Bedside Manner Really Does Matter
A meta-analysis of studies that investigated measures designed to improve health professionals' interactions with patients confirms that such efforts can produce health effects just as beneficial as taking a daily aspirin to prevent heart attack. In contrast to previous reviews, the current report from the Empathy and Relational Science Program at Massachusetts General Hospital (MGH) only included randomized, controlled trials with more reliable results than those included in earlier studies. While it has long been believed that a good patient-clinician relationship can improve health outcomes, objective evidence to support that belief has been hard to come by. The MGH report was published in April 2014 in the open-access journal PLoS ONE.
A release from MGH quotes senior author Helen Riess, MD, director of the Empathy and Relational Science Program in the MGH Department of Psychiatry, as saying. "Although the effect we found was small, this is the first analysis of the combined results of previous studies to show that relationship factors really do make a difference in patients' health outcomes."
Most studies focusing on the clinician-patient relationship have been observational studies – recording aspects of clinical encounters and any potential associations with health outcomes – which cannot prove whether observed differences actually cause any outcome changes. Some studies examined how well patients understood advice they were given or how satisfied they were with their care but did not look at whether or not there were any health improvements.
To get around these limitations, the research team restricted their analysis to studies meeting a high standard of evidence. The only studies that were included were randomized, controlled trials – considered the gold standard of rigorous scientific research – addressing the patient-caregiver relationship in the context of treatment for specific medical conditions. The studies had to have either objective health-related outcomes – measurable factors such as blood pressure reduction or weight loss – or subjective outcomes that had been validated in previous studies, such as patients' reported pain scores. Only studies published in peer-reviewed journals involving interventions directed at caregivers were included.