Emotional contagion, empathy, and clinical decision-making: a preliminary exploration among internal medicine physicians

Abstract

BACKGROUND: Empathy is widely regarded as a cornerstone of effective health communication and clinical care, yet the emotional components of empathy, particularly emotional contagion, are often marginalized in medical education and research. This exploratory study investigates whether internal medicine physicians' self-reported empathy and susceptibility to emotional contagion relate to their clinical decision-making performance. METHODS: An online survey of 99 active U.S. internal medicine physicians assessed clinical empathy (Jefferson Scale of Empathy), general empathy (Interpersonal Reactivity Index), emotional contagion (Emotional Contagion Scale), and demographics. Clinical decision-making was measured with 12 vignette-based items from the American College of Physicians' MKSAP-18, providing a validated proxy for applied reasoning in real-world clinical scenarios. RESULTS: Results showed no direct relationship between emotional contagion or general empathy and decision-making accuracy. However, clinical empathy was positively associated with decision-making among male physicians but negatively associated among female physicians. These gender-specific patterns suggest that emotional attunement may interact with broader social and professional expectations in shaping clinical reasoning. CONCLUSION: Findings challenge the traditional view that emotional sensitivity undermines clinical judgment and open new avenues for understanding the complex, context-dependent role of emotions in clinical care. Moreover, these findings underscore the importance of understanding emotional contagion in health and risk communication, as emotional dynamics significantly influence how information is exchanged and interpreted. Greater attention to these processes may strengthen clinician-patient communication and improve patient outcomes in high-stakes clinical settings.