During her talk, as well as in an interview with AMA Wire® and articles published in BMJ, JAMA and Health Psychology, Crum expanded on how perceived competence by patients and physicians’ warmth and positive messaging, working in concert with each other, produce optimal outcomes.
Crum referred specifically to her longitudinal study of 164 subjects who participated in an experiment in which an allergic reaction was induced by a histamine skin-prick test. All participants developed a wheal, but the size of the red bump was considerably smaller in those who believed their physician was highly competent and compassionate and who received assurances from the physician that the cream given to them to lessen the wheal—which had no medicinal properties—would mitigate the problem.
At the other end of the spectrum—patients with the largest wheals—were those who received the same treatment from physicians they deemed competent but who offered little in the way of warmth and hopeful messages about positive outcomes.
“This study suggests that, if physicians have a reason to hold positive expectations about a particular treatment … [they] may amplify the power of positive expectations by demonstrating warmth (likeability) and competence (credibility) in their interactions with their patients,” she and her Stanford colleagues wrote in a March 2017 Health Psychology article.
Crum said that physicians’ tone of voice, gestures, eye contact and small talk could make an appreciable difference in patients’ recovery times.
But while headaches, colds, rashes and low-grade fevers are conditions from which almost all of your patients are guaranteed to recover, what of patients with graver conditions, such as coronary artery disease, emphysema and cancer? Competence and compassion should be offered to all patients, but how do you convey messages of hope to patients with chronic or life-limiting illnesses? And will doing so make a difference in their lives?
“Compared to the amount of time we spend on developing new drugs and treatment, we have spent next to no time answering those questions,” Crum told the AMA Wire®. “We are still in the infancy of understanding” the roles that patients’ mindsets play as they cope with major conditions.
Such studies are in the offing, Crum said.