Sir William Osler, one of the founders of modern medicine, once said, “The good physician treats the disease; the great physician treats the patient who has the disease.”
This is still a vital distinction to make today, and it is an underlying principle of salutogenesis—the idea that we should focus on finding ways to create health, not just manage symptoms.
Unfortunately, most doctors are trained to focus on the latter. We order tests, run labs, and look at numbers. And to be clear, these are all critically important aspects of medical care. But when we become overly focused on numbers and charts, we forget that the ultimate goal is to create health and resilience in our living, breathing patients—patients whose lives cannot be encapsulated solely by hard data.
This is why David Rakel, MD, calls medicine “an art based in science.” At the end of the day, he argues, the relationship between the clinician and the patient is the real foundation of quality care. In fact, your relationships with your patients serve as the primary vehicle for stimulating their self-healing mechanisms. Moreover, they are often more therapeutic than the actual prescription provided.
Research shows that meaning, purpose, patient connection, and perception have measurable healing effects. In fact, they can often be more powerful than any supplement, medicine, or protocol.
Yet these powerful aspects of healing aren’t taught in medical school and are rarely part of standard medical care. Missing out on these crucial aspects of care can be detrimental to your patients—it could literally be keeping them sick.
In Beyond Pills and Protocols: The Roots of Salutogenic Science, Dr. David Rakel teaches clinicians how to practice medicine in a way that actually heals patients. You’ll learn:
- Why perception shapes physiology.
- How connection activates self-healing.
- Why meaning drives behavior change more powerfully than any protocol.
- And how to structure every patient interaction—even in time-constrained settings—to activate these healing mechanisms ethically and effectively.
This isn’t alternative medicine. It’s the science-backed, common-sense care that should have been taught in medical school but wasn’t. Click here to learn more and register today.
The “Clinician Effect”
The idea that your relationship with your patients matters is often referred to as the “clinician effect.” It states that you can have a measurable therapeutic impact on patient healing, regardless of the specific treatment or protocol prescribed. According to Dr. Rakel, relationship-minded clinicians who prescribe a placebo often outperform distant doctors who prescribe active medications.
And this is not just Dr. Rakel’s opinion; it’s a statement of fact. In this 2014 study, researchers explored whether the relationship between a doctor and a patient actually makes a physical difference in health. They found that a better doctor-patient relationship led to physical changes in patients with chronic conditions, including:
- Better blood pressure control.
- Lower blood sugar levels in diabetic patients.
- Improved weight loss in patients struggling with obesity.
- Lower pain scores for those with conditions like osteoarthritis.
The data suggests that the way you interact with a patient isn’t just a “nice to have;” it should be a functional part of the treatment itself. Fair enough—but why is this the case?
The reason the clinician effect is so powerful ultimately stems from two factors: empathy and presence.
Did you know that people with meaning and purpose in their lives are 2.5x less likely to experience premature death? When you partner with your patients to help them achieve their health goals—rather than just focusing on numbers, charts, and data—you can directly impact their ability to live happier, healthier lives.
This is just one of the pearls of wisdom you’ll receive in Beyond Pills and Protocols: The Roots of Salutogenic Science. This course is a five-hour master class distilling Dr. David Rakel’s 30 years of clinical experience into an applicable framework for shifting from symptom management to a focus on creating health.
You’ll also learn:
- How to make decisions that serve patients instead of protocols
- Why your presence is often more therapeutic than your prescription
- How belief literally becomes biology through neuropeptide cascades
- How to intentionally create healing encounters that activate meaning, purpose, and self-healing
The Importance of Empathy in Care
Showing empathy isn’t just a means of helping your patients feel good about themselves or their relationship with you. The truth is that your presence, perception, and connection can actually lead to better health outcomes.
Dr. Rakel conducted a study in 2009 that offers further evidence for this claim. The study’s “objective was to assess the relationship of empathy in medical office visits to subsequent outcomes of the common cold.” As for methodology, “a total of 350 subjects…received either a standard or enhanced physician visit as part of a randomized controlled trial. Enhanced visits emphasized empathy on the part of the physician.”
The research team used a tool called the CARE (Consultation and Relational Empathy) questionnaire to let patients rate their clinicians on a scale from 0 to 50. The higher the score, the more empathy the patient felt during their interactions with their doctors.
The result? “After accounting for possible confounding variables, cold severity and duration were significantly lower in those reporting perfect CARE scores.” Furthermore, Dr. Rakel’s team concluded that “clinician empathy, as perceived by patients with the common cold, significantly predicts subsequent duration and severity of illness and is associated with immune system changes.”
Presence: “Hearing with Your Eyes”
Another key aspect of providing relational care is presence. Especially in a future where AI handles more and more transactional tasks, Dr. Rakel argues that “authentic intelligence”—the uniquely human ability to be present and hear your patient’s unique story—will be the most important clinical tool in your toolkit.
Thankfully, there are strategies you can adopt to be “more present” in your care. One of the most important strategies is focusing on eliminating multitasking. Yes, our days are busier than ever. Yes, we have more on our plates than at any point in history. But our patients still need us to pay attention to them and their story. They need us to truly connect with them. That requires setting aside all other tasks and priorities, pausing, and sitting with them—even if it’s just for a few minutes.
This is what Dr. Rakel calls the skill of “hearing with your eyes”: the act of giving a patient’s story your full, undistracted attention. While it may seem like a big ask, this is the level of presence required to create a space and an environment that are conducive to healing. And as we have seen, the data indicates that clinicians who are skilled at developing a rapport and connection with their patients achieve significantly better outcomes in treating health conditions.
Beyond Pills and Protocols: The Roots of Salutogenic Science by David Rakel, MD
Presence and empathy are the most important tools in your clinical-care toolbox. Understanding your patient’s health data is, of course, a critical aspect of care—you’ll never find the root cause of disease without it. But it is just as important to form a personal connection with your patients based on your shared humanity. When you can strike the right balance between hard data and soft skills, you can truly create health in your patients, rather than just treating disease.
David Rakel, MD, has spent three decades living and researching this truth. In his newest Kharrazian Institute master class, Beyond Pills and Protocols: The Roots of Salutogenic Science, he dives deep into the second half of this equation: how to provide salutogenic (health-focused) medical care to your patients. He’ll cover topics such as:
- How belief becomes biology
- The ECHO model of decision making
- Low-cost, high-evidence interventions
- And more.
Dr. Rakel is Professor and Chair of Family Medicine and Community Health at the University of Wisconsin, where he founded the Integrative Health Program. He received the Leonard Tow Humanism in Medicine Award and led the VA’s “Whole Health” implementation across more than 50 clinical systems.
You can find out more about his master class and register here.
Frequently Asked Questions
What is the “clinician effect?”
The clinician effect is the idea that your relationship with a patient can cause measurable physical changes in their body, regardless of the treatment you prescribe. Research shows that when patients feel a strong connection with their practitioner, they often see real improvements in blood pressure, blood sugar levels, and even immune system markers.
I’m already short on time. How can I be “present” without falling behind on my schedule?
Being present doesn’t necessarily mean spending more time with a patient; it’s about the quality of the time you do have. By avoiding multitasking and giving the patient your full attention for even just a few minutes, you can build the rapport necessary to jump-start their self-healing mechanisms.
Is empathy a necessity in clinical care?
Yes. Studies have shown that when patients rate their doctors as highly empathetic, their illnesses are actually shorter and less severe.
How can I begin to shift my practice from symptom management to a focus on healing?
In the Beyond Pills and Protocols: The Roots of Salutogenic Science, Dr. David Rakel provides a step-by-step framework to help you move beyond just “running labs” to creating a salutogenic (health-creating) practice.
