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    What makes a high-risk patient, and how do we care for them?


    Regardless, the benefits of being empathetic can be tangible for both the patient and the physician. A few key steps to effective empathy include:

    1.     Legitimizing a patient’s feelings

    This is especially important when treating conditions that may not be physically visible. Legitimizing a patient’s feelings builds trust between the patient and the physician, and can ultimately lead to better outcomes, as the patient may be more willing to discuss their ailment.


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    2.     Pausing to imagine how the patient might be feeling

    Putting yourself in your patient’s position is a powerful tool and requires reflection. Take the time to truly read the patient – what is the body language, tone, and word choice? Are they angry? Tired? Defeated? Perhaps they are burned out from their medication regimen, or may be skipping medication here or there because they don’t see immediate benefit. Recognizing these feelings and legitimizing them can help patients build trust, and may increase the chance that they follow your advice and thus improve outcomes.

    3.     Offer support and partnership

    This is particularly important for high-risk patients. Make sure your commitment and willingness to work with them is clear.


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    Caring for high-risk patients is even more challenging in a value-based environment. However, by practicing empathy, you can not only can help the patient-physician relationship but also improve outcomes.  In fact, in a study of 710 cancer patients in Germany, physician empathy was positively associated with improvement in patient-reported outcomes of depression and quality of life.

     At my practice, we conducted a web-based survey  of 356 adults with type 1 diabetes on the effects of empathy and we learned that provider empathy is strongly associated with higher satisfaction among adults with type 1 diabetes, particularly.1

    The transition to value-based care may feel overwhelming, but demonstrating empathy is a great first step to improving outcomes for high-risk patients.



    1.      Ruck, John D., Shah, Viral N. et all. American Diabetes Association Scientific Sessions 2015. Poster Presentation “Factors Affecting Satisfaction With Providers Among Adults With Type 1 Diabetes: A Web-based Survey”

    Henry Anhalt, DO
    Chief Medical Officer for T1D Exchange, a nonprofit organization that has created a new paradigm fostering collaboration among patients, ...


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