CHICAGO — Heather Cianciolo can tell within minutes if she's going to like a doctor.
"Ten minutes into a doctor's appointment and I know if it's going to be a waste of my time," she said. "It's a warning sign if someone doesn't come in and ask me about me and just starts talking at me. And it happens a lot."
The 46-year-old Oak Park woman who has long suffered from migraines said she's visited numerous specialists for treatment. Cianciolo said she's had to go through several doctors who didn't listen to her before finding one that she loves who is now her primary care physician.
"She listens and then she will explain her thinking. She expresses an interest in what's happening," Cianciolo said. "If you're not going to take the time to answer my questions, why would I entrust my health care to you?"
Experts say the ability for doctors to build a rapport with their patients helps build trust and, in turn, improves patient outcomes. A recent study that establishes a norm-level of empathy among medical students suggests schools across the country could use the data to assess for empathy, alongside academic measures like college transcripts and MCAT scores, when considering medical school applicants.
But others say empathy is already discussed in medical school, and can be taught. And some medical specialties do not rely as much on patient-doctor interpersonal relationships, like radiology or even surgery.
The study, published July 25 in The Journal of the American Osteopathic Association, looked at more than 16,000 students of all levels in schools of osteopathic medicine across the country to set a norm for their level of empathy, using a questionnaire tool.
Study author Mohammadreza Hojat, a research professor of psychiatry and human behavior at Sidney Kimmel Medical College of Thomas Jefferson University in Philadelphia, who also helped develop the empathy assessment tool, said while empathy tests should not replace more traditional, academic measures, it's important to gauge how well a prospective doctor will relate to patients.
"There are two components of medicine. One component is the science of medicine and one component is the art of medicine," he said. "When it comes to art of medicine, it is about interpersonal relationships and empathy, and we have no method in place" to measure that in medical students' applicants.
Although empathy can be taught, Hojat said, students who already come to medical school with a strong sense of empathy will make better doctors.
Hojat said although the study -- part of a larger series of studies dealing with empathy and doctors -- focused on schools of osteopathic medicine, the tool should also be used at traditional medical schools.
Dr. John Prescott, chief academic officer at the Association of American Medical Colleges, said in a statement that "humanism and empathy are critical qualities required of tomorrow's physicians." But the statement also said medical schools already look at a "holistic review of applicants ... which looks beyond grades and test scores."
And changes made to the MCAT exam in 2015 allows applicants to be "evaluated on their knowledge of cultural and social differences, and factors that influence communication and behavior," the statement read. The association is also evaluating new tools.
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Once in medical school, students are taught empathy, and continue to learn as they work with patients, Prescott said.
Mark Speicher, senior vice president for medical education and research at the American Association of Colleges of Osteopathic Medicine, said medical schools and residency programs are moving toward a more holistic approach in medicine "so (patients) get care from students who are not just academically talented, but also talented in forming relationships with their patients."
At schools of osteopathic medicine, students are assessed for this during the interview process, Speicher said. Osteopathic schools focus more on treating "the whole patient."
"Empathy is part of that ... but this study shows we can make it a more explicit part of our process," he said.
But Jean Decety, a University of Chicago neuroscientist who studies empathy, said while he hadn't read the study, his work has shown that while empathy is important for certain types of physicians, there's no need to evaluate prospective medical students using an empathy assessment tool.
Medical school applicants "are already overwhelmed," he said, adding that the subject of empathy and relating to patients is already a focus in medical school classrooms and during their hospital rotations.
And some students will go into specialties that don't require as much interpersonal skills, Decety said, like radiologists who mostly read images, or surgeons who require excellent technical skills but not necessarily a lot of empathy.
"That's what you want from your surgeon," he said.
Dr. Sunil Varma, a hospitalist at Amita Health Saints Mary and Elizabeth Medical Center in Chicago, said empathy is an essential part of his job. His role is to oversee the care of patients who are hospitalized for a variety of reasons, and who range from more minor health complications to very sick.
"I think (empathy) is a skill that I have honed over the years with experience," Varma said. "It's certainly one I feel is very important. When I think of empathy, I think of the ability to connect with the patient."
Varma said empathy assessment tools could be valuable for medical student applicants, especially because some students are so focused on technical skills or medical knowledge that they lose sight of the patients themselves.
Relating to and being open with a patient creates trust, he said, which can lead to higher compliance in patients and thus, better outcomes. If patients "understand the why," they're more likely to follow doctors' orders.
"If you put yourself in their perspective, it can be a scary place being in a hospital," Varma said. "I try to alleviate some of those fears."