A recent study conducted at Michigan State University shows
that a doctor-patient relationship involving trust and empathy changes
stress-related brain activity and increases pain tolerance (2012). In this
study, one of two types of interviews was performed with participants before
they underwent an MRI scan. One type was “patient-centered”, involving an open
dialogue with the participant addressing any concerns and discussing the
participant’s personal life. The other type was a routine interview, with
questions focused around medical history and other relevant clinical
information.
The
participants then were placed in an MRI scanner and received several mild
shocks while looking at the photo of either the doctor they had just spoken to or
an unknown doctor. Before the shocks and during, the experimenters looked at
the anterior insula of the brain, which is associated with the awareness of
pain.
In
the condition with the “patient-centered” interview and known doctor, the
participants showed less activation of the anterior insula and self-reported
less pain.
This
study implies that a good beside manner could not just make the hospital experience
slightly more enjoyable but also have a genuine pain-relieving effect. However,
the study had a small sample size and needs replication. If further studies uphold
these findings, then they could have a significant effect on the decision of
whether the aloof demeanor currently adopted by several doctors is appropriate.
This
apparent apathetic manner could be a symptom of a lack of empathy for patients.
In their review of phylogenetic and ontogenetic perspectives on empathy, Decety
and Svetlova mentioned one study that indicates that physician reactions to
pain differ from others (2011). A group of control participants and a group of
physicians watched short videos showing hands, feet, and faces being pricked by
a needle or touched by a Q-tip. In the painful stimulus (the needle), the
control group had increased activation in their pain matrix. The physicians by
contrast, had no increase in activation of their pain matrix but did display increased
activation in the cortical structures that are associated with executive functioning,
executive attention and self-regulation.
This
study suggests that there is something in the structure of the medical system
that causes physicians to need to highly regulate and suppress their empathetic
reactions. Yet, the first study indicates that the empathetic reaction that is
being suppressed could cause a substantial decrease in a patient’s perceived
pain. Hopefully, these studies will inspire a shift in the current accepted bedside manner for doctors and more research looking into the environmental stimuli that cause the lack of empathy seen in today's doctors.
References:
Michigan State University (2012, December 3). Listen up, doc: Empathy raises patients' pain tolerance. ScienceDaily. Retrieved December 10, 2012, from http://www.sciencedaily.com/releases/2012/12/121203145952.htm
Decety, J., & Svetlova, M. (2011). Putting together phylogenetic and ontogenetic perspectives on empathy . Elsevier,
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