Measurement of empathy among Argentine cardiologists: Psychometrics and differences by age, gender, and subspecialty.

BACKGROUND: Cardiologists are involved in the management of patients with multiple cardiovascular risk factors and chronic heart diseases, so empathy is a necessary feature to deal with them. The aim of the study was to evaluate the validity and reliability of the Spanish version of the Jefferson Scale of Physician Empathy (JSPE) among Argentine cardiologists and to explore the potential differences by age, gender, and subspecialty. METHODS: Between August and September 2012, we performed a survey in a non-randomized sample of 566 Spanish-speaking cardiologists of Argentina. A Principle Component Analysis (PCA) was used to explore the link between observed variables and latent variables in order to identify the factor structure. The PCA criteria for identifying the factor structure were examined with the Kaiser-Meyer-Olkin (KMO) analysis. RESULTS: The KMO measure of sampling adequacy was 0.86 and Bartlett's test of sphericity was highly significant (p = 0.000), determining the suitability of the data set for factor analysis. The PCA of 20 items yielded a three factor model that accounted for 40.6% of the variance. The JSPE mean rank score for women was 307.9 vs. 275.0 for men (p = 0.017). The comparison of mean rank score according to age (quartiles) showed a significant relation between older age and empathy. No difference was found when the mean rank scores were compared by respondent subspecialty. CONCLUSIONS: JSPE provides a valid and reliable scale to measure Argentine cardiologists' attitudes towards empathy. Female cardiologists seem to be more empathic than their male colleagues, and a positive relationship between age and empathy was found.

Survey on Ethical Conduct Thresholds in Cardiologal Medical Practice in Argentina.

The purpose of this study was to analyze the attitude of a group of cardiologists on the ethical conducts they would accept or adopt when encountered with different hypothetical situations of medical practice. Between August and September of 2011, 700 Argentine cardiologists were surveyed in situations which posed ethical dilemmas in the patient-physician relationship, among colleagues or involving financial agreements with employers or the pharmaceutical industry. Ethical conflicts were evidenced in a series of inappropriate conducts such as differential fees, trips and meals sponsored by laboratories, splitting fees, overbilling, self-referral, charging for patient referral, financial compensation for ordering medical procedures, and various situations derived from the relationship with employers. In general, financial compensation from the pharmaceutical industry was more accepted than the conflictive situations which directly involved patients, colleagues or employers. The rejection of these conducts, the physicians' deontological education and the improvement of financial and organizational conditions in medical practice will help to encourage better medical professionalism and avoid unseemly behaviors.

Perception of consultation length in cardiology and its ethical implications.

OBJECTIVES: This study considered whether the time employers allotted to medical consultations in many working environments in Argentina might be inadequate to carry out an interview. The objective was to conduct a survey to gather information on the length of cardiologic medical consultations in Argentina. METHODS: During 2007, a survey was carried out that included 816 cardiologists. RESULTS: Seventy-six percent of participants said they needed 20 to 30 minutes, and 14% considered that 15 minutes was sufficient, for an adequate consultation. On the other hand, 64% reported that their employer required that consultations be done in 10 to 15 minutes, and 86% cited limits of less than 20 minutes (P < 0.0001). This time was inadequate for 60% of physicians. With regard to ethics, 89% answered affirmatively that requiring that patients be attended in such a short time could be considered an ethical flaw of the employer; 75% acknowledged their own ethical flaw when agreeing to conduct the consultation in an inadequate amount of time. When opinions were grouped, 22% considered that an adequate consultation length was fundamental for a correct patient-physician relationship, 27% reported that this time depended on "pressures" of the system, 19% indicated that inadequate consultation length affected the quality of attention patients received, 17% thought that low fees forced employers to reduce this time with a resulting detriment in quality of care, and 15% said that consultation length was variable and depended on the patient. CONCLUSIONS: This study showed that 60% of physicians perceived as insufficient the time their employers allotted for conducting an adequate consultation. Most believed that allotting such a short time for examining patients could be considered an ethical flaw.

Perception of consultation length in cardiology and its ethical implications / Percepción sobre la duración de las consultas de cardiología y sus implicaciones éticas

OBJECTIVES: This study considered whether the time employers allotted to medical consultations in many working environments in Argentina might be inadequate to carry out an interview. The objective was to conduct a survey to gather information on the length of cardiologic medical consultations in Argentina. METHODS: During 2007, a survey was carried out that included 816 cardiologists. RESULTS: Seventy-six percent of participants said they needed 20 to 30 minutes, and 14 percent considered that 15 minutes was sufficient, for an adequate consultation. On the other hand, 64 percent reported that their employer required that consultations be done in 10 to 15 minutes, and 86 percent cited limits of less than 20 minutes (P < 0.0001). This time was inadequate for 60 percent of physicians. With regard to ethics, 89 percent answered affirmatively that requiring that patients be attended in such a short time could be considered an ethical flaw of the employer; 75 percent acknowledged their own ethical flaw when agreeing to conduct the consultation in an inadequate amount of time. When opinions were grouped, 22 percent considered that an adequate consultation length was fundamental for a correct patient-physician relationship, 27 percent reported that this time depended on "pressures" of the system, 19 percent indicated that inadequate consultation length affected the quality of attention patients received, 17 percent thought that low fees forced employers to reduce this time with a resulting detriment in quality of care, and 15 percent said that consultation length was variable and depended on the patient. CONCLUSIONS: This study showed that 60 percent of physicians perceived as insufficient the time their employers allotted for conducting an adequate consultation. Most believed that allotting such a short time for examining patients could be considered an ethical flaw.

OBJETIVOS: Se analizó si el tiempo asignado por los empleadores para las consultas médicas en centros de trabajo en Argentina es insuficiente. El objetivo fue recopilar información mediante una encuesta sobre la duración de las consultas de cardiología en Argentina. MÉTODOS: Se aplicó una encuesta a 816 cardiólogos en 2007. RESULTADOS: De los participantes, 76 por ciento dijo necesitar de 20 a 30 minutos para una consulta adecuada, mientras 14 por ciento consideró que 15 minutos era suficiente. Por otra parte, 64 por ciento informó que sus empleadores exigían que las consultas se realizaran en 10-15 minutos y 86 por ciento citó límites menores de 20 minutos (P < 0,0001); 60 por ciento de los médicos consideraron inadecuado ese tiempo. De los entrevistados, 89 por ciento respondió que exigir que se atienda a los pacientes en ese corto tiempo podría considerarse una falla ética de los empleadores; 75 por ciento reconoció su propia falla ética al aceptar realizar la consulta en un tiempo inadecuado. Cuando se agruparon las opiniones, 27 por ciento manifestó que ese tiempo dependía de "presiones" del sistema, 22 por ciento consideró que realizar la consulta en un tiempo suficiente era fundamental para una correcta relación médico-paciente, 19 por ciento indicó que un tiempo insuficiente de consulta afectaba a la calidad de la atención que recibía el paciente, 17 por ciento pensaba que los bajos honorarios forzaban a los empleadores a reducir ese tiempo con el consiguiente detrimento en la calidad de la atención y 15 por ciento dijo que la duración de la consulta era variable y dependía del paciente. CONCLUSIONES: Estos resultados muestran que 60 por ciento de los médicos percibían como insuficiente el tiempo que sus empleadores les asignaron para llevar a cabo las consultas. La mayoría consideró que asignar un tiempo tan corto para examinar a los pacientes puede considerarse una falla ética.