Little clinical evidence exists to support an effect of physician-related and nurse-related burnout and empathy levels on the quality of care they provide to patients, according to a cross-sectional study published in BMC Medical Ethics.

Investigators performed a cross-sectional analysis to determine the effect of healthcare practitioner burnout and empathy levels on quality of care across 22 primary care centers in Spain. Physicians (n=108) and nurses (n=112) made up the main study population. The Jefferson Physician Empathy Scale and the Maslach Burnout Inventory were used to measure both empathy and burnout, whereas Quality Standard Indicator (QSI) scores provided insight into quality of care delivered to patients.

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From a total score of 1000, the average QSI score for physicians and nurses in this study was 665. Healthcare practitioners with a relatively high burnout score had higher QSI scores, but this finding was not significant. As assessed by QSI, the investigators also found that physicians and nurses with low empathy scores delivered a higher quality of care to patients compared with practitioners with high empathy (QSI score, 672.8 vs 654.4, respectively).

In addition, providers with high burnout tended to have higher QSI scores compared with practitioners who experienced low burnout (702 vs 671). Researchers found no significant correlations between burnout or empathy and quality of patient care.

The researchers note that the Jefferson Physician Empathy Scale, a self-reported questionnaire that was used in this study to rate empathy, is prone to bias and may present significant limitations to the study’s findings.

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Although this study found no significant association between empathy and quality of care, the researchers believe that the promotion of empathy among healthcare professionals “has an intrinsic value in improving the physician-patient relationship (not just ethics) but also of quality of care.”


Yuguero O, Marsal JR, Buti M, Esquerda M, Soler-González J. Descriptive study of association between quality of care and empathy and burnout in primary care. BMC Med Ethics. 2017;18(1):54.