Patients In Greatest Need of Health Care Perceive Their Physicians As “Empty”

Juliana Schroeder PhD, Assistant Professor Berkeley Haas Management of Organizations Group University of California at Berkeley Interview with:
Juliana Schroeder PhD, Assistant Professor

Berkeley Haas Management of Organizations Group
University of California at Berkeley

Medical Research: What is the background for this study? What are the main findings?

Dr. Schroeder: Whereas much research examines how physicians perceive their patients,in this paper we instead study how patients perceive physicians. We propose that patients consider their physicians like personally emotionless “empty vessels:” The higher is individuals’ need for care, the less they value physicians’ traits related to physicians’ personal lives (e.g., self-focused emotions) but the more they value physicians’ traits relevant to patient care (e.g., patient-focused emotions).

​In a series of experiments,we show that participants in higher need for care believe their physicians have less personal emotions. That is, they perceive physicians as emotionally “empty” the more they need them. This was true both when we manipulated need for care – for example, by having participants focus on potential medical problems or reminding them they needed to get a medical check-up – and also when we measured it, for example by comparing patients at a medical clinic (high need) to people not at a clinic (low need).

Medical Research: What should clinicians and patients take away from your report?

Dr. Schroeder: They should understand that patients’ need for care influences how they think about their physicians’ emotions. Patients who feel greater need for care perceive their physicians differently than those who feel less need.

There are at least two possible implications of this research. First, there are potential consequences for patients. A great deal of research suggests that emotionally responsive physicians provide benefits for patients’ health outcomes. As such, choosing emotionally responsive physicians could be beneficial for patients’ health outcomes. But our paper shows that patients in greater need perceive less self-focused emotion in their physicians. This could be problematic if it restricts patients from detecting variance in physicians’ emotional responsiveness. Patients who overlook physicians’ emotions may fail to choose an emotionally responsive physician.

Second, there are potential consequences for physicians. On the one hand, being instrumental should have interpersonal benefits for physicians.

​We demonstrate in one of our studies that instrumentality creates the perception of higher agency which may increase respect and overall value for physicians. Further, when people are in high need of someone they are more likely to approach the person and express appreciation. Conversely, negative consequences for perceiving lack of personal characteristics the patient does not need (e.g., self-focused emotions) may exist. For instance, failing to acknowledge others’ mental states has been shown to make people feel objectified or dehumanized, ​ which might contribute to physician burnout. Indeed, 46% of a recent nationally representative sample of U.S. physicians report experiencing at least one symptom of burnout and physicians in specialties at the front line of care access seem to be at greatest risk. Not only does burnout have adverse personal consequences for physicians (e.g., broken relationships), it also reduces the quality of care for patients (e.g., medical errors). This suggests—ironically—that patients’ own perceptions of their physicians as empty vessels could, at least partly, ultimately reduce their quality of care.

Overall, practitioners and policy-makers considering how to improve healthcare quality may want to target patients’ attitudes toward their physicians, not just physicians’ attitudes toward patients.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Schroeder: ​Broadly, it is important to understand patients perceive their physicians, because this is likely to influence how patients may act toward physicians and how they choose and evaluate physicians. Much more research is needed on this topic. More narrowly, our “empty vessel hypothesis” may be applied to other types of relationships beyond the physician-patient relationship. Our theory suggests that anyone who is in need of another person’s help may perceive the helper’s traits as more aligned with their needs. More research is also needed to understand how this theory applies to different instrumental relationships.


Schroeder, A. Fishbach. The “Empty Vessel” Physician: Physicians’ Instrumentality Makes Them Seem Personally Empty. Social Psychological and Personality Science, 2015; DOI:10.1177/1948550615597976 is not a forum for the exchange of personal medical information, advice or the promotion of self-destructive behavior (e.g., eating disorders, suicide). While you may freely discuss your troubles, you should not look to the Website for information or advice on such topics. Instead, we recommend that you talk in person with a trusted medical professional.

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