This article was produced by Kaiser Health News.A doctor\u2019s training hasn\u2019t historically focused on sensitivity. And too often while juggling heavy workloads and high stress, they can be viewed as brusque, condescending or inconsiderate.A 2011 study, for instance, found barely more than half of recently hospitalized patients said they experienced compassion when getting health care, despite widespread agreement among doctors and patients that kindness is valuable and important.But payment initiatives and increasing patient expectations are slowly forcing changes, encouraging doctors to be better listeners and more sensitive to patients\u2019 needs.\u201cWe train people to ask the question, \u2018What\u2019s the matter?\u2019 We train toward diagnosis,\u201d said Martha Hayward, who leads public and patient engagement efforts at the Institute for Healthcare Improvement, a Massachusetts-based nonprofit. \u201cWe don\u2019t train toward lifestyle understanding.\u201dMany medical centers across the country are striving to improve doctors\u2019 bedside manner. Even some physicians in private practice are working to improve.Much of the motivation is financial. Under the 2010 health law, Medicare payments to hospitals can be affected by patient satisfaction surveys.The trend is also fueled by consumer demand. As patients pick up an increasing share of the cost of care, they\u2019re becoming more particular about quality and experience and choosing doctors accordingly.The University of Michigan, the Cleveland Clinic and some Catholic health systems are among medical systems experimenting with techniques to encourage physicians to be more responsive, said Tim Vogus, an associate professor of management at Vanderbilt University who has researched the relationship between compassion initiatives and patient satisfaction scores.His research found that hospitals that promote compassion \u2013 especially with rewards \u2014 are more likely to have higher patient satisfaction scores.Partners HealthCare in Massachusetts and medical schools such as Duke are requiring some residents to take courses to help them be empathetic and offering training to practicing physicians. Other medical organizations encourage physicians to put personal details about patients in their medical charts so they can bond over topics like hobbies or sports teams. Some urge doctors to send handwritten follow-up notes to patients and their families, according to a survey of 35 health systems published this March by the Schwartz Center, a Massachusetts nonprofit that promotes compassion in health care.Small gestures, like a follow-up phone call from a doctor, go a long way, said Matthew Taylor, 57. After his daughter was prescribed new medication for her anxiety and depression, the doctor called to check up on her.\u201cThat considered it important \u2014 even if it\u2019s only taking 30 seconds or a minute of time to say, \u2018Are things going well? Is there anything we need to be concerned about?\u2019 \u2014 shows that they\u2019re paying attention to things they need to be doing,\u201d said Taylor, who lives in Mount Airy, Md. \u201cIt\u2019s not out of sight, out of mind.\u201dSuch small behavioral modifications aren\u2019t \u201ca panacea,\u201d the Schwartz Center researchers noted in their paper. But they can improve patient experience.Recognizing doctors\u2019 effortsDoctors working in hospitals are at the forefront of the efforts, often because of the patient surveys\u2019 effects on Medicare payments. But health staffers also need to know how patients view them, so they can figure out what actually works, experts said. At the Cleveland Clinic, employees get a quarterly report that includes feedback from patients\u2019 reviews, said Adrienne Boissy, chief experience officer. If they do things patients dislike, they\u2019ll find out and can adjust.\u201cIf you really don\u2019t get any feedback on your ability to communicate or be empathic,\u201d she said, \u201cyou won\u2019t think you have a problem.\u201dAt the University of Rochester Medical Center in upstate New York, doctors who demonstrate compassion are recognized in monthly notes the department head sends out to the hospital\u2019s faculty. Those notes are often based on patient evaluations, which mention, for instance, listening well, spending extra time at a bedside and answering questions in ways the patient can understand.\u201cThese practices are pretty simple things \u2013 recognizing people publicly for giving especially compassionate care,\u201d Vogus said. And they can pay off in higher patient satisfaction.At Rochester, physicians can get coaching. Other doctors watch them practice and work one-on-one with them to help them talk to patients. After shadowing, the coach might talk the doctor through interactions that could have been more thoughtful; then, depending on the critique, they might role-play scenarios based on that conversation.Coaching changes doctors\u2019 behavior, said Susan McDaniel, a psychologist who directs Rochester\u2019s coaching program. \u201cThey\u2019re exhibiting skills that they weren\u2019t exhibiting before.\u201dIt\u2019s hard to say whether factors like age make a difference, she said. Some older doctors are less enthusiastic about changing their ways, but often, they \u201cknow better how important good communication is, because of their years of experience,\u201d McDaniel said. Younger doctors are likelier to have had some kind of communication training in medical school, but that doesn\u2019t necessarily mean they\u2019re always better at talking to patients.\u201cI don\u2019t think I\u2019ve ever in my medical career \u2013 this included medical school \u2013 had somebody observe me to this degree,\u201d said Jonathan Friedberg, Rochester\u2019s chief of hematology and oncology, who participated in the program. He has since noticed small changes, he said, in how he interacts with patients. The exchanges have become less rote and routine, and more of a conversation.Improving healthIf patients feel their doctors genuinely care, experts said, they\u2019re more likely to take medications and comply with recommendations.\u201cEmpathic care is a real intervention that has impact on patients\u2019 adherence, whether they\u2019ll come back to see the doctor or just skip town and go untreated,\u201d said Stephen Post, who directs the Center for Medical Humanities, Compassionate Care and Bioethics at Stony Brook University in New York. And listening more carefully could lead physicians to pick up cues and details they might otherwise miss, and consequently prescribe better treatments.When that thoughtfulness is absent, patients can be turned off. Harvest Moon, 42, who lives Grand Prairie, Texas, found a new doctor condescending and dismissive during a visit in August. She was so upset she forgot to ask about the problem that brought her in and left reluctant to get follow-up care.\u201cI was feeling obstinate,\u201d she said. \u201cIt was almost a way to get back at him.\u201dWhen talking with a patient, doctors need to do more than just run through a list of questions. \u201cIt\u2019s important to train physicians not to just ask about a patient\u2019s medical history and medications but to make a meaningful inquiry,\u201d Post said.Doctors can easily forget to listen, Boissy said. Even in her own experience, she\u2019s seen doctors who don\u2019t introduce themselves when they walk into the exam room \u2013 a small gesture, but one that helps establish trust and gets patients to open up.\u201cIt\u2019s not that they don\u2019t care. There\u2019s a depth of caring,\u201d she said. \u201cBut they forget.\u201dKaiser Health News is an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente.