Patients of Kind Doctors Heal Faster

“It’s a little embarrassing that after 45 years of research and study, the best advice I can give people is to be a little kinder to each other.” (Aldous Huxley)

attribution: Donna CameronI’ve written a few times about the health benefits of kindness. There’s considerable evidence that extending, receiving, and even witnessing kindness improves cardiac health, increases longevity, boosts immune system functioning, reduces stress, and alleviates social anxiety. Now, we’re also learning that having a kind doctor or health care practitioner has a direct impact on our health and healing, as well.

There is a growing body of research showing that a doctor’s disposition and attitude toward his patients influences their health and healing. Researchers at the University of Wisconsin School of Medicine reported that patients whose doctors expressed empathy suffered from a cold for one day fewer than patients whose physicians focused on just the facts and symptoms of the illness. They reported that physician empathy also boosted the patients’ immune systems. There was a direct relation between a physician’s empathy level and his patient’s level of IL-8, a chemical that activates immune system cells to fight disease. This is just one of many recent studies confirming the importance of kindness and empathy in health care providers.

This is something I’ve sensed intuitively for many years, but only recently seen the hard evidence. Kind doctors have better outcomes.

When we first moved to Washington many years ago, I rather randomly selected a primary care physician based on the location of her office and availability the first time I needed to see a doctor. Over the ten or so years that she was my doctor, there were times I saw her that she was friendly, compassionate, and communicative, and other times when she was brusque, taciturn, and remote. I was generally reluctant to call for an appointment because I never knew whether I was going to see Dr. Jekyll or Dr. Hyde. Inertia and good health were the major factors keeping me from seeking another physician.

However, there was an occasion when I needed a medical appointment quickly and my own doctor was out of town so I was referred to a colleague, “Dr. T,” a young doctor who had just joined the practice. I loved her! She answered all my questions, spoke to me as an equal, and never once looked at her watch. I came home elated and told Bill that I had found his doctor, since he hadn’t yet selected a primary care physician. He started seeing Dr. T and loved her as much as I had.

Idiot that I am/was, I stayed with my first physician—out of loyalty, stupidity, and even the fear of hurting her feelings. Then one day a few years later, I received a form letter from her announcing that she was leaving the practice and leaving medicine to “find her passion.” I realized as I read her letter that passion had certainly been absent during my interactions with her. I’m glad she realized it, too, and I sincerely hope she has found her passion, whatever that might be.

I quickly declared Dr. T to be my new physician and was amazed and delighted to see how different medical care could be. She spends as much time as needed with her patients (as a result, appointments are rarely on time, but with a good book and understanding that she is giving every patient the thorough care we receive, delays never bother us). She listens without interrupting, admits when she doesn’t know something, and follows up with us to see how we’re doing. I am confident in both the care and the health guidance she provides. I feel—and I think she does, too—that we’re partners in maintaining my health. What a difference!

Over the years, Dr. T has referred me to a few specialists for surgeries or special care outside of her purview. With few exceptions, each of these docs have demonstrated the same care and empathy—the same kindness. I have been so lucky to have physician partners as I’ve navigated a few serious or chronic illnesses.

One exception was an orthopedist who set my broken wrist after a fall. Each time I saw him for follow-up I told him I thought there was also a problem with my thumb, as the wrist was clearly healing but the thumb remained painfully immobile. He pointed to the x-rays indicating that the wrist was healing and said he saw no problem with the thumb. Finally, after more than a month of him dismissing my concerns I insisted quite fiercely that they take the x-ray from a different angle. When he looked at it, he said (I swear to God), “It’s as I suspected, you also have a fracture in the base of your thumb.” He said it with a straight face as he sent me off to have a new cast made.

That exception just highlighted for me the extreme difference between having doctors who listened and who didn’t, and whom I trusted or did not.

Of course, focusing on a physician’s kindness or empathy in no way diminishes the importance of her competence. The best care must involve both. David Haslam, chair of the U.K’s National Institute for Health and Care Excellence (NICE), has written that kindness, compassion and trust “are the pillars supporting the whole structure of care” in the British National Health Service. He notes that these important values are not optional extras in the health care system, “they are core, central, and vital … they have a profound effect on outcomes.”

In an article entitled, “Why Kindness Heals,” Dr. James Doty, Professor of Neurosurgery at Stanford University School of Medicine, notes that “kindness, compassion and empathy have a profound effect on healing.” He reports that evidence from psychology, neuroscience, and even economics supports the importance of human connection between patient and physician in improving physiology and health. Without such connection, there is evidence that “immune function and wound healing can be negatively affected.”

Jeffrey Young, writing for Dignity Health, cites several studies that support the health benefits of compassionate care. He references a study in Social Science and Medicine finding that patients of courteous and sympathetic doctors showed marked improvements in symptoms of irritable bowel syndrome and quality of life. He also cited a study in the Canadian Medical Association Journal which found that kind, respectful communication between doctor and patient improves patients’ emotional health and results in faster recovery. Yet another study published in The Spine Journal showed that a doctor’s ability to empathize and listen effectively yields better pain relief outcomes.

I have heard that medical schools are putting a bit more emphasis on developing the physicians’ interpersonal skills as well as their technical competence. Knowing that burnout is a serious issue for doctors and other health care practitioners, it is my hope that kindness, compassion, and improved communication not only benefit the patient, but also help the physician to better cope with the stress and pressures of their important job.

As pharmaceutical companies search for the next magic pill we would do well to remember that kindness may be the best medicine of all!

“Words of kindness are more healing to a drooping heart than balm or honey.” (Sarah Fielding)

 

11 thoughts on “Patients of Kind Doctors Heal Faster

  1. Thank you for sharing your experience, Donna!
    I spend a lot of time thinking about and studying the factors that contribute to us doctors being less than our best selves. Burnout certainly plays an increasingly significant role, and most evidence points to the system’s increasing demands, which interfere with our connections with patients, as a central culprit. Here is a prime example, from a study published just this week, on how the electronic health record actually hinders care rather than helps it: http://annals.org/mobile/article.aspx?articleid=2546704

    I looked up the article from U Wisconsin @Madison that you referenced in this post–as I suspected, the lead author of the 2009 study was David Rakel, the director of the integrative medicine program there. He is a thought leader in this realm, and an incredibly kind and empathetic physician himself!

    You may also be interested in work by Helen Riess and colleagues, on physician empathy and patient outcomes: http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0094207

    I’m headed to the International Conference on Physician Health in Boston later this month. Hopefully I will return with slew of strategies for physician self-care, so we may be more our best selves for our patients. We cannot expect to care well for you if we are not well ourselves!

    Please forgive me for the length of this comment.
    Your post reminds me that patients and doctors do not operate in vacuums, irrespective of one another.
    More and more, I think we need patients to advocate, on behalf of doctors, for changes in our healthcare system. Does that seem crazy? I know some of my colleagues balk at this idea–we should not have to ask for help from those whom we work to help, that’s not a relationship dynamic we are used to or feel comfortable with! And yet, if patients had more awareness of, and empathy for, physicians’ challenges in the system, they would realize that we all lose in our current system.
    Physicians, for the most part, answered an intrinsic call to vocation, to serve people in need and help heal. But our system can beat the passion and love out of us, and we harden to survive. It’s not only patients who suffer in this situation.
    My dream for the near future is that physicians and patients will *unite* to advocate for a healthier system, one that emphasizes continuous, personal relationships rather than technology and revenue. I think we will not get there as long as patients and physicians pursue it separately. We are equally adversely affected; we need to find our collective voice to call for change.
    Thank you for stirring my thinking pot, Donna! Have a great weekend! 😊

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    • Thanks so much, Catherine, for commenting. I was hoping that you would. Even though I don’t “know” you—except through our blog interactions—I am certain you are one of those physicians whose patients heal more rapidly because of your empathy and kindness. And I have seen that you are part of the movement to help doctors claim their kindness and navigate/thrive in the system that can be harsh and punishing. I totally agree with your idea that patients and physicians need to advocate for one another. If we want to have an effective and functioning health care system, it’s up to all of us to work together to make it happen. Plus, working together gives us a greater sense of equality and partnership. We need to get beyond the old model of patron/supplicant—it serves no one. Thanks for the links, and for your wise comments. You give us all a lot to think about. Hope you have a lovely weekend, too.

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  2. I posted on my FB. Hugs

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  3. Thanks, Donna, for this fascinating post, especially the information about empathy boosting the immune system. I just experienced a US medical centre here in Hawaii (more focussed on admin than empathy) to find out if my back pain is due to anything serious – it’s not – and am now booked into the hotel spa centre for some (hopefully) more empathetic healing and pampering. I’ll bear in mind what you and Catherine say about having empathy for the physicians.

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    • Carol, so sorry to hear that you’re having back problems on your R&R vacation in Hawaii. Glad to hear it’s nothing serious and hope it’s not impeding your enjoyment. I hope the spa treatment succeeds where medical care was less than nurturing. You’ve had a few very long flights in recent weeks—I can see how airplane seats might cause or exacerbate back problems. I’d be very interested to hear your impressions of the U.S. medical system as compared to the Australian system. Take care and enjoy Hawaii as much as you can. Thanks for taking the time to read and comment on your holiday!

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