MIAMI — Painful medical procedures are less agonizing if you trust your doctor, according to a new study. Scientists say the brain responds to pain in different ways depending on whether a physician is seen as trustworthy or not.
Researchers at the University of Miami report that patients had more activity in parts of the brain that cause pain when they were being seen to by a less trustworthy doctor. In such scenarios, pain was more intense and unpleasant.
Study authors say the neurologic pain signature pattern, which measures responses to pain, was stronger when patients were given painful treatments by a practitioner they were unsure about. Moreover, the more mistrust in medical organizations someone was found to have, the more brain activity they were found to have in brain regions involved in pain, attention and emotion when experiencing and evaluating pain.
For the study, participants took part in simulated painful medical procedures with different virtual doctors who appeared more or less trustworthy. The virtual doctors were dressed in white coats, but had faces designed to elicit various feelings of comfort in patients. Their brain activity during the simulations was measured through functional MRI scans.
Researchers compared their responses to the painful procedure — a real painful heat simulation on their arms — and participants’ ratings of how much pain they were in when treated by more and less trusted doctors.
The research was inspired by earlier studies showing patients’ trust in their doctor can influence health outcomes, including responses to pain. The same team discovered previously that patients placed more trust in doctors they felt “culturally similar” to. For the new study, they wanted to understand how the brain processed these different responses to pain.
“Although we had previously found that how much you trust your doctor can influence your experience of pain, there was surprisingly little known about the brain basis for this effect,” lead study author Dr. Steven Anderson explains in a statement. “The takeaway from this study is not necessarily that we need to train doctors to make different facial expressions. Rather, our results demonstrate that even small changes to the doctor-patient relationship may be enough to decrease patients’ pain. Even non-verbal aspects of the doctor-patient relationship make a difference in the patient’s pain, which can inform interventions aimed at reducing patient pain and pain disparities.”
The team say their research has far-reaching implications for understanding health disparities. Many studies have shown people from marginalized groups, such as people of color, lower income individuals and women, often trust the health care system less in general and doctors in particular.
The findings are published in the journal Cerebral Cortex.
Report by Gwyn Wright, South West News Service