Clinician response to patient emotion: Impact on subsequent communication and visit length

Mary Catherine Beach, Jenny Park, Dingfen Han, Christopher Evans, Richard D. Moore, Somnath Saha

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


PURPOSE It is widely cited—based on limited evidence—that attending to a patient’s emotions results in shorter visits because patients are less likely to repeat themselves if they feel understood. We evaluated the association of clinician responses to patient emotions with subsequent communication and visit length. METHODS We audio-recorded 41 clinicians with 342 unique patients and used the Verona Coding Definitions of Emotional Sequences (VR-CoDES) to time stamp patient emotional expressions and categorize clinician responses. We used random-intercept multilevel-regression models to evaluate the associations of clinician responses with timing of the expressed emotion, patient repetition, and subsequent length of visit. RESULTS The mean visit length was 30.4 minutes, with 1,028 emotional expressions total. The majority of clinician responses provided space for the patient to elaborate on the emotion (81%) and were nonexplicit (56%). As each minute passed, clinicians had lower odds of providing space (odds ratio [OR] = 0.96; 95% CI, 0.95-0.98) and higher odds of being explicit (OR = 1.02; 95% CI, 1.001.03). Emotions were more likely to be repeated when clinicians provided space (OR = 2.33; 95% CI, 1.66-3.27), and less likely to be repeated when clinicians were explicit (OR = 0.61; 95% CI, 0.47-0.80). Visits were shorter (β =−0.98 minutes; 95% CI, −2.19 to 0.23) when clinicians’ responses explicitly focused on patient affect. CONCLUSIONS If saving time is a goal, clinicians should consider responses that explicitly address a patient’s emotion. Arguments for providing space for patients to discuss emotional issues should focus on other benefits, including patients’ well-being.

Original languageEnglish (US)
JournalAnnals of family medicine
Issue number6
StatePublished - Nov 1 2021


  • Behavior
  • Emotions
  • Empathy
  • Office visits
  • Patient-clinician communication
  • Personalized care
  • Practice-based research
  • Primary care
  • Psychological distress
  • Time management

ASJC Scopus subject areas

  • Family Practice


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