Branch WT, Gracey CF, Haidet P, Frankel RM. Role modeling humanistic behavior: learning bedside manner from the experts. Acad Med. 2006;81(7):661–7.PubMed Weissmann PF, Branch WT, Gracey CF, Haidet P, Frankel RM. Role modeling humanistic behavior: learning bedside manner from the experts. Acad Med. 2006;81(7):661–7.PubMed
93.
go back to reference Windish DM, Price EG, Clever SL, Magaziner JL, Thomas PA. Teaching medical students the important connection between communication and clinical reasoning. J Gen Intern Med. 2005; 20:1108–13.PubMed Windish DM, Price EG, Clever SL, Magaziner JL, Thomas PA. Teaching medical students the important connection between communication and clinical reasoning. J Gen Intern Med. 2005; 20:1108–13.PubMed
94.
go back to reference Fox R. Experiment Perilous: Physicians and Patients Facing the Unknown. Philadelphia, PA: University of Pennsylvania Press; 1974. Fox R. Experiment Perilous: Physicians and Patients Facing the Unknown. Philadelphia, PA: University of Pennsylvania Press; 1974.
95.
go back to reference Leape L. A systems analysis approach to medical error. J Eval Clin Pract. 1997;3(3):213–22.PubMed Leape L. A systems analysis approach to medical error. J Eval Clin Pract. 1997;3(3):213–22.PubMed
96.
go back to reference McIntyre N, Popper KB. The critical attitude in medicine: the need for a new ethics. Br Med J. 1983;287:1919–23. McIntyre N, Popper KB. The critical attitude in medicine: the need for a new ethics. Br Med J. 1983;287:1919–23.
97.
go back to reference Stein H. The Psychodynamics of Medical Practice. Berkeley, CA: University of California Press; 1985. Stein H. The Psychodynamics of Medical Practice. Berkeley, CA: University of California Press; 1985.
98.
99.
go back to reference Havens L. Participant Observation: The Psychotherapy Schools in Action. New York, NY: Jason Aronson; 1993. Havens L. Participant Observation: The Psychotherapy Schools in Action. New York, NY: Jason Aronson; 1993.
100.
go back to reference Halpern JL. Empathy: using resonance emotions in the service of curiosity. In: Spiro HM, Peschel E, Curnen MG, St. James D, eds. Empathy and the Practice of Medicine: Beyond Pills and the Scalpel. New Haven, CT: Yale; 1993:160–73. Halpern JL. Empathy: using resonance emotions in the service of curiosity. In: Spiro HM, Peschel E, Curnen MG, St. James D, eds. Empathy and the Practice of Medicine: Beyond Pills and the Scalpel. New Haven, CT: Yale; 1993:160–73.
101.
go back to reference McCord RS, Floyd MR, Lang F, Young V. Responding effectively to patient anger directed at the physician. Fam Med. 2002;34(5):331–6.PubMed McCord RS, Floyd MR, Lang F, Young V. Responding effectively to patient anger directed at the physician. Fam Med. 2002;34(5):331–6.PubMed
102.
go back to reference Gallagher TH, Waterman AD, Ebers AG, Fraser VJ, Levinson W. Patients’ and physicians’ attitudes regarding the disclosure of medical errors. JAMA. 2003;289(8):1001–7.PubMed Gallagher TH, Waterman AD, Ebers AG, Fraser VJ, Levinson W. Patients’ and physicians’ attitudes regarding the disclosure of medical errors. JAMA. 2003;289(8):1001–7.PubMed
103.
go back to reference Groman R, Ginsburg J. American College of Physicians. Racial and ethnic disparities in health care: a position paper of the American College of Physicians. Ann Intern Med. 2004;141(3):226–32.PubMed Groman R, Ginsburg J. American College of Physicians. Racial and ethnic disparities in health care: a position paper of the American College of Physicians. Ann Intern Med. 2004;141(3):226–32.PubMed
104.
go back to reference LaVeist TA, Nickerson KJ, Bowie JV. Attitudes about racism, medical mistrust, and satisfaction with care among African American and white cardiac patients. Med Care Res Rev. 2000;57(Suppl 1):146–61.PubMed LaVeist TA, Nickerson KJ, Bowie JV. Attitudes about racism, medical mistrust, and satisfaction with care among African American and white cardiac patients. Med Care Res Rev. 2000;57(Suppl 1):146–61.PubMed
105.
go back to reference Moseley KL, Church A, Hempel B, Yuan H, Goold SD, Freed GL. End-of-life choices for African-American and white infants in a neonatal intensive-care unit: a pilot study. J Natl Med Assoc. 2004;96(7):933–7.PubMed Moseley KL, Church A, Hempel B, Yuan H, Goold SD, Freed GL. End-of-life choices for African-American and white infants in a neonatal intensive-care unit: a pilot study. J Natl Med Assoc. 2004;96(7):933–7.PubMed
106.
go back to reference Charon R. Narrative and medicine. N Engl J Med. 2004;350(9):862–4.PubMed Charon R. Narrative and medicine. N Engl J Med. 2004;350(9):862–4.PubMed
107.
go back to reference Brady DW, Corbie-Smith G, Branch WT. ‘What’s important to you?’: the use of narratives to promote self-reflection and to understand the experiences of medical residents. Ann Intern Med. 2002;137(3):220–3.PubMed Brady DW, Corbie-Smith G, Branch WT. ‘What’s important to you?’: the use of narratives to promote self-reflection and to understand the experiences of medical residents. Ann Intern Med. 2002;137(3):220–3.PubMed
108.
go back to reference DasGupta S, Charon R. Personal illness narratives: using reflective writing to teach empathy. Acad Med. 2004;79:351–6.PubMed DasGupta S, Charon R. Personal illness narratives: using reflective writing to teach empathy. Acad Med. 2004;79:351–6.PubMed
109.
go back to reference Parle M, Maguire P, Heaven C. The development of a training model to improve health professionals’ skills, self-efficacy and outcome expectancies when communicating with cancer patients. Soc Sci Med. 1997;44(2):231–40.PubMed Parle M, Maguire P, Heaven C. The development of a training model to improve health professionals’ skills, self-efficacy and outcome expectancies when communicating with cancer patients. Soc Sci Med. 1997;44(2):231–40.PubMed
110.
go back to reference Langewitz W, Denz M, Keller A, Kiss A, Ruttimann S, Wossmer B. Spontaneous talking time at start of consultation in outpatient clinic: cohort study. Br Med J. 2002;325:682–3. Langewitz W, Denz M, Keller A, Kiss A, Ruttimann S, Wossmer B. Spontaneous talking time at start of consultation in outpatient clinic: cohort study. Br Med J. 2002;325:682–3.
111.
go back to reference Marvel M, Doherty W, Weiner E. Medical interviewing by exemplary family physicians. J Fam Pract. 1998;47(5):343–8.PubMed Marvel M, Doherty W, Weiner E. Medical interviewing by exemplary family physicians. J Fam Pract. 1998;47(5):343–8.PubMed
112.
go back to reference Branch WT, Malik TK. Using ‘windows of opportunities’ in brief interviews to understand patients’ concerns. JAMA. 1993;269(13):1667–8.PubMed Branch WT, Malik TK. Using ‘windows of opportunities’ in brief interviews to understand patients’ concerns. JAMA. 1993;269(13):1667–8.PubMed
113.
go back to reference Nightingale SD, Yarnold PR, Greenberg MS. Sympathy, empathy and physician resource utilization. J Gen Intern Med. 1991;6:420–3. Nightingale SD, Yarnold PR, Greenberg MS. Sympathy, empathy and physician resource utilization. J Gen Intern Med. 1991;6:420–3.
114.
go back to reference Wear D, Bickel J, eds. Educating for Professionalism: Creating a Culture of Humanism in Medical Education. Iowa City, IA: University of Iowa Press; 2000. Wear D, Bickel J, eds. Educating for Professionalism: Creating a Culture of Humanism in Medical Education. Iowa City, IA: University of Iowa Press; 2000.
115.
go back to reference Bellini LM, Baime M, Shea JA. Variation of mood and empathy during internship. JAMA. 2002;287(23):3143–6.PubMed Bellini LM, Baime M, Shea JA. Variation of mood and empathy during internship. JAMA. 2002;287(23):3143–6.PubMed
116.
go back to reference Bellini LM, Shea JA. Mood change and empathy decline persist during three years of internal medicine training. Acad Med. 2005;80(2):164–7.PubMed Bellini LM, Shea JA. Mood change and empathy decline persist during three years of internal medicine training. Acad Med. 2005;80(2):164–7.PubMed
117.
go back to reference Coulehan J, Williams PC. Conflicting professional values in medical education. Camb Q Healthc Ethics. 2003;12:7–20.PubMed Coulehan J, Williams PC. Conflicting professional values in medical education. Camb Q Healthc Ethics. 2003;12:7–20.PubMed
118.
go back to reference Coulehan J, Williams PC. Vanquishing virtue: the impact of medical education. Acad Med. 2001;76(6):598–605.PubMed Coulehan J, Williams PC. Vanquishing virtue: the impact of medical education. Acad Med. 2001;76(6):598–605.PubMed
119.
go back to reference Jahoda A, Wanless LK. Knowing you: the interpersonal perceptions of staff towards aggressive individuals with mild to moderate intellectual disabilities in situations of conflict. J Intellect Disabil Res. 2005;49:544–51.PubMed Jahoda A, Wanless LK. Knowing you: the interpersonal perceptions of staff towards aggressive individuals with mild to moderate intellectual disabilities in situations of conflict. J Intellect Disabil Res. 2005;49:544–51.PubMed
120.
go back to reference Jain A, Ogden J. General practitioners’ experiences of patients’ complaints: qualitative study. BMJ. 1999;318:1596–9.PubMed Jain A, Ogden J. General practitioners’ experiences of patients’ complaints: qualitative study. BMJ. 1999;318:1596–9.PubMed
Metadata
Title
Empathy and Patient–Physician Conflicts
Author
Jodi Halpern, MD, PhD
Publication date
01-05-2007
Publisher
Springer-Verlag
Published in
Journal of General Internal Medicine / Issue 5/2007
Print ISSN: 0884-8734
Electronic ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-006-0102-3

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