BackgroundPhysician empathy is both theoretically and empirically critical to patient health, but research indicates that empathy declines throughout medical school and is lower than ideal among physicians. In this paper, we synthesize the published literature regarding interventions that were quantitatively evaluated to detect changes in empathy among medical students, residents, fellows and physicians.MethodsWe systematically searched PubMed, EMBASE, Web of Science and PsychINFO in June of 2014 to identify articles that quantitatively assessed changes in empathy due to interventions among medical students, residents, fellows and physicians.ResultsOf the 1,415 articles identified, 64 met inclusion criteria. We qualitatively synthesized the findings of qualified studies by extracting data for ten study metrics: 1) source population, 2) sample size, 3) control group, 4) random assignment, 5) intervention type, 6) intervention duration, 7) assessment strategy, 8) type of outcome measure, 9) outcome assessment time frame, and 10) whether a statistically significant increase in empathy was reported. Overall, the 64 included studies were characterized by relatively poor research designs, insufficient reporting of intervention procedures, low incidence of patient-report empathy assessment measures, and inadequate evaluations of long-term efficacy. 8 of 10 studies with highly rigorous designs, however, found that targeted interventions did increase empathy.ConclusionsPhysician empathy appears to be an important aspect of patient and physician well-being. Although the current empathy intervention literature is limited by a variety of methodological weaknesses, a sample of high-quality study designs provides initial support for the notion that physician empathy can be enhanced through interventions. Future research should strive to increase the sample of high-quality designs through more randomized, controlled studies with valid measures, explicit reporting of intervention strategies and procedures, and long-term efficacy assessments.Electronic supplementary materialThe online version of this article (doi:10.1186/1472-6920-14-219) contains supplementary material, which is available to authorized users.

Chronic dizziness can be challenging for both patients and physicians, as a variety of specialists may be consulted and tests ordered before a diagnosis is established. The various potential etiologic processes involved in chronic dizziness require an interdisciplinary approach to care. Common causes include neurologic, vestibular, and cardiac diseases. Psychiatric disorders, however, may be overlooked when establishing a differential diagnosis. This case report illustrates some of the complexities in diagnosing and effectively managing chronic dizziness and serves as a reminder that psychiatric disorders should be considered in the differential diagnosis.