Patient perceptions of empathy in primary care telephone consultations: A mixed methods study

Clinical empathy can enhance patient outcomes. This study examined patients’ perceptions of empathy in primary care consultations delivered by telephone. A mixed methods study was nested in a larger feasibility study conducted May-October 2020. Adults reporting a UK primary care consultation in the previous 2 weeks completed an online survey. A sample of survey respondents participated in a semi-structured qualitative interview. Interviews were analysed thematically. Survey respondents (n = 359) rated practitioners as between ‘good’ and ‘very good’ at established patient-reported indicators of clinical empathy. Telephone consultations were rated slightly lower than face-to-face or other consultations. 30 survey respondents were interviewed. Three qualitative themes identified how telephone consultations can shape clinical empathy: setting for an empathic encounter; feeling connected; being acknowledged. Primary care patients typically perceive good levels of clinical empathy in telephone consultations; specific features of telephone consultations may facilitate and/or hinder clinical empathy. To ensure patients feel listened to, acknowledged and understood, practitioners may need to increase their empathic verbalisations in telephone consultations. By using verbal responses to demonstrate active listening and by clearly describing and/or implementing next steps in management, practitioners may be able to enhance clinical empathy in telephone consultations. •Clinical empathy can improve patient outcomes.•Patients reported good clinical empathy in primary care telephone consultations.•Patients rated telephone consultations slightly less empathic than other types.•We show how telephone consultations may facilitate and/or hinder clinical empathy.•Verbal signs of listening may enhance empathy in telephone consultations.