Good doctors feel their patients' pain, literally

Monday, February 11, 2013 by: David Gutierrez, staff writer
Tags: doctors, empathy, patients

(NaturalNews) In a new study that helps illuminate why a good doctor-patient relationship is so important, researchers have found that doctors' brains respond to patients' experiences the same way they would respond to their own. The study was conducted by researchers from Massachusetts General Hospital and Beth Israel Deaconess Medical Center/Harvard Medical School, and published in the journal Molecular Psychiatry.

"Our findings showed that the same brain regions that have previously been shown to be activated when patients receive placebo therapies are similarly activated in the brains of doctors when they administer what they think are effective treatments," first author Karin Jensen said.

Previous studies have shown that doctors' expectations can influence the strength of patients' placebo effect.

Inducing empathy

The study consisted of three separate parts. It was conducted on 18 doctors from nine different specialties.

In the first part, doctors underwent functional magnetic resonance imaging (fMRI) of their brains while receiving a dose of heat pain to their forearms. The doctors were then hooked up to a sham treatment device that they were told was real. The researchers pretended to treat the doctors, while actually reducing the amount of heat they were receiving from the pain machine. This phase was meant in part to convince the doctors that both the pain machine and the pain-relieving machine were real, whereas in fact the devices used in the rest of the study were fake.

In the second part, the doctors met a 25-year old woman who was introduced as a patient, but who was in fact following a rehearsed script. The doctors performed a standard clinical examination of the "patient," so that they could establish a rapport with her. The doctors then filled out a questionnaire, ranking their own perceived "perspective-taking" (empathy) skills - that is, their ability to relate to another person's experience.

In the third part, the doctors were hooked up again to the fMRI while watching the "patient" being treated with the (sham) pain device, then to push a button that was supposed to either provide pain relief or no relief.

Doctors' brains respond

The researchers found that when viewing a patient in pain, the pain processing regions of the doctors' brains were activated. Likewise, when they believed that they were administering pain relief, their brains became active in regions that have previously been linked to the placebo response.

The placebo response occurs any time patients believe they are receiving a real treatment. It has been shown to play a major role in symptomatic relief and healing in a variety of conditions, even when actual drugs are involved.

Significantly, the doctors who ranked themselves highest on empathy were also the most likely to show activity in the brain regions associated with rewards, signifying that they felt gratification when they believed that they were helping a patient.

"We already know that the physician-patient relationship provides solace and can even relieve many symptoms," senior author Ted Kaptchuk said.

"Our ultimate goal is to transform the 'art of medicine' into the 'science of care.'"

Sources:

http://www.eurekalert.org/pub_releases/2013-01/bidm-pbs012513.php