Future directions

- Toward a Biopsychosocial Understanding of the Patient–Physician Relationship: An Emerging Dialogue

Empirical studies of clinical empathy might proceed in three steps. The first would be to establish the presence of interpersonal neurobiological and empathic responses during the medical encounter. This could be done during the medical encounter by performing neuroimaging and physiologic studies that have been used to monitor the process of psychotherapy,99^,100 and immediately afterward by administering an empathy scale, such as the Relationship Inventory,101 to both patients and physicians. Second, researchers could demonstrate subsequent changes in biological variables that are plausibly relevant to disease, employing the methodology used to study the psychoneuroendocrine effects of conflict and resolution in spouses.97^,102 The third and final step would be to explore the strategies and techniques71 that an empathic physician can use with the patient103 in a way that maximizes the therapeutic potential of the biopsychosocial relational process.