Journal of General Internal Medicine

, Volume 6, Issue 5, pp 420–423 | Cite as

Sympathy, empathy, and physician resource utilization

  • Stephen D. Nightingale
  • Paul R. Yarnold
  • Michael S. Greenberg
Original Articles


Objective:To test the hypothesis that physicians preferring a sympathetic over an empathetic response to a hypothetical patient’s misfortune will utilize more health care resources in the care of their patients.

Design:Physicians were asked to select either the sympathetic response or the empathetic response to a hypothetical patient’s misfortune (death of a spouse) and to state their preferences for intubation of a hypothetical end-stage lung-disease patient. For each physician, hospital records were retrospectively reviewed to assess the mean number of laboratory tests ordered per clinic patient and the mean duration of cardiopulmonary resuscitations he or she performed before declaring his or her efforts unsuccessful.

Setting:General medicine clinic at a large urban hospital.

Participants:101 physicians above the postgraduate year-1 level who attended the general medicine clinic.

Measurements and main results:As hypothesized, physicians selecting the sympathetic option (n=58) had a greater mean preference for intubation (p<0.02), ordered more laboratory tests per patient in clinic (p<0.03), and performed cardiopulmonary resuscitation for longer periods of time before declaring their efforts unsuccessful (p<0.06) than did physicians selecting the empathetic option (n=38).

Conclusions:These data suggest that the constructs of sympathy and empathy reflect psychological aspects of physicians that have a measurable influence on their practice behaviors.

Key words

empathy physician-patient interaction practice style resource utilization sympathy 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Wispé L. The distinction between sympathy and empathy. To call forth a concept, a word is needed. J Pers Soc Psychol. 1986;50:314–21.CrossRefGoogle Scholar
  2. 2.
    Nightingale SD. Risk preference and laboratory use. Med Decis Making. 1987;7:168–72.PubMedCrossRefGoogle Scholar
  3. 3.
    Nightingale SD, Grant M. Risk preference and decision making in critical care situations. Chest. 1988;93:684–8.PubMedGoogle Scholar
  4. 4.
    Pearlman RA, Inui TS, Carter WB. Variability in physician bioethical decision making. A case of euthanasia. Ann Intern Med. 1982;97:420–5.PubMedGoogle Scholar
  5. 5.
    Magnusson D. Test theory. Reading, MA: Addison-Wesley, 1967.Google Scholar
  6. 6.
    Stevens J. Applied multivariate statistics for the social sciences. Hillsdale, NJ: Erlbaum, 1986.Google Scholar
  7. 7.
    Reynolds HT. The analysis of cross classifications. New York: Free Press, 1977.Google Scholar
  8. 8.
    Eisenberg JM. Physician utilization. The state of research about physicians’ practice patterns. Med Care. 1985;23:461–83.PubMedCrossRefGoogle Scholar
  9. 9.
    Wennberg JE. The paradox of appropriate care. JAMA. 1987;258:2568–9.PubMedCrossRefGoogle Scholar

Copyright information

© Society of General Internal Medicine 1991

Authors and Affiliations

  • Stephen D. Nightingale
    • 1
  • Paul R. Yarnold
    • 2
    • 3
  • Michael S. Greenberg
    • 4
  1. 1.the Section of General Internal MedicineUniversity of Texas Southwestern Medical CenterDallas
  2. 2.the Division of General Internal MedicineNorthwestern University Medical SchoolUSA
  3. 3.the Department of PsychologyUniversity of Illinois at ChicagoChicago
  4. 4.the Section of General Internal MedicineUniversity of the Health Sciences/Chicago Medical SchoolNorth Chicago

Personalised recommendations