Good Doctors Listen Carefully
December 5, 2012 by Sam Rolley
New research suggests that a doctor can better the health of a patient simply by ensuring that a relationship is built upon trust and empathy.
Researchers from Michigan State University have shown that doctors who listen carefully have happier patients with better health outcomes not only because they make better treatment decisions, but also because empathy actually changes the brain’s response to stress and increases pain tolerance.
“This is the first study that has looked at the patient-centered relationship from a neurobiological point of view,” said Issidoros Sarinopoulos, the lead researcher. “It’s important for doctors and others who advocate this type of relationship with the patient to show that there is a biological basis.”
In the study patients were randomly assigned to one of two types of interview with a doctor before undergoing an MRI scan. One set was asked only specific questions about clinical information such as their medical history and what drugs they were taking. The other patients were assigned doctors who 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 patients were then given a series of electric shocks while looking at a photo of a doctor who they were told was supervising the procedure. Using the MRI, researchers measured activity in the anterior insula — the part of the brain that makes people aware of pain.
Individuals who had a previous 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. They participants also self-reported less pain when the photos showed the known doctor.
“Medicine has for too long focused just on the physical dimensions of the patient,” said MSU professor of medicine Robert Smith, who co-authored the paper. “Those clinical questions are important and necessary, but we’re trying to demonstrate that when you let patients tell their story in an unfettered way, you get more satisfied patients who end up healthier.”