As a physician, I was profoundly trained to recognize the immense clinical significance of human touch, understanding its crucial role in preserving both physical and mental health. As a fellow human being, I find myself increasingly concerned about the potential loss of this vital connection. Furthermore, as a dermatologist, my insights allow me to grasp the serious implications this loss holds, especially for the loneliest and most vulnerable individuals in our society.
Scientific studies prove that human touch — whether it manifests as a brief hug, cradling a newborn, or enjoying a professional massage — fundamentally contributes to our mental and physical well-being. Alarmingly, infants who lack essential touch can face life-threatening consequences, and even adults benefit from tactile experiences that stimulate our brains to release oxytocin, dopamine, and serotonin, while concurrently decreasing negativity from stress hormones like cortisol and norepinephrine. Touch builds our immune systems, fortifies our bodies against infections, and can even enhance regulation of digestion and sleep patterns. Remarkably, even petting a dog or cat can lead to a slower heart rate and lower blood pressure, reinforcing the significant impact of touch on our health.
For my psoriasis patients, the value of empathic touch during medical examinations encompasses these benefits and extends further. Psoriasis, a chronic skin condition characterized by raised, red patches, evokes misunderstanding and stigma, despite being non-contagious. Although awareness of psoriasis has improved over time and it afflicts between 2-3% of the population, individuals with this condition have historically faced isolation and societal judgment. For these patients, a simple act of touch becomes a powerful affirmation of their humanity and worth in a world that often discriminates based on appearances.
Before the pandemic transformed our world, the healing touch was naturally woven into my interactions with patients. However, the COVID-19 crisis ushered in a seismic shift. With social distancing protocols, protective gear necessities, and a heightened dread of contagion, physical touch regrettably became a rare occurrence in examination rooms. Now that we are emerging from the shadows of the crisis, the pressing challenge lies in finding the right balance between ensuring safety and reintroducing the healing power of touch into medical care. Recent changes — both advantageous and detrimental — have effectively diminished the consistent touch that I once took for granted. The rise of technology has enabled millions of us to work remotely, often in isolation. The pandemic also disrupted long-standing practices of handshake greetings, hugs, and other gestures of warmth, particularly within the medical community.
While increasing awareness of the prevalence of unwanted touch marks an essential step in safeguarding individuals’ boundaries, it has undoubtedly complicated the dynamics between doctors and their patients. Many physicians, who previously engaged with touch — always with prior consent — as a means of connecting with their patients, have since retreated from physical contact due to fears of misinterpretation.
What’s more, the rise of technology in medicine has further diminished the practice of empathic touch in clinical settings. Virtual consultations, while bringing healthcare to the doorstep of millions who may otherwise have been deprived of it, lack the personal connection fostered through physical examinations. In this evolving landscape, it becomes imperative for physicians to navigate the delicate terrain of physical contact, becoming comfortable once more with the nuances of touch while simultaneously discerning each patient’s comfort level. It is paramount that we seek permission, valuing and respecting individual patient boundaries, as well as their unique needs for both healing and connection.
As I engage with my dermatology patients, I remain acutely aware that due to their skin conditions, many harbor varied experiences and emotions regarding touch — particularly its absence. My mission is to exemplify that their skin disease does not spread and is certainly nothing to be feared. In consultations, I may choose to hold their hand, gently raise an arm, or assist them in turning their body for a clearer view, thus conveying a message of acceptance.
“I am not afraid of you. Your skin isn’t scary. I care about you.”
All of this is communicated without the need for words, sending a compelling message of care and understanding. Of course, there are individuals who prefer to avoid touch — those who don’t identify as “huggers.” Yet for many, the warmth of touch provides comfort and establishes a connection that is just as essential to our health as consulting a physician. Numerous patients and doctors alike have expressed feelings of sorrow over the absence of healing touch in their interactions. One patient articulated her experience of feeling unseen after a visit where her primary care physician refrained from any physical contact, conveying the impression that she had been merely “processed,” rather than genuinely treated.
Perhaps this is the crux of the issue: As physicians, our roles extend beyond merely processing patients. As internist and Massachusetts Medical Society President Dr. Barbara S. Spivak articulates, “For us to help them heal, we need to understand who they are, what is important to them, and what in their lives is impacting their health.”
We are designated caregivers for a fundamental reason, and one of the most poignant ways humans exhibit care is through that necessity of healing touch: “Whether it be examining them or providing gentle contact on their knee or shoulder while they articulate their pain — whether physical or emotional — this action significantly enhances that feeling of acceptance, understanding, and compassion that is so essential,” Spivak asserts.
And so, it is vital that doctors do not lose sight of the integral value tied to healing touch. Engaging with a patient involves more than just visual observations; for many, it necessitates the act of reaching out a hand in connection.
Alexa B. Kimball, M.D., M.P.H., is CEO of Harvard Medical Faculty Physicians at Beth Israel Deaconess Medical Center in Boston.
In the context of recent changes due to the COVID-19 pandemic, what strategies does Dr. Jane Smith employ to safely reintroduce touch in her dermatology practice?
**Interview with Dr. Jane Smith, Dermatologist on the Importance of Touch in Patient Care**
**Interviewer:** Dr. Smith, thank you for joining us today. Your insights on the significance of human touch in medical interactions are truly enlightening. Can you explain how touch contributes to both physical and mental health?
**Dr. Smith:** Thank you for having me. Touch is an incredibly powerful aspect of human interaction. Scientific studies have shown that touch can release hormones like oxytocin, dopamine, and serotonin, which play critical roles in promoting feelings of happiness and reducing stress. For instance, petting a pet can lower blood pressure and heart rate, which highlights how even simple interactions can enhance our well-being.
**Interviewer:** That’s fascinating. You mentioned that touch is especially meaningful for your psoriasis patients. How do you approach touch in these sensitive situations?
**Dr. Smith:** Absolutely. Psoriasis often carries stigma and misunderstanding, which can leave patients feeling isolated. When I incorporate touch into my examinations—like gently holding a hand or assisting them to show a specific skin area—it affirms their humanity and worth. It communicates that I see them as more than just a skin condition; I see them as whole individuals deserving of care and respect.
**Interviewer:** With the COVID-19 pandemic drastically changing protocols around physical interaction, how has this affected your practice?
**Dr. Smith:** The pandemic indeed transformed how we engage with patients. Social distancing and fears of contagion made touch almost nonexistent in examination settings. Now, as we emerge from these restrictions, the challenge is to find a balance between ensuring patient safety and reintroducing that healing power of touch.
**Interviewer:** Given the increased awareness around unwanted touch, how do you navigate consent and boundaries in your practice?
**Dr. Smith:** It’s essential to prioritize each patient’s comfort. I’ve always engaged in touch with prior consent, but now it’s about more than that. I actively communicate with my patients: asking for permission, explaining the reasons behind the touch, and being attentive to their reactions. It’s vital to respect their unique experiences and emotional responses regarding touch.
**Interviewer:** You seem passionate about advocating for your patients’ needs. What message do you hope to convey through your approach?
**Dr. Smith:** Ultimately, I want my patients to feel safe and understood. I strive to communicate, “I am not afraid of you. Your skin isn’t scary. I care about you.” This message, conveyed through touch and empathy, goes beyond words. It’s about reaffirming their dignity and ensuring they feel accepted despite the societal stigma around their condition.
**Interviewer:** Thank you, Dr. Smith. Your dedication to your patients and the significance you place on human touch in healthcare is truly inspiring.
**Dr. Smith:** Thank you for shedding light on this important topic. It’s crucial we continue to prioritize the human connection in medicine, especially as we navigate the new normal.
