Patient perception of physician empathy in stroke telemedicine

William Polk Jr. Cheshire, Kevin M. Barrett, Benjamin H. Eidelman, Elizabeth Mauricio, Josephine F. Huang, William D Freeman, Maisha T. Robinson, Gary R. Salomon, Colleen T. Ball, Dale M. Gamble, Vickie S. Melton, James F. Meschia

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Introduction: We assessed patients’ perceptions of physician empathy during telemedicine consultations as compared to in-person consultations during clinical encounters for acute stroke. Methods: This prospective cohort study was undertaken at a comprehensive stroke centre hub in collaboration with a distant community hospital spoke site. Eligible participants presented to hub or spoke emergency departments with suspected acute stroke within three hours of symptom onset. Participants were evaluated at the hub site in person or at the remote site via telemedicine by the same group of neurologists. Following acute care decisions, single-visit data including participant-reported assessments of physician empathy were collected within 24 h. The primary outcome was the Consultation and Relational Empathy score. The secondary outcome for the telemedicine cohort was the Telemedicine Patient Satisfaction Measure score. Results: Between 31 May 2013–13 March 2019, 70 patients completed the study. Fifty patients were seen by telemedicine and 20 patients were seen in person. Median Consultation and Relational Empathy scores (with a possible score of 10–50) were 49 (range 27–50) for telemedicine and 45 (range 26–50) for in-person consultations (Wilcoxon rank sum p = 0.18). Each item of the Consultation and Relational Empathy questionnaire was rated very good or excellent by at least 87% of participants in the telemedicine group. The median Telemedicine Patient Satisfaction Measure score was 54 (range 12–60), with each item rated agree or strongly agree by at least 84% of participants. Discussion: We found no difference between telemedicine and in-person visits in patient perception of physician empathy in acute stroke care. Therefore, we conclude that empathy can be conveyed by facial expression, voice and attentiveness in a telemedicine encounter and, in the setting of acute stroke care, does not require physical touch or proximity.

Original languageEnglish (US)
Pages (from-to)572-581
Number of pages10
JournalJournal of Telemedicine and Telecare
Issue number9
StatePublished - Oct 2021


  • Telemedicine
  • empathy
  • ischaemic stroke
  • patient satisfaction
  • professionalism

ASJC Scopus subject areas

  • Health Informatics


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