Level of trust in a doctor may correlate to patients’ level of pain during procedures

Results from a recent study suggested that patients’ pain-related brain activity was higher during procedures when they had less trust in their doctor.

The study, published in Cerebral Cortex, was led by Steven Anderson, PhD, a recent graduate from University of Miami Department of Psychology, and Elizabeth Losin, PhD, assistant professor of psychology at University of Miami. For their study, Anderson and Losin aimed to understand whether there was an association with a patient’s level of pain and the trust they have in their doctor.

The investigation involved participants undergoing a series of simulated painful medical procedures, which involved heat stimulations on their arms, performed by a variation of virtual doctors. Using a computer algorithm, the virtual doctor’s faces were made to appear more or less trustworthy. Researchers used  functional magnetic resonance imaging (fMRI) to measure the participants’ brain activity during the time of the virtual procedure. In addition, patients were asked to self-report their pain levels after the procedures.

The study’s results showed that patients reported increased pain when they perceived their doctor as untrustworthy. In addition, the fMRI results suggested that patients had increased levels of pain-related brain activity when they underwent a simulated procedure with a low-trust doctor compared to a high-trust doctor.

To understand the real-world factors effecting participants’ trust in doctors and level of pain during procedures, researchers compared how much trust the participants had in medical organizations as a whole, with their fMRI results during the simulated medical interaction. Researchers found that those with less trust in medical organizations had more pain-related brain activity during the simulated procedures than those who had more trust in medical institutions.

These results suggest that there is an association between how a patient perceives their doctor, and how much pain the experience during medical interactions.

“The takeaway from this study is not necessarily that we need to train doctors to make different facial expressions,” said Anderson in a statement. “Rather, our results demonstrate that even small changes to the doctor-patient relationship may be enough to decrease patients’ pain.”