By Suzanne Rostler

NEW YORK, Mar 09 (Reuters Health) - In an era of brief doctor visits and high-tech medicine, it may be the development of warmth and empathy between doctors and their patients that makes the difference in care, study findings suggest.

The study, published in the March 10th issue of The Lancet, found that doctors who showed empathy and acknowledged their patients' fears and anxieties were more effective than doctors who kept patients at an emotional arm's length.

"A sense of partnership and trust should be nurtured and thought of as part of the healthcare package," said the study's lead author Dr. Zelda Di Blasi, of the University of York, UK. "Unfortunately, the current system discourages continuity of care and does not allow enough time for a healing interaction."

Di Blasi and colleagues grouped 25 medical, psychological and sociological studies of care delivery by the doctor's style of interaction with patients. In "cognitive" care, the doctor tried to influence or convince a patient about an illness or treatment, while in "emotional" care, the consultation was deemed warm and empathic and the doctor tried to relieve patients' anxiety and fears.

Although none of the studies looked exclusively at emotional care, four evaluated both cognitive and emotional care. Three of these studies showed that support and reassurance enhanced health outcomes as measured by blood pressure readings and patient reports of pain. Of the 19 studies that investigated cognitive care, only half demonstrated significant effectiveness.

"In a healthcare consultation, doctors can offer social support to patients, give them a safe space to open up and discuss their problems and reassure them with a diagnosis or a treatment, thereby relaxing them and lowering their anxiety," Di Blasi said. "All of these ingredients have been linked with immune function."

The study should be a wake-up call to doctors, writes Dr. Chris van Weel from University Medical Centre St. Radboud in Nijmegen, the Netherlands. While acknowledging that the overall effects on patients' health were fairly small, "the effects of the relationship on the course of illness indicates that the context of care influences patients' well-being," van Weel writes in an accompanying editorial.