Empathy is seen by some researchers as a cognitive attribute (i.e. ‘understanding’ another person’s concerns) and by others as an affective attribute (i.e. ‘feeling’ another person’s suffering) or both. We propose that clinical empathy should be viewed as a continuum of three obligatory sequential stages: ‘comprehension’ of the patient’s predicament (a cognitive process based on listening); followed by ‘compassion’ (an emotional or affective process) and then, ‘commitment’ to do the best for this patient (a practical stage of obtaining and applying the best patient-suited evidence and providing ongoing support). Thus, for empathy to be effective, the physician’s compassion needs to be not only felt by the patient but also followed by action.