Empathy in Patient Care

Hojat, Mohammadreza

Primary Category: Literature / Nonfiction

Genre: Treatise

Annotated by:
Coulehan, Jack
  • Date of entry: Dec-08-2009
  • Last revised: Dec-07-2009


Dr. Hojat's comprehensive survey of empathy in medicine is subtitled "Antecedents, Developments, Measurement, and Outcomes." He begins by carefully distinguishing empathy from related concepts or qualities, like sympathy and compassion; and by clarifying the cognitive, as opposed to affective, nature of empathy. Essentially, empathy creates our sense of connectedness with other human beings and, to a limited extent, with some animals. After sketching its evolutionaly and neurological substrates, Hojat then summarizes research in measuring empathy, with particular emphasis on empathy in the clinical setting.

The Jefferson Scale of Physician Empathy (JSPE), developed by Hojat, is among the most useful and well-validated self-report survey instruments. This scale is also available in a form to be completed by patients, the Jefferson Scale of Patient's Perception of Physician Empathy (JSPPPE). Hojat presents the results of numerous studies using the JSPE and other instruments to asses medical student and physician empathy. For example, some evidence suggests that female physicians are more empathic than male physicians, that students with higher empathy scores are more likely to engage in prosocial behavior, and that primary care attracts medical students who score higher in empathy. There is also a considerable body of evidence showing that empathic engagement with patients by physicians leads to better health outcomes.

The chapter on enhancement of empathy is especially important for medical education. Hojat reviews various methods for enhancing clinical empathy, including, for example, communication skills training, systematic "shadowing," teaching narrative skills, and study of literature and the arts. He concludes "research shows that empathy can be enhanced effectively by dedicated educational programs," although such programs face many obstacles in the current context of medical education.


Dr. Hojat has performed an important service by providing us with this lucid, well-organized, and comprehensive study of clinical empathy. He is one of the most experienced and productive investigators in the field; the JSPE and JSPPPE constitute significant steps forward in measuring perceived empathy.

Conceptualizing and measuring clinical empathy presents a complex problem. In particular, the affective vs. cognitive distinction, in which empathy is ascribed to the latter but not the former, seems somewhat artificial, given our current knowledge of the deep connection between cognition and emotion. Likewise, the notion that a set of self-reported qualities could effectively function as an accurate measure of empathy-in-action seems either wrong or, more likely, incomplete. However, Hojat is aware of this and is moving toward more comprehensive approaches to evaluation. His Empathy in Patient Care is an absolutely essential book for all students of empathy and the clinician-patient relationship.

Primary Source

Empathy in Patient Care



Place Published

New York



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