Wednesday, February 8, 2012

Doctor-Patient Relationship: A Key Ingredient for a Successful Treatment

Did you know that when we feel understood by our doctor we do get better faster? In fact, the relationship between the doctor and the patient can stimulate...or hinder the efficacy of the treatment. Research has shown that people, who feel cared for with attention, not only reported a higher satisfaction, but also better results with their care. Let's discover why the exchange between the physician and the patient is so important, and why we should seek a doctor who is ready to listen to us.
An interaction between 2 persons
When a patient meets a doctor, he meets another human being who is going to convey a general impression, which will affect the patient and his condition. That interaction was, up to the 18th century, the essential component of the medical care. In an article on the history of medicine, Ivan Illich (1) notes that the 'ars medendi' (medical art) was mainly verbal. The doctor not only listened with attention, he adapted his voice inflexion and the choice of his words to the patient. He used an elaborate body language to express his understanding of the patient's condition. That mimetic diagnosis was considered as having a major therapeutic function. Today, neuroscience helps us better understand how the doctor/patient relationship affects the physiology of the patient. Let's take a closer look at a significant discovery in neurophysiology: Mirror neurons
Mirror neurons: we neurologically mimic what others do
Mirror Neurons were discovered in 1995 by an Italian team of researchers in psycho-neurology. The discovery happened, as major discoveries often do, by chance. They were studying the brain function of a monkey. During their lunchtime, as they started to eat a pizza, they noticed that the scanner to which the monkey was hooked started to ring. The animal was nonetheless seating quietly looking at the researchers who were eating. As Professor Giacomo Rizzolatti, the lead researcher, looked closer at the scanner, he noticed that the monkey, when he saw the men reaching for the pizza, was firing the same neurons he would have to move his right arm. That initial discovery was further studied over the following decade, and major research centre like the Center for Brain and Cognition at the University of California, confirmed the mimetic function of neurons. What they found was that whenever we would look at another person act, we would fire the same neurons in our brain as the ones used by the other person's brain. And the more similarities we would have with that person the more mirror neurons would fire. That understanding of human neurology explains how children can assimilate their cultural environment. It is through their nervous system's natural ability to reproduce the acts of their parents. Now, if we look at the doctor/patient relationship through this new perspective, we will better understand how the feelings of the doctor can affect the body of the patient. Let's take a closer look at the concept of empathy and its effect on health.
Empathy: I know and feel what you are going through
A patient comes in the doctor's office. The doctor welcomes him warmly and listens to his condition with attention. The patient feels understood and he feels a sense of proximity with the doctor. The neurons mirrors are now in a condition to be activated. After the doctor has understood the patient's situation, he poses his diagnosis and shares the best way to manage it. He does it in a confident and calm way. The serenity the doctor conveys, will immediately be mirrored by the patient who would feel reassured about his condition. That shift in the patient's perspective on his condition will drastically help the healing process. A study published in the Journal of General Internal Medicine (2), and involving 100 primary care physicians and 4,746 patients revealed that when the physician expressed empathy it was associated with higher patient ratings of interpersonal aspects of care (satisfaction) and a stronger sense of reassurance. Knowing that the faith a patient puts into his treatment does play a major role in its efficacy; we now better understand the importance of finding a doctor that emanates confidence and empathy.

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