It’s true! In a recent small meta-analysis published in PLOS ONE, researchers found that the patient-clinician relationship has a small, but statistically significant effect on healthcare outcomes. In fact, the effect was even stronger than the preventative benefit of aspirin after a heart attack.
This is not the first study to evaluate the power of the therapeutic relationship on health outcomes. I discussed this topic in a blog last year after attending training in functional medicine on the importance of the presence of the physician (2-4).
Today, more and more physicians are paying attention to the power of emotions and there role in healing (2-4). An easy example of this connection is how long-term stress negatively impacts our biochemistry (6).
This reignited interest in the mind-body connection makes sense with our current crisis in medicine. It is becoming evident that an inhumane, disconnected approach to our bodies is not faring well. In fact, in 1982, a literature analysis on the effect of psychological intervention on recovery from a heart attack reported that medicine was in a downhill spiral for not accounting for the power of compassion. They noted, over twenty years ago, that we couldn’t afford to continue ignoring the impact of emotions on our biochemistry. The researchers reported:
It is often argued that the medical care system cannot afford to take on the emotional status of the patient as its responsibility. Time is short and costs are high. However, it may be that medicine cannot afford to ignore the patient’s emotional status assuming that it will take care of itself. Anxiety and depression do not go away by being ignored.
Looking at this with a positive spin, a client or patient can impact their wellness by choosing a physician they can trust to confide in while feeling positive and comfortable working with. That is, happiness can be just as vital for positive effects on mood as anxiety and depression have on predicting negative effects on health.
This also translates to the fact that we can help heal others with our own attitudes of joy and compassion. This is why I always try to keep humor in my visits, not just because it’s healing, but it is also contagious and great for my clients’ healing!
In the beginning of this month, Dr. Mercola summarized why happiness does a body good:
- Positive thoughts and attitudes are able to prompt changes in your body that strengthen your immune system, boost positive emotions, decrease pain and chronic disease, and provide stress relief
- One study found that happiness, optimism, life satisfaction, and other positive psychological attributes are associated with a lower risk of heart disease
- A team of researchers at UCLA showed that people with a deep sense of happiness and well-being had lower levels of inflammatory gene expression and stronger antiviral and antibody responses
- Self-acceptance was found to be the strongest predictor of life satisfaction in one survey (but many people have difficulty accepting themselves)
- Emotions are known to be contagious among people in direct contact (this is true for friends, acquaintances, and even strangers), and new research suggests they may also be contagious via social media (7)
The Compassionate Healer
Some that read this blog may remember when doctors made house calls or when they actually had time to ask about how little Teddy was doing in little league and listen to the response!
Thankfully, functional and naturopathic medicine does allow for this listening healing space. In this beautiful twenty minute TEDx talk, Dr. Verghese summarizes the importance of the ritual of one individual coming to another in a trusting relationship. This is the magic formula for optimal healing:
I have been humbled by the feedback from my clients that allowing for a full recollection of their wellness history was the first time someone actually listened and that it is profoundly healing. In New York State, naturopathic physicians aren’t licensed; therefore, I cannot perform physical exams as Dr. Verghese mentions. However, no one can stop a hug or handshake to transmit a healing touch.
Why Doctors are Tired & Visits Are So Short
So, if we are becoming aware of the importance of relationships in healing, why aren’t we seeing more therapeutic presence in doctors’ visits?
It is true that most physicians went into medicine to help people. In reality, the vision of “rich doctors” is not true. Most physicians aren’t paid enough to make up for the loans accrued in training, social time lost to studying, the thousands of dollars of training for electronic health record implementation (8), and the high expectations to perform superhuman tasks with little or no sleep.
The problem isn’t with “disconnected doctors.” So many physicians are burned out and suffer compassion fatigue for the following reasons:
- it is not taught in medical school that we have to wear all the hats of billing specialist, business owner, diagnostician, treatment specialist, and expert that is expected to answer concerns at a moment’s notice
- it is viewed as “bad medicine” to take time off and refresh when one could be “on call”
- our current system is set up in a way where insurance companies are taking over physicians’ decisions
- they are deciding on what tests to run and when and how doctors get reimbursed
- they are also taking over the patient’s decisions as to who they prefer to see based on “in network coverage”
How can a doctor truly be present and efficient in their job if they can’t do what needs to be done to truly heal their patients?
Finally, there exists a societal meme that has become normalized. This is the belief that it is acceptable to put our health in the hands of our insurance companies. In fact, as long as physician visits and solutions are covered by their insurance’s pocketbook, most people will continue to take part in a broken system. After all, the cheapest, latest, and/or quickest fix is a lot easier to implement than taking responsibility for one’s own wellness and stepping outside the accepted belief system.
Therefore, it is easy to understand why the humanity of compassion is becoming extinct in medicine.
Physicians Heal Thy Practice
Physicians who strike out on their own and refuse the medical model of insurance are often viewed as “non-compassionate” or “greedy” because they charge for their services. However, the fact is they must run a business of medicine as a specialist that is getting paid for their training, akin to any expert such as a lawyer or accountant.
They are looking for freedom to spend time with their “clients” and make their own suggestions, outside of a system that is draining the economy with health care premiums and expensive tests.
Still, physicians who feel appreciated and feel that they are being reimbursed for their skills provide better care than burnt-out physicians who are unhappy (9).
This is why I continue to be included amongst the wellness consultants that provide the following services that are missing in conventional medicine:
-the individual wellness provider who operates solo and is invested in every client
-a consultant who offers suggestions on supplements and who makes recommendations based on each individual’s needs vs. what’s in the dispensary
-as someone who knows and cares for all clients to continue to study and research wellness notes after-hours in order to provide you with optimal solutions
-a wellness practitioner who offers free health information via blogs
-a writer who provides a book for beloved clients and wellness seekers alike who are struggling with the finances at this time and want information but are unable to do an in-person visit at this time
My goal is to continue to be a wellness consultant that has an overall interest in my clients beyond the visit for as long as we work together. I want to continue to provide this additional care that is compensated for in order to stay a compassionate and present practitioner for healing that I feel is vital in our society. 😀
Therefore, current clients and readers, please stay in touch with the updates on my website in the future. There will be a slight increase in monthly hourly consults and fees but also more options for length of visits starting in June.
Finally, don’t miss this important blog…
Learn my not-so-happy lesson on the bio-individuality of skin response to “helpful superfoods.”
Essential Oils Highlight: Peppermint
Here’s a summary of a recent article on the power of peppermint for digestive woes:
A systematic review of nine studies that included 726 patients was done to assess the benefits of peppermint oil for IBS (Irritable Bowel Syndrome). Patients who received peppermint oil had significantly greater improvement in global IBS symptoms than placebo and greater improvement in abdominal pain in five studies. Khanna R, et al. J Clin Gastroenterol. October 4, 2013; Goldman, E. Minty Fresh and Symptom Free. Holistic Primary Care: Upshots. March 27, 2014.
1. Kelley JM, et al. The Influence of the Patient-Clinician Relationship on Healthcare Outcomes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. PLOS ONE, published: April 09, 2014. DOI: 10.1371/journal.pone.0094207. Find it here.
2. Here is a short list of references that Dr. Rakel presented summaries for in our training at the IFM’s 2013 Symposium:
- Colloca L, et al. Lancet Neurology. 3(11); 2004
- McKay KM, Imel ZE, Wampold BE. Psychiatrist effects in the psychopharmacological treatment of depression. J Affect. Disord. 2006;92:287-90
- Kaptchuk TJ. et al. Components of the Placebo Effect: RCT in patients with IBS. BMJ 336 (7651), 2008).
3. Dean Ornish , MD. Love and Survival: The Scientific Basis for the Healing Power of Intimacy. Harper Collins. New York:NY. 1998.
4. Mumford E, Schlesinger HJ, Glass GV. The effect of psychological intervention on recovery from surgery and heart attacks: an analysis of the literature. American Journal of Public Health. 1982; 72: 141–151. http://ajph.aphapublications.org/doi/pdf/10.2105/AJPH.72.2.141
5. Nieuwenhuizen AG1, Rutters F.The hypothalamic-pituitary-adrenal-axis in the regulation of energy balance. Physiol Behav. 2008 May 23;94(2):169-77. doi: 10.1016/j.physbeh.2007.12.011. Epub 2007 Dec 23.
6. Erica C. Leifheit-Limson, et al. The Role of Social Support in Health Status and Depressive Symptoms After Acute Myocardial Infarction: Evidence for a Stronger Relationship Among Women. Circulation: Cardiovascular Quality and Outcomes. 2010; 3: 143-150 Accessed August 15, 2011. http://circoutcomes.ahajournals.org/content/3/2/143.full
7. Mercola, J. Why Happiness is Healthy. mercola.com. April 3, 2014.
8. Miller, RH, West, C, Brown, TH, et al. The Value of Electronic Health Records in Solo or Small Group Practices. Health Affairs, September/October 2005, 24 (5): 1127-37.
9. Freidberg, M, Chen, PG, Van Busum, KR, Aunon, F, Pham, C, et al. Factors Affecting Physician Professional Satisfaction and Their Implications for Patient Care, Health Systems, and Health Policy. RAND Corporation. October 2013. http://www.rand.org/pubs/research_reports/RR439.html
Images courtesy of istockphotos: istockphoto.com