I believe that it is the empathic connection that I’ve forged with my healthcare team that has ignited my own healing. While they may be smart and skilled and filled with great ideas, it has been their interest in me, in getting to know me, in hearing and understanding my story, in encouraging me and rooting me on, that has been the foundation and the power of our work together. If I didn’t love and trust the people I let help take care of me, I’d be out there searching for someone new.
Empathy is the power of our connection to one another when we are fully present, listening with interest and compassion, and willing to share our understanding of one another’s experience. It is so true that one brief meaningful look or word of empathy from the people in our lives has the power to shift us out of despair or loneliness, and into transformation. Commiseration with friends makes us feel less alone. Being on the receiving end of compassion opens our hearts and ignites hope.
In healthcare, is empathy just a personal choice? Or is there evidence that empathy is good for us?
A few years ago a Functional Medicine colleague of mine published an article about the health effects of empathy that occurs within the relationship between physician and patient. He looked at 719 patients who were experiencing new-onset symptoms of the common cold. They were randomized to three different groups. The “no patient-practitioner interaction” group received the standard protocol for treating a cold without a practitioner encounter. The “standard visit” group received the orthodox encounter with a brief history of present illness, past medical history, focused physical exam and a diagnosis. This visit was purposely kept short and every effort was made by the practitioner not to form a bond by making eye contact or offering reassurance. Finally, the “enhanced visit” interaction group received the basics of the standard visit group along with warmth and encouragement through five specific domains of interaction: positive prognosis, empathy, empowerment, connection and education. This came about through eye contact, appropriate touch, individualized instruction, active listening, caring facial expressions and verbiage, and encouragement delivered both verbally and in writing.
The severity of all of the study subjects’ cold symptoms were assessed twice daily. In addition, they used a standardized scale (the Consultation and Relational Empathy–CARE– measure) to rate the level of empathy the study participants perceived by their clinician, and they measured markers of immune function (cytokine IL-8 and neutrophil counts, a type of infection-fighting white blood cell) from nasal washings, both at the beginning of the study and 48 hours later.
The results of the study demonstrated significant reduction in the severity and duration of cold symptoms in those participants who rated the empathy of their physicians as high. Of the 483 subjects seen by a clinician, 112 interactions received a perfect score on the CARE empathy tool. Of these encounters, there was a 17.4% reduction in patient reports of cold symptom severity and a reduction in cold duration by 1.11 days. These subjects also showed huge changes in their immune markers compared to other groups, demonstrating a marked augmentation of their immune response associated with the perception of empathy by their care provider. Neutrophil counts in nasal washings were 49.42 in the perfect group vs. 11.93 in the sub-perfect group. Cytokine IL-8 levels were 1585.5 in the perfect group vs. 72 in the sub-perfect group.
There’s no doubt that we all feel better when our encounters with healthcare practitioners are positive and caring. This is now one study, amongst a growing body of literature, demonstrating that concrete changes occur in our biology when we feel cared about.
Empathy heals. How have you healed from an empathic encounter?
David Rakel, MD, et al. Perception of Empathy in the Therapeutic Encounter: Effects on the Common Cold, Patient Educ Couns. 2011 Dec; 85(3): 390-397. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3107395/