Study leader Dr. Ronald Epstein of the University of Rochester Medical Center used nearly 4,800 patient surveys concerning doctor visits, and 100 covertly recorded visits by actors posing as patients, and concluded that only 15 percent of the office visits showed doctors voicing empathy.

The study involved 100 doctors in the Rochester area in 2001 to 2002, who agreed to receive two unannounced visits during a one-year period by actors trained to portray patients in a realistic and uniform way. The actors recorded the visits without the doctors' knowledge.

The researchers also collected 10-minute surveys from real adult patients in doctors' waiting rooms. The actor/patients asked loaded questions indicating worry about symptoms involving chest pain.

Epstein and colleagues evaluated the surveys and the transcripts to characterize the responses by type, frequency, pattern and communication style, and correlated them with patient satisfaction ratings. They also looked for signs that doctors doled out empty reassurances, were dismissive or made statements that served as conversation-stoppers.

The findings were published in the Journal of General Internal Medicine.