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Oncology clinicians' empathy association with mean number of visits and referrals to psychosocial oncology services
Journal article   Peer reviewed

Oncology clinicians' empathy association with mean number of visits and referrals to psychosocial oncology services

Daniel Curtis McFarland and Arwa Aburizik
Journal of clinical oncology, Vol.44(16_suppl), pp.e24125-e24125
06/01/2026
DOI: 10.1200/JCO.2026.44.16_suppl.e24125

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Abstract

e24125 Background: Referrals to psychosocial services is not standardized despite national mandates for distress screening and embedded psychological services. Nationally, approximately 3% of patients with cancer are ultimately referred to dedicated psychological/psychiatric services. This study evaluated oncologists' knowledge, attitudes, and practice, racial biases, and empathy along with discreet numbers of patients seen, followed up in clinic, and referred to an academic medical center's dedicated psychosocial service. Methods: Oncologists and Advance Practice Providers at a single institution were sent questionnaires containing Knowledge/Attitudes/Behavior (KAPb), Racial Colorblindness (COBRAS), and Interpersonal Reactivity Index (IRI) empathy scales. Demographic and practice data were collected such as age, licensure (physician versus APP), years in practice/career stage, race, sex, discreet number of patients seen (18 months duration of study), number of visits, and referrals to psychosocial oncology service. Descriptive and inferential statistical modeling using linear regression were conducted. Results: Twenty clinicians (10 oncologists: 10 APPs) responded (35% response rate). Clinicians referred 8.2 (13.2) patients on average (range 1-57) out of 380.6 (280.7) discreet patients over 987.2 (1063) visits or 2.1% (4.3) of their total patients to psychosocial services. Referrals were correlated with female sex (r = -.49, p = .03), seeing less patients (r = -.46, p = .03), and empathy (r = .51, p = .02). While controlling for age, sex, # discreet patients, empathy predicted 32% variance of referrals to psychosocial services. A higher average number of visits per patient was associated with empathy (t = .2.31, p-03) and more experience in oncology (t = 2.9, p = .01). Racial biases nor knowledge, attitudes or practice behavior influenced referrals. Conclusions: Referrals to psychosocial services are inadequate to meet the psychological distress with which patients present to oncology clinic. Referrals to psychosocial services should be standardized to meet patients' psychological distress needs. These findings suggest enhanced empathy training could lead to increased referral patterns and considerations around how often patients are seen in clinic. Multivariate model predicting referrals to psychosocial oncology Services.Coefficient (unstandardized)SEtP95% CIAge-.027.113-.24.82-.269, .215Sex-1.6321.563-1.04.31-4.985, 1.721# discreet patients-.005.003-1.78.10-.012, .001Empathy (IRI total).227.1092.11.05*.008, .462IRI =Interpersonal Reactivity Index.
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