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Thomas Jefferson University
Jefferson Digital Commons
CRMEHC Faculty Papers
Center for Research in Medical Education and
Health Care
9-1-2002
Physician empathy: definition, components,
measurement, and relationship to gender and
specialty
Mohammadreza Hojat
Thomas Jefferson University, Mohammadreza.Hojat@jefferson.edu
Joseph S. Gonnella
Thomas Jefferson University, Joseph.Gonnella@jefferson.edu
Thomas J. Nasca
Thomas Jefferson University, Thomas.Nasca@jefferson.edu
Salvatore Mangione MD
Thomas Jefferson University, Salvatore.Mangione@jefferson.edu
Michael Vergare
Thomas Jefferson University, Michael.Vergare@jefferson.edu
See next page for additional authors
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Recommended Citation
Hojat, Mohammadreza; Gonnella, Joseph S.; Nasca, Thomas J.; Mangione, Salvatore MD; Vergare,
Michael; and Magee, Michael, "Physician empathy: definition, components, measurement, and
relationship to gender and specialty" (2002). CRMEHC Faculty Papers. Paper 4.
http://jdc.jefferson.edu/crmehc/4
Am J Psychiatry 159:9, September 2002 1563
Article
Physician Empathy: Definition, Components,
Measurement, and Relationship to Gender and Specialty
Mohammadreza Hojat, Ph.D.
Joseph S. Gonnella, M.D.
Thomas J. Nasca, M.D.
Salvatore Mangione, M.D.
Michael Vergare, M.D.
Michael Magee, M.D.
Objective: There is a dearth of empirical
research on physician empathy despite its
mediating role in patient-physician rela-
tionships and clinical outcomes. This
study was designed to investigate the
components of physician empathy, its
measurement properties, and group dif-
ferences in empathy scores.
Method: A revised version of the Jeffer-
son Scale of Physician Empathy (with 20
Likert-type items) was mailed to 1,007
physicians affiliated with the Jefferson
Health System in the greater Philadelphia
region; 704 (70%) responded. Construct
validity, reliability of the empathy scale,
and the differences on mean empathy
scores by physicians’ gender and specialty
were examined.
Results: Three meaningful factors emerged
(perspective taking, compassionate care,
and standing in the patient’s shoes) to pro-
vide support for the construct validity of
the empathy scale that was also found to
be internally consistent with relatively
stable scores over time. Women scored
higher than men to a degree that was
nearly significant. With control for gender,
psychiatrists scored a mean empathy rat-
ing that was significantly higher than that
of physicians specializing in anesthesiol-
ogy, orthopedic surgery, neurosurgery, ra-
diology, cardiovascular surgery, obstetrics
and gynecology, and general surgery. No
significant difference was observed on em-
pathy scores among physicians specializ-
ing in psychiatry, internal medicine, pedi-
atrics, emergency medicine, and family
medicine.
Conclusions: Empathy is a multidimen-
sional concept that varies among physi-
cians and can be measured with a psy-
chometrically sound tool. Implications for
specialty selection and career counseling
are discussed.
(Am J Psychiatry 2002; 159:1563–1569)
The patient-physician relationship is the center of
medicine. (1, p. 148)
In a series of reports by the Association of American
Medical Colleges on the Medical School Objectives Project
(2), it was stated that medical schools are expected to edu-
cate altruistic physicians who “must be compassionate
and empathetic in caring for patients.” Physicians’ under-
standing of a patient’s perspective—and their expression
of caring, concern, and empathy—are among the listed
educational objectives (p. 13). However, without a concep-
tual framework and an operational measure of physician
empathy, it is not possible to assess the degree to which
these objectives are ever achieved.
Although researchers agree on the positive role of em-
pathy in interpersonal relationships (3), they are divided
on the definition and, hence, the measurement of empa-
thy (4). Similarly, research on empathy in medicine has
been hampered both by a lack of conceptual clarity and
lack of an operational measure of physician empathy.
Empathy has been described as a concept involving
cognitive as well as affective or emotional domains (5).
The cognitive domain of empathy involves the ability to
understand another person’s inner experiences and feel-
ings and a capability to view the outside world from the
other person’s perspective (6). The affective domain in-
volves the capacity to enter into or join the experiences
and feelings of another person (6, 7). The affective rela-
tionships that elicit emotional response are conceptually
more relevant to sympathy than to empathy (3).
Although the concepts of empathy and sympathy are of-
ten mistakenly tossed into one terminological basket, they
should be distinguished in patient-care situations (8).
Both concepts involve sharing, but empathetic physicians
share their understanding, while sympathetic physicians
share their emotions with their patients (9). The two con-
cepts do not, however, function independently. For exam-
ple, in one study (6), we found a correlation coefficient of
0.45 between the two.
Because sympathy, if excessive, could interfere with ob-
jectivity in diagnosis and treatment (7, 9), “compassionate
detachment” has been used to describe the physician’s
empathetic concern for the patient while keeping sympa-
thy at a reasonable distance to maintain an emotional bal-
ance (9, 10). Hence, an “affective distance” would be desir-
able to avoid bursts of emotions that might interfere with
clinical neutrality and personal durability (11).
1564 Am J Psychiatry 159:9, September 2002
PHYSICIAN EMPATHY
In contrast, empathy has no restraining boundary be-
cause it is assumed that understanding is always benefi-
cial in patient care. An abundance of empathy should
never impede patient care. According to Bolognini (12),
empathy is a complementary state of separateness and
sharing, and its abundance adds to the crucial element of
healing.
On the basis of the aforementioned conceptualization,
we define empathy in patient-care situations as a cogni-
tive attribute that involves an ability to understand the pa-
tient’s inner experiences and perspective and a capability
to communicate this understanding. Despite the mediat-
ing role empathy can play in improving clinical outcomes
(9, 13), there is a dearth of empirical study on the topic in
the medical literature. One reason cited for this scarcity is
the absence of an operational measure of empathy that is
specific to the physician-patient relationship (6).
Among the few research instruments for measuring em-
pathy in the general population are the Interpersonal Re-
activity Index, developed by Davis (14), the Hogan Empa-
thy Scale (15), and Emotional Empathy, developed by
Mehrabian and Epstein (16). A few methods of measuring
empathy have also been developed for use in nursing.
These include the Empathy Construct Rating Scale (17),
the Empathic Understanding of Interpersonal Processes
Scale (18), the empathy subtest of the Relation Inventory
(19), and the Empathy Test (20). None of these scales was
specifically developed to measure physician empathy and,
therefore, may not capture the essence of empathetic care
rendered by physicians.
Research indicates that empathy has been linked, theo-
retically or empirically, to a number of attributes, such as
dutifulness (21), prosocial behavior (22), moral reasoning
(23), good attitudes toward elderly patients (24), a reduc-
tion in malpractice litigation (25), competence in history
taking and performance of physical examinations (26),
patient satisfaction (9, 25), physician satisfaction (27), bet-
ter therapeutic relationships (28, 29), and good clinical
outcomes (9). It has also been reported that women dem-
onstrate more empathy than men (6, 30) and express more
caring attitudes (31, 32).
Little empirical evidence is available to link empathy
and physician specialty. In one study (33), general practice
physicians ranked highest among different medical (phy-
sicians, nurses) and nonmedical (clergymen, lawyers)
professions on empathy, warmth, and genuineness. In
another study (34), no difference was observed in empa-
thy among medical students with different specialty pref-
erences. In a recent study (35), medical students who
planned to pursue specialties such as family medicine and
pediatrics scored higher on empathy measures than their
counterparts who planned to pursue radiology or pathol-
ogy. In one of our recent studies (36), physicians in “peo-
ple-oriented” specialties (primary care, obstetrics and gy-
necology, emergency medicine, psychiatry, and medical
subspecialties) scored a significantly higher average em-
pathy rating than their counterparts in “technology-ori-
ented” specialties (hospital-based specialties, surgery, and
surgical subspecialties).
We designed this study to empirically examine the un-
derlying structure of a newly developed scale of physician
empathy and its reliability as well as to investigate differ-
ences on empathy scores between male and female physi-
cians and among physicians in different specialties.
Method
Participants
Study participants included 704 physicians in the Jefferson
Health System, which is affiliated with Thomas Jefferson Univer-
sity Hospital and Jefferson Medical College in the greater Phila-
delphia region. The mean age of the participants was 46.8 years
(SD=10.5, range=29–87).
Instrument
A revised version of the Jefferson Scale of Physician Empathy
(6) was used in this study. This scale was originally developed to
measure the attitudes of medical students toward physician em-
pathy in patient-care situations (the “S” version). The scale was
constructed on the basis of an extensive review of the literature,
followed by pilot studies with groups of practicing physicians,
medical students, and residents. After several iterations and re-
finements, the Jefferson Scale of Physician Empathy included 20
Likert-type items answered on a 7-point scale (1=strongly dis-
agree, 7=strongly agree).
Psychometric data in support of the construct validity and
criterion-related validity (convergent and discriminant) and in-
ternal consistency reliability of the original Jefferson Scale of Phy-
sician Empathy (the “S” version) have been reported (6). Conver-
gent validity was confirmed by significant correlations (p<0.05)
between scores on the empathy scale and conceptually relevant
measures, such as compassion (for residents, r=0.56; for medical
students, r=0.48) (6). Also, significant correlations were observed
between the Jefferson Scale of Physician Empathy and Interper-
sonal Reactivity Index (14) subtest scores for empathetic concern
(for residents, r=0.40; for medical students, r=0.41), perspective
taking (for residents, r=0.27; for medical students, r=0.29), and
fantasy (for residents, r=0.32; for medical students, r=0.24) (6).
Correlations of scores on the Jefferson Scale of Physician Empa-
thy and self-ratings of empathy were 0.45 for residents and 0.37
for medical students (6). Discriminant validity was supported by
the lack of a relationship between empathy and conceptually ir-
relevant measures such as self-protection (r=0.11, nonsignifi-
cant). Internal consistency reliability of the original scale was de-
termined by coefficients alpha (0.87 for residents and 0.89 for
medical students) (6).
We developed a revised version of the Jefferson Scale of Physi-
cian Empathy for physicians and health professionals (the “HP”
version) for this study by slightly modifying the wording of the “S”
version to make it more relevant to the caregiver’s empathetic be-
havior rather than to empathetic perceptions (attitudes). The
changes were made on the basis of the assumption that empa-
thetic attitudes (perceptions) and behaviors (actions) are two dif-
ferent aspects of empathy (37) even though they are correlated.
For example, the following item is from the “S” version: “Be-
cause people are different, it is almost impossible for physicians
to see things from their patients’ perspectives” (6). It was revised
to read as follows in the “HP” version: “Because people are differ-
ent, it is almost impossible for me to see things from my patients’
perspectives.” These modifications were also intended to make
Am J Psychiatry 159:9, September 2002 1565
HOJAT, GONNELLA, NASCA, ET AL.
the scale applicable to other health-care providers (e.g., nurses,
psychotherapists, etc.), as well as physicians.
Furthermore, there were only three negatively worded items in
the “S” version of the Jefferson Scale of Physician Empathy. Nega-
tively worded items are usually used in psychological tests to de-
crease the confounding effect of the “acquiescence response
style” (e.g., the tendency to constantly agree or disagree by yea-
sayers and naysayers). In the “HP” version, a balance was main-
tained by making 10 items positively worded and 10 items nega-
tively worded. Questions were also included about respondents’
gender and primary areas of practice. (Copies of the “S” and “HP”
versions of the Jefferson Scale of Physician Empathy can be ob-
tained from the first author.)
Procedures
The Jefferson Scale of Physician Empathy was mailed to 1,007
physicians. Each was accompanied by a cover letter signed by one
of the authors (T.J.N.) to increase cooperation. A handwritten
note was included on the cover letter for many of the physicians
who were personally known to the author who signed the letters.
The respondents were instructed not to identify themselves
and were assured about the strict confidentiality of individual re-
sponses. An addressed, postage-paid envelope was provided for
return of the survey. Two follow-up reminders were sent to nonre-
spondents at 4- and 8-week intervals after the original mailing. A
total of 704 completed surveys were returned, representing a 70%
response rate.
For the purpose of studying the test-retest reliability of the Jef-
ferson Scale of Physician Empathy, a group of 100 physicians who
responded to the survey were randomly selected. They were sent
a second copy of the Jefferson Scale of Physician Empathy with a
thank-you note for their participation and a request to complete
the second copy of the empathy scale for the purpose of the reli-
ability study. Seventy-one physicians responded, and their scores
from the two tests were correlated. The exact time interval be-
tween completion of the two tests could not be accurately deter-
mined because we did not ask the physicians to specify the date
on which they completed the questionnaires. On the basis of the
postmarks, we estimated that the testing interval was approxi-
mately 3–4 months.
Statistical Analyses
To investigate the underlying components of the Jefferson
Scale of Physician Empathy (“HP” version), data were subjected
to principal-component factor analysis by using orthogonal rota-
tion to obtain a simpler factor structure. A t test was also used to
compare the scores of men and women, and analysis of variance
was used to examine the differences on the mean empathy scores
among physicians in different specialties. Because of the small
number of women in some of the specialties, we used analysis of
covariance (ANCOVA) (with gender as a covariate) instead of a
two-way analysis of variance (with gender and specialty as the in-
dependent variables) to control for the effect of gender on empa-
thy scores for physicians in different specialties.
Results
The response rate achieved in this study (70%) is con-
siderably higher than the typical rate of 52% reported for
mailed surveys to physicians (38). But according to Gough
and Hall (39), a response rate of at least 75% should be
achieved to ensure representativeness of the sample for
mailed surveys to professionals. Since our response rate
was lower than 75%, we compared the respondents and
nonrespondents on their specialties (the only variable
available to us for nonrespondents) to ensure that the re-
spondents were representative in that regard. No signifi-
cant difference in specialties was observed between the
respondents and the nonrespondents.
Components of the Empathy Scale
To examine the underlying factors (components) of the
empathy scale, an exploratory factor analysis was con-
ducted that produced three meaningful factors with eigen-
values greater than one. The first factor accounted for 21%,
the second factor for 8%, and third factor for 7% of the total
variance. The magnitudes of the eigenvalues, proportions
of variance, and factor coefficients are reported in Table 1.
As shown in the table, the 10 positively worded items had
factor coefficients greater than 0.35 for factor 1 (shown in
bold). On the basis of the content of these items and the
magnitude of the eigenvalue, the first factor can be consid-
ered the grand factor of perspective taking, the core ingre-
dient of empathy (5, 13, 14). This factor is very similar to
the grand factor of physician’s view from patient’s perspec-
tive that emerged in the “S” version of the scale (6).
Eight of the negatively worded items had factor coeffi-
cients greater than 0.35 for factor 2. On the basis of the
content of these items, this factor can be considered a
construct involving “compassionate care” (which is in op-
position to the negatively worded items’ contents)—simi-
lar to the emotions in patient care that emerged in the “S”
version (6). Finally, two other negatively worded items had
high coefficients for factor 3, titled the ability to stand in
the patient’s shoes (which is in contrast to the negatively
worded items’ contents). This factor is also similar to
thinking like the patient, which is found in the “S” version
of the scale (6).
The factor structure of the Jefferson Scale of Physician
Empathy is consistent with the conceptual aspects of a
multidimensionality notion of empathy (4, 14). The stabil-
ity of factor structure and factor similarity across different
groups (medical students and practicing physicians) and
across different forms (the “S” and “HP” versions) provide
further support for the construct validity of the scale.
Descriptive Statistics and Reliability Coefficients
Score distribution and descriptive statistics for the Jef-
ferson Scale of Physician Empathy (“HP” version) are re-
ported in Table 2. The internal consistency of the empathy
scale was examined by calculating Cronbach’s coefficient
alpha. This reliability coefficient was 0.81, indicating that
the Jefferson Scale of Physician Empathy is internally con-
sistent. The test-retest reliability coefficient was 0.65, sug-
gesting that the empathy scores were relatively stable over
time.
Gender Difference and Age
We compared the empathy scores for 507 men and 179
women who reported their gender. The mean empathy
score for men (mean=119.1, SD=11.8) was slightly lower
than that for women (mean=120.9, SD=12.2), and the dif-
1566 Am J Psychiatry 159:9, September 2002
PHYSICIAN EMPATHY
ference between genders was nearly significant (t=1.71,
df=684, p=0.08). Age did not significantly correlate with
empathy scores for men (r=0.01) or women (r=0.07).
Specialty Comparisons
We compared the mean empathy scores for physicians
in 12 different specialty groups. For a meaningful compar-
ison, only the specialties reported by more than 20 physi-
cians were included in this analysis. Statistically signifi-
cant differences were found in empathy scores among
physicians in different specialties (F=1.99, df=11, 493,
p<0.05) (Table 3).
The specialties in Table 3 are listed in descending order
of magnitude of mean empathy scores. Psychiatrists had
the highest mean empathy score (mean=127.0), followed
by physicians in general internal medicine (mean=121.7),
general pediatrics (mean=121.5), emergency medicine
(mean=121.0), and family medicine (mean=120.5). The
lowest means were scored by physicians in anesthesiol-
ogy (mean=116.1), orthopedic surgery (mean=116.5),
neurosurgery (mean=117.3), radiology (mean=117.9),
and cardiovascular surgery (mean=118.0). Physicians in
general surgery (mean=119.3) and obstetrics and gyne-
cology (mean=119.2) had scores that fell between these
high- and low-scoring specialties. The differences in em-
pathy scores among psychiatrists and physicians in inter-
nal medicine, pediatrics, and emergency medicine were
not statistically significant, but physicians in all other
specialties scored significantly lower than psychiatrists
(p<0.05, by Duncan’s post hoc mean comparison test).
When we controlled the effect of physician gender (by
ANCOVA), the aforementioned differences among spe-
cialties remained unchanged with one exception—physi-
cians in family medicine were among the high scorers for
empathy and were not significantly different from their
counterparts in psychiatry, general internal medicine,
general pediatrics, and emergency medicine. These re-
sults are consistent with our previous findings (36) and
with findings reported by Newton and colleagues (35) but
not with those reported by Harsch (34).
Discussion
A positive patient-physician relationship is a critical el-
ement in the practice of medicine and in the art of healing
(1, 4, 9, 25); however, such relationships have been se-
verely strained by changes in the economics of medical
practice (1) as well as recent developments in the organi-
zation and delivery of health care (40). When one consid-
ers the many changes within the health-care system that
TABLE 1. Rotated Factor Loadings for the Jefferson Scale of Physician Empathy, Based on the Responses of 704 Physicians
a
Factor
Item 123
1. An important component of the relationship with my patients is my understanding of the emotional
status of the patients and their families. 0.70 0.21 –0.08
2. I try to understand what is going on in my patients’ minds by paying attention to their nonverbal
cues and body language. 0.62 0.06 0.23
3. I believe that empathy is an important therapeutic factor in medical treatment. 0.60 0.28 –0.25
4. Empathy is a therapeutic skill without which my success as a physician would be limited. 0.58 0.22 –0.16
5. My understanding of my patients’ feelings gives them a sense of validation that is therapeutic in its
own right. 0.58 0.32 0.03
6. My patients feel better when I understand their feelings. 0.50 –0.02 0.16
7. I consider understanding my patients’ body language as important as verbal communication in
physician-patient relationships. 0.48 –0.18 0.30
8. I try to imagine myself in my patients’ shoes when providing care to them. 0.46 0.29 0.28
9. I have a good sense of humor, which I think contributes to a better clinical outcome. 0.45 –0.02 0.14
10. I try to think like my patients in order to render better care. 0.46 0.20 0.25
11. Patients’ illnesses can be cured only by medical treatment; therefore, affectional ties to my patients
cannot have a significant place in this endeavor.
b
0.17 0.60 –0.01
12. Attentiveness to my patients’ personal experiences is irrelevant to treatment effectiveness.
b
0.07 0.59 0.07
13. I try not to pay attention to my patients’ emotions in interviewing and history taking.
b
0.02 0.54 0.02
14. I believe that emotion has no place in the treatment of medical illness.
b
0.22 0.50 –0.03
15. I do not allow myself to be touched by intense emotional relationships among my patients and their
family members.
b
0.13 0.44 0.26
16. My understanding of how my patients and their families feel is an irrelevant factor in medical
treatment.
b
–0.03 0.43 0.14
17. I do not enjoy reading nonmedical literature or experiencing the arts.
b
0.05 0.37 0.13
18. I consider asking patients about what is happening in their lives an unimportant factor in
understanding their physical complaints.
b
0.10 0.37 –0.12
19. It is difficult for me to view things from my patients’ perspectives.
b
0.10 0.05 0.74
20. Because people are different, it is almost impossible for me to see things from my patients’
perspectives.
b
0.17 0.20 0.66
Eigenvalue 4.2 1.5 1.3
% variance 21 8 7
a
Items are listed by the order of magnitude of the factor structure coefficients within each factor. Values greater than 0.35 are in bold.
Responses were based on a 7-point Likert-type scale.
b
Responses were reverse-scored on these items (strongly agree=1, strongly disagree=7); otherwise, items were scored directly (strongly
agree=7, strongly disagree=1).
Am J Psychiatry 159:9, September 2002 1567
HOJAT, GONNELLA, NASCA, ET AL.
may negatively influence the patient-physician alliance
and undermine empathy in therapeutic relationships, it
makes sense to begin studying the development and cor-
relates of physician empathy and its contribution to clini-
cal outcomes.
The findings of this study suggest that physician empa-
thy is a multidimensional concept involving at least three
components. The most important component is perspec-
tive taking, an outcome consistent with that reported for
the general population (5, 13, 14). Other components of
empathy are compassionate care and standing in the pa-
tient’s shoes, which are both specific to the patient-physi-
cian relationship.
Studies are inconsistent about how amenable empathy
is to educational intervention among medical students
and physicians. Some researchers believe that empathy is
a personality state that can decline during medical educa-
tion (41) but can also be improved by targeted educational
activities (42, 43). Others report that empathy is a person-
ality trait that cannot be easily taught (44, 45). We do not
know which of the three components of empathy found in
this study is more or less amenable to educational inter-
ventions in training physicians, nor do we know which of
the physician’s three professional roles as clinician, educa-
tor, and resource manager (46) can be enhanced by in-
creasing his/her empathy. Further empirical research is
needed to address these issues.
It is important to investigate the underlying reasons for
variations in empathy among health-care professionals.
For example, although it did not reach statistical signifi-
cance in this study, the finding that women tend to score
higher on empathy ratings than men is consistent with the
findings of other studies (30, 47), but it falls short of pro-
viding an explanation for gender differences in empathy.
Several explanations can be offered for gender differ-
ences in empathy. For example, it has been suggested that
women are more receptive than men to emotional signals
(48), a quality that can contribute to a better understand-
ing and, hence, to a better empathetic relationship (47).
Also, on the basis of the evolutionary theory of parental in-
vestment, women are believed to develop more caregiving
attitudes toward their offspring than men (48). The find-
ings on gender differences in empathy are in agreement
with the reports that female physicians spend more time
with their patients, have fewer patients (49), and render
more preventive and patient-oriented care (50, 51).
More empirical evidence is needed to test the hypothe-
sis that relates gender differences on empathy to intrinsic
(e.g., evolutionary gender characteristics) or to extrinsic
(e.g., gender role expectations) factors (30). Each hypothe-
sis has potentially different implications in the selection
and training of physicians.
The significant differences in empathy scores observed
among physicians in various specialties might reflect the
notion that different individuals with different degrees of
interpersonal skills, reflected in their empathy scores, are
attracted to different specialties (34). These differences
might also result from the amount of emphasis in training
that is placed on interpersonal skills in different special-
ties. Each of these notions has implications in the selec-
tion, career counseling, and curriculum development of
academic medical centers.
Prospective studies might well be conducted to examine
the relationship between empathy scores and perfor-
mance measures in medical school, to address changes in
empathy at different levels of undergraduate and graduate
TABLE 2. Distributions, Percentiles, and Descriptive Statis-
tics for Scores on the Jefferson Scale of Physician Empathy
of 704 Physicians
Score Variable Frequency
Cumulative
Frequency
Cumulative
%
Interval
≤75 3 3 <1
76–80 3 6 1
81–85 2 8 1
86–90 3 11 2
91–95 13 24 3
96–100 21 45 6
101–105 31 76 11
106–110 57 133 19
111–115 97 230 33
116–120 111 341 48
121–125 114 455 65
126–130 126 581 83
131–135 85 666 95
136–140 38 704 100
Mean 120
SD 12
Percentile
25th 113
50th (median) 121
75th 128
Possible range 20–140
Actual range 50–140
Alpha reliability estimate 0.81
Test-retest reliability
a
0.65
a
Test-retest reliability was calculated for 71 physicians within an
approximately 3–4-month interval between tests.
TABLE 3. Scores of 704 Physicians on the Jefferson Scale of
Physician Empathy by Gender and Specialty
Gender and Specialty N Mean SD
Gender
a
Men 507 119.1 11.8
Women 179 120.9 12.2
Specialty
b
Psychiatry 24 127.0 5.5
Internal medicine 60 121.7 10.6
Pediatrics 78 121.5 12.2
Emergency medicine 23 121.0 10.7
Family medicine 69 120.5 12.6
General surgery 33 119.3 14.9
Obstetrics/gynecology 24 119.2 10.4
Cardiovascular surgery 44 118.0 13.2
Radiology 43 117.9 13.1
Neurosurgery 21 117.3 9.5
Orthopedic surgery 24 116.5 12.9
Anesthesiology 51 116.1 12.0
a
Difference was nearly significant (t=1.71, df=684, p=0.08).
b
Differences were statistically significant (F=1.99, df=11, 493,
p
<0.05). Specialties are listed in descending order by the magni-
tude of the mean empathy score.
1568 Am J Psychiatry 159:9, September 2002
PHYSICIAN EMPATHY
medical education, and to investigate the long-term ef-
fects of physician empathy on patient satisfaction, clinical
outcomes, and malpractice litigation.
This study is a step toward clarification and measure-
ment of physician empathy. The definition and measure-
ment of empathy deserves attention because this essential
humanistic aspect of medicine eludes the performance
measures that are commonly used in medical education.
Such research could have important implications in the
selection and education of medical students and residents
and in career counseling. The Jefferson Scale of Physician
Empathy that was used in this study, supported by con-
struct validity, test-retest, and internal consistency reli-
abilities, provides a psychometrically sound tool for future
research on physician empathy.
Received Nov. 16, 2001; revision received April 10, 2002; accepted
April 22, 2002. From the Center for Research in Medical Education
and Health Care and the Department of Psychiatry and Human
Behavior, Jefferson Medical College, Thomas Jefferson University.
Address reprint requests to Dr. Hojat, Center for Research in Medical
Education and Health Care, Jefferson Medical College, 1025 Walnut
St., Philadelphia, PA 19107; mohammadreza.hojat@mail.tju.edu (e-
mail).
Supported in part by a grant from the Pfizer Medical Humanities
Initiative of Pfizer, Inc.
The authors thank Dorissa Bolinski for editorial assistance.
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