This cohort study investigates the association between physician empathy and outcomes in patients with chronic low back pain (CLBP). The study included 1470 adult patients from the PRECISION registry, with data collected over 12 months. Physician empathy was assessed using the Consultation and Relational Empathy (CARE) measure, which was dichotomized into very empathic (VEP) and slightly empathic (SEP) groups. Main outcomes included patient-reported pain intensity, back-related disability, and health-related quality of life (HRQOL) measures. Multivariable generalized estimating equations were used to analyze the data, adjusting for baseline and longitudinal covariates. Results showed that VEPs reported significantly better outcomes compared to SEP groups, with clinically relevant differences in pain intensity, back-related disability, and HRQOL deficits. The study concluded that physician empathy is an important factor in improving outcomes for patients with chronic pain and suggested that efforts to cultivate and improve physician empathy are warranted.This cohort study investigates the association between physician empathy and outcomes in patients with chronic low back pain (CLBP). The study included 1470 adult patients from the PRECISION registry, with data collected over 12 months. Physician empathy was assessed using the Consultation and Relational Empathy (CARE) measure, which was dichotomized into very empathic (VEP) and slightly empathic (SEP) groups. Main outcomes included patient-reported pain intensity, back-related disability, and health-related quality of life (HRQOL) measures. Multivariable generalized estimating equations were used to analyze the data, adjusting for baseline and longitudinal covariates. Results showed that VEPs reported significantly better outcomes compared to SEP groups, with clinically relevant differences in pain intensity, back-related disability, and HRQOL deficits. The study concluded that physician empathy is an important factor in improving outcomes for patients with chronic pain and suggested that efforts to cultivate and improve physician empathy are warranted.