Practitioner empathy and patient enablement at a "contact" consultation were retrospectively associated with changes in main complaint and well-being, in a cross-sectional study of out-patients attending the Glasgow Homoeopathic Hospital. Patient expectation, relational continuity, and duration of attendance at the hospital were also correlated with perceived change in health outcome in univariate analysis. However, multi-regression analysis suggested three major independent variables associated with health outcome -- empathy, enablement, and duration of attendance. Health outcomes were then measured in the same cohort 12 months after "contact" consultation. Both univariate and multivariate analysis indicated that the only significant predictive factor in health change over the 12-month period was patient enablement score at contact consultation. This study demonstrates the importance of prospective studies in assessing potentially causal relationships between consultation quality and health outcomes and suggests a key role for patient enablement.