Blog | Tuesday, February 5, 2013

QD: News Every Day--Empathetic doctors get rewarded for care, MRIs show

MRIs show that physicians who empathize with patients are getting a reciprocal boost in the regions of their brains associated with pain relief and rewards, a study found.

Harvard researchers showed that the same brain regions that are activated when patients receive placebo therapies are turned on in the brains of doctors when they administer what they think are effective treatments. And physicians who reported greater ability to empathize with their feelings and experienced more satisfaction during patients' treatments, which was reflected in the brain scans.

Researchers did functional magnetic resonance imaging (fMRI) of the physicians' brains while the doctors had face-to-face interactions with patients, including observing patients as they underwent pain treatments.

Results appeared in Molecular Psychiatry.

Eighteen physicians examined two women who played the role of patients and followed a rehearsed script. The experiment called for the participating physicians to administer pain relief with a placebo device that they thought was a pain-relieving electronic device.

Next, physicians performed a standardized clinical examination and then answered a questionnaire, the Interpersonal Reactivity Index, to measure self-reported perspective-taking skills.

Then, physicians went inside the fMRI scanner with a remote control that could activate the placebo device when randomly prompted. Using mirrors to maintain eye contact with the patient outside the MRI, when physicians were told not to activate pain relief, the patient's face reacted in pain. When the physicians were instructed to treat the patients' pain, they saw that the subjects' faces were neutral and relaxed.

While treating patients, the physicians activated the right ventrolateral prefrontal cortex, which is associated with pain relief, and physicians who reported high perspective-taking skills were more likely to show activation in the rostral anterior cingulate cortex, which is associated with reward.

Reciprocal interactions between clinicians and patients are a hallmark for successful treatment outcomes, the researchers noted.

"We already know that the physician-patient relationship provides solace and can even relieve many symptoms," the lead author said in a report. "Now, for the first time, we've shown that caring for patients encompasses a unique neurobiology in physicians."