An Empathetic Doctor Can Increase A Patient’s Pain Tolerance
Clinicians are taught as part of their medical training that the therapeutic relationship is an important component of treatment and that reassurance, empathy and compassionate care are valuable elements in improving medical outcomes.
A recent study published in the journal Patient Education and Counseling demonstrated that the doctor-patient relationship can actually change the brain’s response to stress and increases pain tolerance.
A research team from Michigan State University looked at patient-centered relationships from a neurobiological perspective. Patients (n=9) were randomly assigning patients to one of two types of interview with a doctor before undergoing an MRI scan. One, a patient-centered approach, in which doctors addressed any concerns participants had about the procedure and asked open-ended questions allowing them to talk freely about their jobs, home life and other psychological and social factors affecting health. The other patients were asked only specific questions about clinical information such as their medical history and their medication regimen.
Patients were then given a post interview questionnaire and as expected, those who had the patient-focused interview reported greater satisfaction and confidence in their doctor. Each participant was then placed in the MRI scanner and given a series of mild electric shocks, similar to the discomfort of having an IV needle inserted, while looking at a photo of a doctor who they were told was supervising the procedure. The scans measured activity in the anterior insula – the brain area that acknowledges pain – in anticipation of the shocks and when they actually occurred.
The brain scans revealed those who had the patient-centered interview showed less activity in the anterior insula when they were looking at a photo of the interviewing doctor than when the doctor in the photo was unknown. Those participants also self-reported less pain when the photos showed the known doctor.
The authors concluded that this is an initial step in understanding the neural underpinnings of a patient-centered interview and provides an additional scientific rationale for its use clinically. Giving patients the opportunity to tell their story rather than an interview that focuses only on physical dimensions can improve patient satisfaction and health outcomes.