Why looking shifty can be worse for your patients than you think.
We all know that the words “This won’t hurt a bit” scare the crap out of patients.
“Trust me, I’m a doctor” might be more on the money.
In a study to investigate the question, a team from the University of Miami’s psychology department took a look at how a patient’s trust in their doctor affected what was going on in their brain when they experienced a painful procedure.
The team used computer-generated facial images developed during earlier studies which they tacked onto a body in a white coat with stethoscope draped casually over the shoulder.
Both fresh faced and bald, one of these young chaps had already been established as higher trust. The other, virtually identical except for a slight frown and downturned lips, was supposed to be the untrustworthy guy. (Think a kindlier, much younger version of Peter Dutton had he plumped for med school rather than the cops then Liberal boss man.)
During the experiment, participants viewed an image series with one, but not both, of the doctors.
“Hi, I’m Doctor Peterson,” the doc said, via a speech bubble. “Let me take a moment to look over your chart”.
While this has a slight “Come up and see my etchings” vibe, so far all seems harmless enough.
But wait, there’s more.
In the next image, the doctor brandishes what looks like a riding crop but is, in fact, a medical device for inflicting a nasty stimulus.
And in the speech bubble, the words, “The heat will begin shortly.”
The Back Page has a bad feeling at this point.
Functional MRI was used to follow what was going on in the 42 participants’ brains as they made their way through the virtual interaction then got zapped with the thermode.
Both the perceived low-trust and high-trust medicos doled out the same punishment.
The victims reported feeling increased pain when receiving painful heat stimulations from the low-trust doctors, which was accompanied by increased activity in pain-related regions of the brain.
Participants who viewed the high-trust doctor also suffered a bit in the name of science but apparently not as much.
But pulling a smiley face may not be the best way to put your patients at ease before hitting them with an intramuscular jab.
“We do not suggest that altering doctor facial expressions associated with trustworthiness should be an intervention for improving real-world doctor-patient relationships,” the researchers said.
“Rather, our results suggest that even small and implicitly perceived changes in trustworthiness in the doctor-patient interaction may improve patient health.”
And if you plan to buy a clown suit to humour your terrified patient, remember you can’t bill Medicare for it.
If you do attend clinic in a clown suit, send pics to penny@medicalrepublic.com.au.
