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Dave Rakel (L) and Bruce Barrett.

The perception of physician empathy helps patients fight colds faster, according to the final results of a study led by physicians Dave Rakel and Bruce Barrett.

Final Study: Physician Empathy Helps Patients Overcome Colds Faster

A final study led by Department of Family Medicine (DFM) Associate Professors David Rakel, MD, and Bruce Barrett, MD, PhD, has shown that physician empathy really does help patients fight the common cold.

In fact, a therapeutic encounter based on empathy, compassion, and a willingness to listen not only helps patients feel better faster, it can also translate to actual changes in their immune response.

Promoting ‘PEECE’

The randomized controlled trial was published electronically in February 2011 in Patient Education and Counseling (Perception of Empathy in the Therapeutic Encounter: Effects on the Common Cold), and will be available in print later this year. It builds on earlier similar findings published last year in Family Medicine (Practitioner Empathy and the Duration of the Common Cold).

The final sample group comprised 719 patients who had just begun to come down with a cold. Participants had either 1) no interaction with a practitioner; 2) a “standard” interaction that focused on history and examination, but offered little touch or eye contact; or 3) an “enhanced interaction” in which clinicians promoted “PEECE”: positive prognosis, empathy, empowerment, connection, and education.

Patients in the “standard” or “enhanced” interaction groups rated the degree of empathy during the therapeutic encounter. They also assessed the severity of their colds twice a day. Study staff measured two immunological markers from nasal mucosa, interleukin-8 (IL-8) and neutrophil count, at the beginning of the study and 48 hours later.

Shorter Colds, Improved Immune Function

As in previous studies, physician empathy clearly correlated with shorter, less severe colds—and improved immune function.

The 112 patients who rated their therapeutic encounter “perfect” in empathy recovered from their colds more than a day faster (5.89 days vs 7 days) than those who rated the encounter “sub-perfect.” These patients also reported that their cold symptoms were 17.4 percent less severe (223 vs. 271, as rated on the Wisconsin Upper Respiratory Symptom Survey [WURSS-21]).

In addition, perfect scores were associated with a substantially higher change in IL-8 (1586 for “perfect” encounters vs 72 for “subperfect”) and neutrophil count (49 vs 12), as measured 48 hours after the onset of cold symptoms.

Process Versus Pill

Dr. Rakel explained that the results above are based on the full patient sample after unblinding. “Compared to earlier findings, this showseven more powerfully how patients’ perception of empathy can support their immune function's ability to recover from the common cold more quickly and with fewer symptoms,” he said.

And if the way patients are treated helps them recover more quickly, it can translate into lower health care costs and improved health care delivery.

“This study gives us a lot of hope that relationship-centered care really matters,” he added. “There is power in the process before the pill even takes effect.”