By STEPHANIE GALL ’14
If you have ever developed a close relationship with your doctor, you know the effect a positive, supportive connection can have on the entire treatment process. Physicians do more than treat physical pains or illnesses; they give emotional care as well. As the director and founder of Massachusetts General Hospital’s Empathy and Relational Science Program, Dr. Helen Riess studies how physicians’ empathy can impact their patients’ health and well-being.
Her most recent findings show that improving the quality of clinicians’ relationships with their patients can produce small but significant improvements in their patients’ physical health. “I hope doctors realize that taking the extra time to make themselves available or remember things about their patients will not only strengthen the relationship they have with their patients but will also result in patients’ overall health improvements,” Riess said.
Past research has examined how manipulating specific facets of the physician-patient relationship. such as making eye contact or not interrupting or sitting down while talking with the patient, can affect the patient physically and emotionally. Riess’s study is a meta-analysis of these previous studies on empathy. By looking for significant results across a number of studies, she sought to determine whether clinicians’ relationships with their patients can influence their patients’ physical outcome. For a paper to be included in the analysis, the study had to have involved patients over the age of 18 who were being treated for a specific condition that was not a psychiatric or substance abuse disorder. Additionally, the researchers of each study had to have measured patients’ final outcomes objectively by physical measurements such as blood pressure and weight loss or by accepted subjective measurements such as pain scales in which the patient ranked his or her discomfort from zero (no pain) to 10 (extreme pain).
After applying these restrictions, Riess selected 13 papers to use in her analysis. The patients’ conditions in them ranged from obesity and diabetes to asthma and fibromyalgia. The ways in which clinicians tried to improve their relationships with their patients also varied between studies. Some clinicians tried sharing the decision-making process with their patients, some provided more motivational encouragement and others focused on creating a patient-centered environment.
When clinicians employed these techniques, their patients’ physical health improved in small but measurable ways. “Most physicians understand and value that patients want a caring and compassionate relationship,” Riess explained. “With the tremendous time pressures in medicine today, the majority of physicians would say they can’t spend the amount of time they would like with their patients. These findings point to the fact that a relationship with your doctor is not only a ‘nice to have’ component but it affects the very outcomes that the doctors are working hard to affect.” Riess also pointed out that communicating more empathically does not necessarily require more time. “By being more attuned to nonverbal cues and responding to them in the moment, busy physicians may receive fewer phone calls and return visits and learn more about what is affecting their patient’s symptoms.”
When Riess teaches residents at Massachusetts General Hospital how they can become empathic physicians, she shows them the benefits of getting a patient’s perspective rather than taking his or her perspective. Getting perspective involves asking the person what he or she is experiencing, while taking perspective is done by simply imagining what he or she might be feeling. Since founding the Empathy and Relational Science Program in 2011, Riess says she has become “more and more fascinated with how many different places in healthcare the skill of empathy is needed.” Now she is studying how empathy is expressed across cultures. Through her research and teaching, Riess helps physicians better communicate with and relate to their patients. With this knowledge, physicians can provide their patients with the best care possible. “When you get to know a person’s whole story,” she said, “it becomes easier to understand them, see their perspective and become more patient with how much change they can make at a given time.”