Just do it! Ten easy ways to enhance empathy in the consultation

Enhanced empathy is a professional virtue recognised by the General Medical Council.¹ It can lower patient pain, raise patient satisfaction,² and reduce practitioner burnout.³ The absence of empathy increases medico-legal risk and reduces patient safety.⁴ The Ockenden, Kirkup, and Francis reports into the avoidable deaths at three NHS hospitals all cite lack of empathy as one of the causes of the tragedies.^5–7 The Francis report concluded that a contributing cause of the hundreds of unnecessary deaths was ‘an attitude which would be unlikely to be persisted in if those adopting it were constantly to place an empathy for the predicament of patients at the forefront of their mind’.⁷

Yet, the extent to which patients report that their practitioners are empathic varies.⁸ A reason for the variation is the perception that empathic care takes more time than busy healthcare practitioners have to spare.⁹ The good news is that there are at least 10 evidence-based ways to enhance empathy. These take little time and can pay back the moments invested (sometimes with compound interest).

1. Greet patients in the waiting room instead of having a receptionist or an electronic noticeboard summon them to your office. Observing how well they rise, walk, breathe, and navigate the corridor is valuable diagnostic information. It is also good for you to get up and move (if you are able to).¹⁰

2. Introduce yourself by name. Patients prefer this, and it will make them more satisfied with your care.¹¹

3. In situations such as home visits or care-home rounds, sit beside the patient instead of standing up. Practitioners who sit down are perceived to spend more time with their patients,¹² while improving communication and patient satisfaction.¹³

4. Look at the patient when talking with them rather than a computer screen or notes.¹⁴

5. Use facial expressions or other non-verbal communication that mirror the patients’, where appropriate, to show that you understand and build connection.¹⁵

6. Don’t interrupt the patient. Paradoxically, not interrupting the patient can reduce the overall consultation length while providing patients with the opportunity to express their concerns.¹⁶ A leading GP and chair of NICE, David Haslam famously taught this idea as ‘Shut up and listen!’¹⁷

7. Go beyond objective observation to be genuinely curious about the patient. Curiosity improves diagnostic accuracy, especially with complex patients.¹⁸

8. Consciously use body language. Have physically engaging body language such as a slight lean forward, or appropriate physical contact.¹⁹ Express concern with your tone of voice (as opposed to dominance or anxiety); concerned tones are associated with lower rates of malpractice suits.²⁰

9. Give a truthful, positive message of hope, even if it is just, ‘We are going to do our best to take care of you.’ Positive messages can reduce patient pain.¹

10. Take care of yourself. Being a healthcare practitioner is inherently difficult and stressful. Taking a deep breath before starting any new task takes a negligible amount of time and can make a small positive difference.²¹

These tools take little or no training or time to adopt, so remove barriers to implementing empathic care within clinical practice. Enhanced empathy leads to safer, high-quality care, more satisfied patients, and improved careers for practitioners; it is incumbent on practitioners and policymakers to use the tools described here to implement enhanced empathic care.

Competing interests

Andrew Papanikitas attended the Stoneygate Centre for Empathic Healthcare on a visiting fellowship in October 2023. He is also deputy editor and has written about the experience here: https://bjgplife.com/bjgplife-on-tour-find-us-in-the-crowd-at-rcgp-annual-conference-2023/