Doctor!

February 2nd, 2019| Topic: RaMbLeS | 0

Nowadays, my patients already know who I am, where I went to school, my Dallas Seminary affiliation, and a host of other factoids about me, even before they enter my exam room.

It’s the age of the internet, after all.

Reviews, credentials, ethnicity—everything about every doctor is freely available somewhere online.

And one would suspect that all of these data are somehow important in improving the health of patients.

Bedside manner? Well, it’s nice to have a physician who is nice and caring and friendly, but surely that’s not going to affect one’s rash, or appendicitis, or acne.

You’d be wrong. So says “Physician Assurance Reduces Patient Symptoms in US Adults: an Experimental Study,” an article in the Journal of Internal Medicine by researchers from Stanford’s Department of Psychology.

They used a skin prick test (usually used to assess allergies) with histamine that turns the skin red and itchy, and assessed reactions. For some subjects, the doctor didn’t say much. Others were told:

From this point forward, your allergic reaction will start to diminish, and your rash and irritation will go away.”

Believe it or not, more of these reassured patients showed improvement than those of the unreassured group, and all without any medication being administered whatsoever. Reported the researchers:

These results provide empirical support for the clinical utility of assurance alone and suggest that reassuring patients who consult for minor complaints may not only equip patients with helpful information—it may assist in alleviating patients’ symptoms. … This study highlights the critical yet rarely quantified healing effect of visits in which the physician’s sole role is to assure patients they will soon feel better.”

Your warm and reassuring physician can actually improve your health! In fact, that person’s words alone did the trick.

In another study, “Harnessing the Placebo Effect: Exploring the Influence of Physician Characteristics on Placebo Response,” published in Health Psychology, the same team assessed their subjects the same way. This time one group was assigned to a provider who was warm, called patients by name, smiled, chatted, etc. Another group found themselves with a doctor who made no eye contact, was detached, and asked only a few questions. Both sets of folks got a cream that was purported to be an antihistamine to reduce redness and itchiness. Unbeknownst to both groups of subjects, it was only a placebo.

Guess what?

The impact of expectations on allergic response was enhanced when the provider acted both warmer and more competent and negated when the provider acted colder and less competent. This study suggests that placebo effects should be construed not as a nuisance variable with mysterious impact but instead as a psychological phenomenon that can be understood and harnessed to improve treatment outcomes.”

All that’s well and good. But despite (or maybe because of) my years of training and decades of patient-care and benchtop research, I can attest to one more thing:

Unless the LORD builds the house,
They labor in vain who build it;
Unless the LORD guards the city,
The watchman keeps awake in vain.
Psalm 127:1

Work hard by all means, but unless the Great Physician will it, there is no healing.

Bless the LORD, O my soul, And all that is within me, bless His holy name.
Who pardons all your iniquities, Who heals all your diseases.
Psalm 103:1, 3

The Great Physician now is near,
The sympathizing Jesus;
He speaks the drooping heart to cheer,
Oh, hear the voice of Jesus!

Sweetest note in seraph song;
Sweetest name on mortal tongue;
Sweetest carol ever sung:
Jesus, blessed Jesus!

William Hunter, 1859