Clinical empathy in medical consultations in Japan: An exploration of the medical education context

Extant research has provided evidence of a positive link between doctors’ expressions of empathy and increased patient satisfaction with the quality of care (e.g. Hojat et al. 2010; Silverman, Kurtz, and Draper 2013). In the Japanese context, several studies have reported that Japanese doctors’ expressions of empathy were extremely infrequent (e.g. Ishikawa et al. 2002a,b; Wheeler 2011) and that doctors are often described as being distant and that such attitudes towards patients commonly result in complaints from foreign residents of Japan. This study examines how and why the expression of empathy observed among Japanese doctors is so limited. A structured literature search of clinical communication skills textbooks and guidelines for the medical education context was undertaken. The review highlights the following three contributing factors: 1) clinical empathy, as a concept in clinical communication, remains reflective of the Western conceptions, and uncertainty lies behind the conceptualisation and definition of clinical empathy in the Japanese context; 2) most references to empathy in Japan are representative of Japanese doctors’ listening style; 3) there is a notable lack of encouragement to elicit information (e.g. concerns, ideas, expectations) from patients.