We All Need a Dose of the Doctor; The healing relationship between patient and physician plays a vital role in medical care.(Cover Story)

(Miller is editor in chief of the Harvard Mental Health Letter (health.harvard.edu).)

You're the doctor. Your patient feels ill, but you don't have anything curative in your medicine bag. What do you do? That question has long stymied physicians. But as the Hungarian psychoanalyst Michael Balint recognized a half century ago, mystifying symptoms are not necessarily untreatable. Listen to patients' stories, Balint urged his colleagues. Treat them as friends. They may need a dose of the strongest drug of all: the doctor.

Balint's prescription is as timely today as it was in the 1950s. A founding insight of mind-body medicine is that everyone needs a dose of the doctor, even when state-of-the-art tests and treatments are available. Patients who have a good and trusting relationship with a clinician are more satisfied, studies show--and satisfied patients get better clinical results. They're more motivated to take care of themselves, more comfortable seeking help when problems arise and more willing to follow advice and take medication as prescribed. A healthy doctor-patient relationship can also give consolation when bad news comes. The relationship itself provides an emotional safety net.

Yet as science confirms the power of the healing relationship, other forces are conspiring to undermine it. Health systems can leave patients and doctors feeling stressed out and alienated from one another. Relationships take time. Fifteen minutes may be long enough for a practitioner to diagnose an infection and dash off a prescription. It's rarely enough to make sense of another person's experience, convey that understanding or act as an advocate.

The medical profession, to its credit, is struggling to ...