Bridging clinical assessment-patient perception gaps through physician empathy: A vignette-based experimental study in South Korea.

Abstract

Patients sometimes perceive their medical conditions as more serious than clinically warranted, potentially obstructing effective healthcare delivery. Informed by the Common-Sense Model of Self-Regulation, this study examined how physicians' empathic communication-addressing patients' cognitive and emotional concerns with compassion-bridges these clinical assessment-patient perception gaps, ultimately improving patients' treatment adherence and reducing their intention to seek second opinions. A vignette-based experiment was conducted within a nationwide online survey among South Korean adults. The experiment employed a 2 × 2 full-factorial between-subjects experimental design, manipulating physicians' empathic communication (low vs. high empathy) and hospital setting (regional general hospital vs. top-tier tertiary hospital in Seoul) (N = 487). Parallel mediation analyses showed that physicians' empathic communication effectively aligned patients' illness and treatment representations with clinical assessments. This alignment manifested as decreased perceptions of illness consequences and timeline, increased perceptions of personal and treatment control, and reduced anxiety. Empathic communication reduced participants' treatment non-adherence, decisional conflict, and intention to seek second opinions, with these effects being fully or partially mediated by their illness and treatment representations. Moderated mediation analyses revealed that the indirect effects of empathic communication were stronger in regional hospital settings and among patients with stronger medical maximizing orientation. Physicians' empathic communication can effectively bridge the clinical assessment-patient perception gaps, leading to improved treatment decisions. Physicians should respond directly yet empathetically when patients' perceptions diverge from medical evidence. With treatment control playing the most potent mediating roles, physicians should highlight how their treatment plan addresses patients' concerns about serious diseases. This approach would build patients' confidence in the treatments and reduce unnecessary pursuit of second opinions. To facilitate empathic care, healthcare reform should prioritize adequate time and supportive environments for physician-patient interactions.