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The Association Between Physician Empathy and Variation in Imaging Use
Edward R Melnick1, Elizabeth G J O'Brien1, Olga Kovalerchik1
1Department of Emergency Medicine, Yale University School of Medicine, New Haven, CT.
Summary
Physician empathy and other psychometric traits did not predict computed tomography (CT) utilization in the emergency department (ED). Further research is needed to identify factors influencing physician CT ordering variation.
Area of Science:
- Emergency Medicine
- Radiology
- Medical Education
Background:
- Computed tomography (CT) utilization varies significantly among emergency physicians.
- Physician empathy is a proposed factor influencing CT imaging decisions.
- Understanding drivers of CT utilization is crucial for optimizing resource allocation.
Purpose of the Study:
- To assess empathy levels in emergency physicians.
- To determine the association between physician empathy and CT utilization.
- To compare empathy's predictive power with other psychometric tests for CT use.
Main Methods:
- Cross-sectional study analyzing ED CT utilization data (July 2013-June 2014).
- Survey of emergency physicians using the Jefferson Scale of Empathy (JSE), Risk-Taking Scale (RTS), Stress from Uncertainty Scale (SUS), and Malpractice Fear Scale (MFS).
- Hierarchical, mixed-effects regression model to evaluate associations between psychometric scores and risk-adjusted CT utilization.
Main Results:
- 113,517 patients and 74 physician respondents were included; 18.5% received CT scans.
- No statistically significant correlation was found between JSE scores and other psychometric scales.
- No significant association was observed between performance on any psychometric scale and CT utilization.
Conclusions:
- Physician empathy, risk-taking, stress from uncertainty, and malpractice fear do not predict risk-adjusted CT utilization in the ED.
- Underlying physician-based factors driving CT utilization variation remain unidentified.
- Further investigation is required to elucidate the determinants of interphysician variation in CT ordering.
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