Eight easy ways to enhance empathy in consultations

With busy workloads continuing to challenge healthcare professionals, Dr Andy Ward from the Stoneygate Centre for Empathic Healthcare offers a useful checklist for empathic care

Empathy is increasingly recognised as a cornerstone of effective healthcare. A growing body of evidence shows that empathy not only reduces pain¹ and enhances patient satisfaction² but also helps protect healthcare practitioners from burnout.³

Despite these clear advantages, patients experience varying levels of empathy from their providers.⁴ This inconsistency has been identified as a contributing factor in the tragedies outlined in the Ockenden⁵, Francis⁶, and Kirkup⁷ reports on failures at three NHS hospitals.

One common barrier to empathic care, often cited by busy healthcare practitioners, is a lack of time.⁸

There are several quick and easy, evidence-based strategies that can significantly enhance empathy in your consultations. Here are eight of them:

Greet your patient in person

Instead of relying on an intercom or electronic calling system, meet your patient in the waiting room. The walk to your consulting room offers an opportunity to observe the patient’s mobility and engage in informal conversation, helping to put them at ease.⁹

Give your name

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The first few moments of a consultation are crucial to establishing rapport.

Most patients want practitioners to use their name when greeting them. If using both a patient’s first name and last name when verifying identity at the start of a consultation, you should also use the same approach when introducing yourself, like this: ‘Jane Smith? Hello, I’m Margaret Jones’.

Check the patient’s preferred form of address after this initial greeting and make a note of this for future consultations.¹⁰

Prioritise eye contact

Avoid the temptation to look at your computer screen while you or the patient are speaking.

Eye contact is a crucial non-verbal cue that communicates empathy. If you need to check something on the screen, explain what you’re doing and why before turning away.¹¹

Take a seat

When your patient is lying on an examination couch and you need to speak with them before or after a procedure, sit beside them rather than standing.

This simple gesture makes patients feel that you’re spending more time with them and improves communication. It also enhances patient satisfaction.¹²

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Mind your body language

A slight forward lean and appropriate physical contact can signal engagement and increase patient satisfaction with the consultation.¹³

Don’t interrupt

While it may seem counterintuitive, refraining from interrupting can actually shorten the consultation time and yield valuable insights.

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Patients’ opening statements, if uninterrupted, usually last less than 30 seconds.¹⁴

Cultivate curiosity

Show genuine interest in your patients by following up on cues or things that you notice about them. Curiosity not only enhances diagnostic accuracy, especially in complex cases, but also helps challenge assumptions.^15,16

Practice self-empathy

Healthcare can be stressful, and self-care is often overlooked. Taking a deep breath before starting a new task, especially between patients, can help reduce anxiety and maintain your well-being.¹⁷

By incorporating these simple practices, you can enhance the empathy in your consultations, improving outcomes for both your patients and yourself.

Dr Andy Ward is an Associate Professor of Medical Education at the University of Leicester’s Stoneygate Centre for Empathic Healthcare and an Honorary Senior Academic GP

This article was developed based on previous research that Andy Ward has done for general practitioners: Just do it! Ten easy ways to enhance empathy in the consultation.¹⁸

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The Stoneygate Centre for Empathic Healthcare will run a ‘Putting Evidence-Based Empathy into Practice’ workshop for healthcare professionals on 8 October – booking available.

References

1. Howick J, Moscrop A, Mebius A, Fanshawe TR, Lewith G, Bishop FL, et al. Effects of empathic and positive communication in healthcare consultations: a systematic review and meta-analysis. Journal of the Royal Society of Medicine. 2018;111(7):240-52. https://doi.org/10.1177/0141076818769477
2. Keshtkar L, Madigan CD, Ward A, Ahmed S, Tanna V, Rahman I, et al. The effect of practitioner empathy on patient satisfaction: a systematic review of randomized trials. Annals of Internal Medicine. 2024;177(2):196-209. https://doi.org/10.7326/M23-2168
3. Thirioux B, Birault F, Jaafari N. Empathy is a protective factor of burnout in physicians: new neuro-phenomenological hypotheses regarding empathy and sympathy in care relationship. Frontiers in psychology. 2016;7:763. https://doi.org/10.3389/fpsyg.2016.00763
4. Howick J, Steinkopf L, Ulyte A, Roberts N, Meissner K. How empathic is your healthcare practitioner? A systematic review and meta-analysis of patient surveys. BMC Medical Education. 2017;17:1-9. https://pubmed.ncbi.nlm.nih.gov/28823250/3
5. Ockenden D. Ockenden report: findings, conclusions and essential actions from the independent review of maternity services at the Shrewsbury and Telford Hospital NHS Trust. 2022. https://assets.publishing.service.gov.uk/media/624332fe8fa8f527744f0615/Final-Ockenden-Report-web-accessible.pdf
6. Mid Staffordshire N. Report of the Mid Staffordshire NHS Foundation trust public inquiry: Stationery Office; 2013. https://assets.publishing.service.gov.uk/media/5a7ba0faed915d13110607c8/0947.pdf
7. Kirkup B. The report of the Morecambe Bay investigation. Google Scholar. 2015. https://assets.publishing.service.gov.uk/media/5a7f3d7240f0b62305b85efb/47487_MBI_Accessible_v0.1.pdf
8. Morse DS, Edwardsen EA, Gordon HS. Missed opportunities for interval empathy in lung cancer communication. Archives of internal medicine. 2008;168(17):1853-8. https://doi.org/10.1001/archinte.168.17.1853
9. Wilkinson M. Consultations start in the waiting room. British Journal of General Practice. 2018;68(666):28-. https://doi.org/10.3399/bjgp17X694205
10. Makoul G, Zick A, Green M. An evidence-based perspective on greetings in medical encounters. Archives of internal medicine. 2007;167(11):1172-6. https://doi.org/10.1001/archinte.167.11.1172
11. Kraft-Todd GT, Reinero DA, Kelley JM, Heberlein AS, Baer L, Riess H. Empathic nonverbal behavior increases ratings of both warmth and competence in a medical context. PloS one. 2017;12(5):e0177758. https://doi.org/10.1371/journal.pone.0177758
12. Iyer R, Park D, Kim J, Newman C, Young A, Sumarsono A. Effect of chair placement on physicians’ behavior and patients’ satisfaction: randomized deception trial. bmj. 2023;383. https://doi.org/10.1136/bmj-2023-076309
13. Little P, White P, Kelly J, Everitt H, Mercer S. Randomised controlled trial of a brief intervention targeting predominantly non-verbal communication in general practice consultations. British Journal of General Practice. 2015;65(635):e351-e6. https://doi.org/10.3399/bjgp15X685237
14. Rabinowitz I, Luzzati R, Tamir A, Reis S. Length of patient’s monologue, rate of completion, and relation to other components of the clinical encounter: observational intervention study in primary care. Bmj. 2004;328(7438):501-2. https://doi.org/10.1136/bmj.328.7438.501
15. Adashi EY, Ahmed A-KH, Gruppuso PA. The importance of being curious. The American journal of medicine. 2019;132(6):673-4. https://doi.org/10.1016/j.amjmed.2018.12.002
16. Halpern J. From idealized clinical empathy to empathic communication in medical care. Medicine, Health Care and Philosophy. 2014;17:301-11. https://doi.org/10.1007/s11019-013-9510-4
17. Sajidah H, Khairunnisa S, Nabila C. The effect of relaxing a deep breath on anxiety levels. KESANS: International Journal of Health and Science. 2021;1(2):88-95. https://doi.org/10.54543/kesans.v1i2.15
18. Howick J, Ward A, Papanikitas A. Just do it! Ten easy ways to enhance empathy in the consultation.  British Journal of General Practice 2024; 74 (740): 124-125. DOI: https://doi.org/10.3399/bjgp24X736593