Leonard Calabrese, DO, on the Importance of Empathy in Rheumatology

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During the American College of Rheumatology’s (ACR) annual meeting, ACR Convergence, Leonard Calabrese, DO, spoke about “The Science of Empathy in Rheumatology.” In this video, Dr Calabrese highlights the main takeaways of his presentation and explains how empathetic communication can benefit not only patients, but also providers.

Additional Resource:

Calabrese L. In the Rheum: the science of empathy in rheumatology: why we should care. Talk presented at: ACR Convergence 2020; November 9, 2020; Virtual.

Leonard Calabrese, DO, is a professor of medicine at the Cleveland Clinic where he also serves as the director of the RJ Fasenmyer Center for Clinical Immunology.


Leonard Calabrese: Hi. This is Dr Len Calabrese. I’m a professor of medicine here at the Cleveland Clinic. I’m looking forward to be able to talk to my colleagues about the science of empathy and rheumatology. I ask a rhetorical question, “Why we should care.”

I think this is the first time that the science of empathy has been formally addressed at [the American College of Rheumatology’s annual meeting]. I had the opportunity to participate in the seminar a number of years ago, briefly touch upon this. It’s so timely. In the era of COVID‑19, we are all stressed, and we want to take care of our patients the best of our ability. We want to be careful to the best of our ability. 

I am going to break down the notion that we have the opportunity to provide extraordinary care, and it will be enhanced when we provide extraordinary caring.

I think most of us have the idea of empathy in our heads, and some implicit definition about it is now a science. They’re both qualitative and quantitative measurements of empathy that have been developed by psychosocial scientists and had been applied to a variety of settings.

We know that in medicine we come in strong with empathy to medical school; it starts to erode about the third year. That trajectory may continue to decline during training, but 1 in 3 people maintains their empathy.

In a snapshot, empathy is the ability to stand in someone’s shoes without living in those shoes. It helps us communicate with our patients and [reach] this goal we have of shared and informed decision‑making. Advanced communications is fused with empathy, because in medical empathy, it’s no good to have it in your brain. It has to be communicated back to the patient.

A few summary points about empathy and medicine is that it correlates with performance in training, but it doesn’t correlate with board scores.

Self‑rated highly empathic practitioners get sued less, have greater career satisfaction, and less burden. Higher empathically scored practitioners have been demonstrated to reach targets in diseases ranging from diabetes and other treatments of illnesses such as the common cold.

The field of rheumatology and empathy is nascent. We have not studied it formally. I’ve talked to colleagues around the world, and the time is here. Empathic communications increase the response rates through a variety of quality-reported measures.

Patients who perceive their visits as being more empathic vs less empathic are likely not only to be more satisfied, but we have greater potential to influence things such as pain, triggerability, well‑being, lower stress. All things that I think we are interested in.

Finally, I draw upon some of the literature in rheumatology to show that, in our daily practice, treating patients with inflammatory disease like rheumatoid arthritis, many patients do not feel listened to in the context of their provider‑patient interactions.

It’s all about better care, better caring. That includes care for both the patient and ourselves. 

For more from ACR Convergence, visit the Newsroom.