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January 20, 2010

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Scientists: docs don’t feel your pain much—and maybe that’s best

Jan. 20, 2010
Special to World Science  

If you’ve ev­er felt like you’ve had a doc­tor who just did­n’t care, your feel­ing might have some ba­sis.

Doc­tors tend to sup­press the urge to em­pa­thize with oth­er peo­ple’s suf­fer­ing, re­search­ers have found in a brain study. But they claim this may be a good thing, as it could help the physi­cians fo­cus on ac­tu­ally help­ing.

“With­out emo­tion regula­t­ion skills, re­peat­ed ex­po­sure to the suf­fer­ing of oth­ers in health­care pro­fes­sion­als may be as­so­ci­at­ed with… per­son­al dis­tress, burn­out and com­pas­sion fa­tigue,” wrote Jean De­cety of the Univers­ity and Chi­ca­go and col­leagues, au­thors of the study pub­lished in the Jan. 14 on­line is­sue of the jour­nal Neu­roim­age.

Past re­search has found that watch­ing or im­ag­in­ing oth­er peo­ple in pain ac­ti­vates the brain’s own pain cen­ters, the group noted. Doc­tors’ di­al­ing down their own pain re­sponse may thus free up “cog­ni­tive re­sources nec­es­sary for be­ing of as­sis­tance.”

De­cety and col­leagues meas­ured elec­tri­cal ac­ti­vity in the brain from physi­cians, and from a matched group of non-physi­cians, as they watched im­ages of body parts pricked by ei­ther a nee­dle, or a Q-tip. The goal was to meas­ure wheth­er the brain would dis­tin­guish these “pain” and “no-pain” situa­t­ions.

Non-physi­cians showed di­verg­ing brain re­sponses to the two types of stim­u­li, the re­search­ers found. The dif­fer­ent re­sponses oc­curred early in the brain pro­cess­ing, and showed up in brain ar­eas known as front­al and centro-parietal re­gions, roughly the front and top of the scalp.

No such re­sponses were de­tected in the physi­cians, ac­cord­ing to the re­search­ers, who stud­ied elec­tri­cal ac­ti­vity by means of elec­tro­en­ceph­a­lo­gra­phy, or elec­trodes placed on the scalp. “Our re­sults in­di­cate that emo­tion regula­t­ion in physi­cians has very early ef­fects, in­hibit­ing the bottom-up pro­cess­ing of the per­cep­tion of pain in oth­ers,” De­cety and col­leagues wrote.

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If you’ve ever felt like you’ve had a doctor who just didn’t care, your feeling might have some basis. Doctors tend to suppress the urge to empathize with other people’s suffering, researchers have found. But they claim this may be a good thing, as it could help the physicians focus on actually helping. “Without emotion regulation skills, repeated exposure to the suffering of others in healthcare professionals may be associated with… personal distress, burnout and compassion fatigue,” wrote Jean Decety of the University and Chicago and colleagues, authors of the study published in the Jan. 14 online issue of the journal Neuroimage. Past research has found that watching or imagining other people in pain activates the brain’s own pain centers, the group added. Doctors’ dialing down their own pain response may free up “cognitive resources necessary for being of assistance,” they wrote. Decety and colleagues measured electrical activity in various parts of the brain from physicians and a matched group of non-physicians as they watched images of body parts pricked by either a needle, or a Q-tip. The goal was to measure whether the brain would distinguish these “pain” and “no-pain” situations. Non-physicians showed diverging brain responses to the two types of stimuli, the researchers found. The different responses occurred early in the brain processing, and showed up in brain areas known as frontal and centro-parietal regions, roughly the front and top of the scalp. No such responses were detected in the physicians, according to the researchers, who studied electrical activity by means of electroencephalography, or electrodes placed on the scalp. “Our results indicate that emotion regulation in physicians has very early effects, inhibiting the bottom-up processing of the perception of pain in others,” Decety and colleagues wrote.