In search of compassion: a new taxonomy of compassionate physician behaviours

Health Expect. 2015 Oct;18(5):1672-85. doi: 10.1111/hex.12160. Epub 2013 Dec 4.


Background: Compassion has been extolled as a virtue in the physician-patient relationship as a response to patient suffering. However, there are few studies that systematically document the behavioural features of physician compassion and the ways in which physicians communicate compassion to patients.

Objective: To develop a taxonomy of compassionate behaviours and statements expressed by the physician that can be discerned by an outside observer.

Design: Qualitative analysis of audio-recorded office visits between oncologists and patients with advanced cancer.

Setting and participants: Oncologists (n = 23) and their patients with advanced cancer (n = 49) were recruited in the greater Rochester, New York, area. The physicians and patients were surveyed and had office visits audio recorded.

Main outcome measures: Audio recordings were listened to for qualitative assessment of communication skills.

Results: Our sensitizing framework was oriented around three elements of compassion: recognition of the patient's suffering, emotional resonance and movement towards addressing suffering. Statements of compassion included direct statements, paralinguistic expressions and performative comments. Compassion frequently unfolded over the course of a conversation rather than being a single discrete event. Additionally, non-verbal linguistic elements (e.g. silence) were frequently employed to communicate emotional resonance.

Discussion and conclusions: This study is the first to systematically catalogue instances of compassionate communication in physician-patient dialogues. Further refinement and validation of this preliminary taxonomy can guide future education and training interventions to facilitate compassion in physician-patient interactions.

Keywords: communication; compassion; oncology; patient suffering.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Beneficence*
  • Communication
  • Delivery of Health Care
  • Empathy*
  • Female
  • Humans
  • Male
  • Medical Oncology
  • Middle Aged
  • Physician's Role*
  • Physician-Patient Relations*
  • Physicians / psychology*
  • Surveys and Questionnaires