Original Research Reports
Are Doctors Who Have Been Ill More Compassionate?
Attitudes of Resident Physicians Regarding Personal Health
Issues and the Expression of Compassion in Clinical Care
Laura Weiss Roberts, M.D., M.A., Teddy D. Warner, Ph.D., Christine Moutier, M.D.,
Cynthia M. A. Geppert, M.D., Ph.D., M.P.H., Katherine A. Green Hammond, Ph.D.
Background: Compassion is an attribute central to pro-
fessionalism and modern clinical care, yet little is
known about how compassion is acquired and preserved
in medical training. We sought to understand whether
personal illness experiences are thought by residents to
foster compassion. Methods: The authors surveyed 155
(71% response rate) second- and third-year residents at
the University of New Mexico School of Medicine re-
garding their views of the relationship of personal life
experience with illness to compassion and empathy for
patients. Results: Residents believe that experience
with personal health issues enhances physician com-
passion for patients. Residents who report more per-
sonal health concerns, such as physical or mental
health problems and family health problems, endorse
the connection between direct experience with illness
and empathy. Conclusion: Health care trainees’ own
illness experiences may increase compassionate patient
care practices and foster empathy.
(Psychosomatics 2011; 52:367–374)
C
ompassion is the capacity to appreciate deeply the
perspective of another person, and a compassionate
physician is one who is well attuned to the experience of
patients and responds in a manner that brings solace.
1
Medical educators see compassion as key to many objec-
tives of contemporary medical training, including im-
proved communication skills, increased respect for the
dignity and autonomy of patients, enhanced cultural and
spiritual sensitivity, and a physician-patient partnership in
medical decision-making.
2–4
Empirical studies that ex-
plore how compassion may be nurtured, expressed, im-
parted, and evaluated in medical training have, to date,
been quite limited.
5–8
Compassion is a virtue that many believe is threatened
across the course of medical training.
9,10
Indeed, a clear
and disconcerting finding in the literature is the erosion of
compassion and emergence of cynicism among early ca-
reer physicians. In a longitudinal cohort study over the 3
years of internal medicine residency training, Bellini et
al.
11
measured empathic attitudes expressed by 61 resi-
dents at six points in their training. A steady decline in
empathic concern was observed, and this decrement in
empathy endured beyond graduation. Similar results have
been obtained in other studies.
12–15
Much less is known about factors or experiences fos-
tering compassion. One study of the levels of empathy in
Received October 30, 2010; revised January 7, 2011; accepted January 10,
2011. From Dept. of Psychiatry and Behavioral Sciences, Stanford
University, Stanford, CA (LWR); Dept. of Family and Community
Medicine, School of Medicine, University of New Mexico, Albuquer-
que, NM (TDW); School of Medicine, University of California, San
Diego, La Jolla, CA (CM); Dept. of Psychiatry, Veterans Administration
Medical Center, School of Medicine, University of New Mexico, Albu-
querque, NM (CMAG); and Ecosystem Modeling, Albuquerque, NM
(KAGH). Send correspondence and reprint requests to Laura W. Rob-
erts, M.D., M.A., Dept. of Psychiatry and Behavioral Sciences, Stan-
ford University, 401 Quarry Road, Room 3215, Stanford, CA 94305-
5717. e-mail: RobertsL@stanford.edu
© 2011 The Academy of Psychosomatic Medicine. Published by
Elsevier Inc. All rights reserved.
Psychosomatics 2011:52:367–374 © 2011 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.
367 Psychosomatics 52:4, July-August 2011 www.psychosomaticsjournal.org