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Empathy, Immunity, and the Common Cold

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Empathy heals, according to the Nov/Dec 2009 issue of Scientific American Mind. I checked their reference in Family Medicine. Sure enough, researchers at University of Wisconsin found that patients with cold recovered an average of one day faster (7 days instead of 8) if they rated their doctor as more caring. This improvement is comparable to the results that the Tamiflu web site reports in treating the flu, and came from just one visit.

The results of Reference 1 are part of a larger study, called the PEP trial, which stands for Physician, Empathy, and Placebo. Six clinicians (five family physicians and one nurse practitioner) and 350 patients participated in this part of the study. The measure of empathy was a questionnaire called CARE (Consultation And Relational Empathy), about how well the clinician paid attention to the patient and communicated helpfully. Eighty-four patients reported perfect CARE scores. These patients were sick for an average of 7.10 days, compared to the remaining patients, who were sick for an average of 8.01 days.

Immune function was measured by analyzing IL-8, a cytokine, from nasal samples. An increase in IL-8 indicates the immune system is fighting the infection. The group with perfect CARE scores had IL-8 increases twice as high as those with imperfect scores. Thus it appears that empathy boosts immune function. However, there was a wide variation in IL-8 increases in both groups, so the difference is not statistically significant in this relatively small study. Larger studies, with more interaction between patients and clinicians, may provide better quantitative data.

Each clinician in the study had a similar proportion of perfect and imperfect CARE scores, so the authors suggest that none had a natural advantage in demonstrating empathy. For the imperfect scores, there was no correlation between worse score and longer duration of the cold. The authors suggest that empathy is an on or off phenomenon; either we feel connected to the other person, or we don't.

As part of the larger study, clinicians were trained by an acting coach to provide either a standard visit or an enhanced visit. The enhanced visit includes elements of clinician/patient interaction described by the acronym PEECE: Positive prognosis, Empathy, Empowerment, Connection, and Education. The results of this part of the study are not yet available. I look forward to finding out whether our health care providers can be trained to be more caring and effective.


Rakel DP et al, “Practitioner Empathy and the Duration of the Common Cold”, Family Medicine 2009 July-Aug; 41(7):494-501.

“Empathy Heals”, Harvey Black, Scientific American Mind, November/December 2009, p. 10.

Linda Fugate is a scientist and writer in Austin, Texas. She has a Ph.D. in Physics and an M.S. in Macromolecular Science and Engineering. Her background includes academic and industrial research in materials science. She currently writes song lyrics and health articles.

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