Physician responses to patients' emotional cues and concerns and their association with patient-related outcomes.

Abstract

Addressing patient emotions is a key aspect of patient-centered care and can strengthen trust and the physician-patient relationship. However, research suggests that physicians often miss opportunities to respond empathically to patients' emotional cues and concerns. We conducted a systematic review and meta-analysis to evaluate the proportion of empathic opportunities physicians took in response to patients' emotional cues and concerns, and how this is associated with outcomes such as the physician-patient relationship, satisfaction, anxiety, and consultation duration. We systematically searched PubMed, EMBASE, and PsycINFO from the inception of each database to February 28, 2025. Eligible studies included randomized clinical trials and observational studies assessing physicians' responses to adult patients' emotional cues and concerns. Three independent reviewers extracted data on outcomes and study characteristics. Risk of bias was assessed using the JBI Critical Appraisal Checklist for Analytical Cross-Sectional Studies. The study is registered in PROSPERO and was conducted according to the PRISMA guidelines. The primary outcome was the proportion of empathic opportunities taken by physicians. Secondary outcomes included the frequency and type of physicians' responses to patients' emotional expressions, and their associations with the physician-patient relationship, patient anxiety, satisfaction, and consultation duration. We included 61 studies (10,013 patients) in this review and 43 studies (6662 patients) with a total of 19,227 emotional cues and concerns in the quantitative synthesis. The overall pooled proportion of empathic opportunities taken by physicians was 0.47 (95 % CI, 0.39-0.54). Rates were lower in oncology (0.35; 95 % CI, 0.27-0.44) compared to general practice (0.61; 95 % CI, 0.49-0.72) and other disciplines (0.50; 95 % CI, 0.36-0.63). Physicians respond to fewer than half of patients' emotional cues-especially in oncology, where response rates are lowest-highlighting the need for better support in developing empathic skills. PROSPERO (CRD42023405646).