Perceived empathy in chronic pain care: Differences across healthcare types and patient gender

Chronic pain care involves interactions with multiple healthcare providers, yet how individuals with chronic pain perceive empathy across provider types, and whether associations between these perceptions and patient outcomes differ by patient gender, remain poorly understood. This prospective observational study examined perceived empathy across provider types, its associations with treatment satisfaction and psychosocial outcomes, and the moderating role of patient gender. A secondary analysis was conducted on 2309 provider ratings from 231 individuals with chronic pain (77.9% women; Mage = 49.5 years; all cisgender) across four waves administered approximately three months apart. At each wave, participants rated all providers consulted in the preceding three months. Multilevel models decomposed perceived empathy into between- and within-person components. Perceived empathy differed significantly across provider types, with psychologists rated highest and orthopedists and rheumatologists rated lowest. No significant gender difference in mean perceived empathy was observed. Both between-person and within-person empathy were positively associated with treatment satisfaction. A crossover interaction indicated that at lower empathy levels, men reported greater reductions in treatment satisfaction than women. These findings highlight the importance of consistent empathic engagement across multidisciplinary chronic pain teams and suggest that gender-sensitive communication approaches may be warranted. PERSPECTIVE: This study shows that perceived empathy varies meaningfully across healthcare provider types in chronic pain care, with psychologists rated highest, and that lower empathy is associated with reduced treatment satisfaction, particularly among men. Consistent empathic engagement across multidisciplinary teams may support more equitable, patient-centered chronic pain care.