A price tag on clinical empathy? Factors influencing its cost-effectiveness

摘要

Good communication is a pillar of medical professionalism.1 As such, it is required independently of its economic cost. Yet, faced with scarce resources, it is useful to know the extent to which devoting resources to ensure or enhance high-quality communication is cost-effective. The benefits of enhancing one particular type of communication, namely empathic positive communication, have been studied in a number of randomised trials.2 These trials suggest that compared with ‘usual care’, empathic positive communication can reduce pain, improve patient satisfaction and increase quality of life. Observational studies suggest that empathic care has benefits ranging from reducing mortality3 and practitioner burnout4 to increasing safety.5 On the other hand, these very same studies reveal that additional time is required to undertake empathy training and to treat patients in the clinic; both of these can be costly. Unfortunately, with a few notable exceptions,6 empathy’s cost-effectiveness has not been rigorously evaluated. A definitive answer to whether practitioner empathy is cost-effective requires sufficiently powered trials or decision models that measure relevant outcomes, and this is starting to happen.6 In this overview, we consider the factors that might be weighed in future trials of empathy’s cost-effectiveness (see Table 1).