JAMA Network publishes HSC study showing chronic pain favorable outcomes associated with physician empathy

Thursday, April 11, 2024

Dr.John C. LicciardoneJAMA Network Open this month published an article, “Physician Empathy and Chronic Pain Outcomes,” based on national data collected by the Pain Registry for Epidemiological, Clinical, and Interventional Studies and Innovation (PRECISION) at The University of North Texas Health Science Center at Fort Worth.

The research team was led by John C. Licciardone, DO, MS, MBA, PRECISION director. Other investigators included Yen Tran, Khang Ngo, David Toledo and Navya Peddireddy, all students at HSC’s Texas College of Osteopathic Medicine, and Subhash Aryal, PhD, a registry biostatistician affiliated with Johns Hopkins University.

The study involved 1,470 adults with chronic low-back pain and found that patients treated by very empathic physicians reported significantly better outcomes pertaining to pain, function and health-related quality of life over 12 months compared with patients treated by slightly empathic physicians.

“Patients with chronic pain may feel misunderstood and marginalized when there are no objective findings to explain their symptoms, and physicians often have difficulty providing pain relief,” Licciardone said. “Our results underscore the importance of the patient-physician relationship in such cases. Having a very empathic physician appears to provide more favorable outcomes than prescribing opioid therapy, lumbar spine surgery or other treatments.”

“I strongly believe that empathy and building rapport are key to patient-physician interactions,” said Tran, a second-year TCOM student. “The phrase ‘patient-centered care’ has become widespread, indicating that patients prefer physicians with strong interpersonal skills and empathy. Beyond pain, physician empathy is important in treating other chronic conditions such as diabetes and pulmonary diseases that require long-term management. In such cases, very empathic physicians may prevent patients from becoming disheartened and noncompliant with their treatment plan.”

“There has been a long-standing debate about whether physicians can or should be taught to be empathic,” Licciardone said. “Medical students and residents often become less empathic during their education and training, owing to a greater perceived need for patient detachment and reliance on technology. The challenges of contemporary medicine, including electronic medical records documentation, treatment authorizations and time constraints during patient encounters, may lead to burnout and erode empathy even among seasoned physicians. Our results support greater efforts to cultivate physician empathy.”

PRECISION was established in 2016 at HSC to meet the vision of “a future for all unbounded by pain.” The registry has a unique focus on the patient-physician relationship in chronic pain management, including the prescribing of opioid therapy. Recent registry research published in the JAMA Network examined racial differences in the patient-physician relationship.

The full text of the newly released article can be found here. To learn more about PRECISION, contact Samantha Johnson at samantha.johnson@unthsc.edu or 817-735-0532.

From HSC Newsroom - Research by Steven Bartolotta