The placebo effect – where medication can make you feel better because you think it will, even if it doesn’t have active ingredients – has been area of fascination for decades.

Equally fascinating is the nocebo effect, the opposite of placebo, where you think that a medication or treatment will do something bad to you, and that expectation leads to the negative effect happening, even when you’ve only taken a sugar pill.

But most of the placebo/nocebo research involves giving patients a pill, cream, or other sham treatment. Can a doctor’s words alone induce similar effects in people?

In an experiment at a doctor’s office, 76 people were given a histamine skin prick, which induces irritation and itchiness. They rated how itchy their arm felt every few minutes after the prick.

In one group, three minutes after the skin prick, the doctor looked at their arm and gave them assurances that their allergic reaction would now start to decrease, and their rash would go away. In the other group, the doctor only looked at the reaction on the person’s arm, but said nothing.

What they found was that for the first three minutes, itchiness and irritation increased in a similar amount for both groups. But after the doctor’s reassurance, that group of patients immediately felt significantly less itchy, and it continued to reduce over time at a faster rate than the group who were told nothing.

After nine minutes, both of the groups felt roughly the same – the difference was that the group who were reassured saw a sudden improvement, much faster, right after they were spoken to by the doctor.

Implications

The researchers say that this demonstrates the power of a doctor’s words in a consultation, even when there’s no medication or treatment being offered. They also think that the response shown in the experiment is probably at the lower end of how effective it could be – given all of the patients were healthy and it was a low-stress situation.

What’s more, it was just a single sentence of reassurance – the effect may be even greater if consistent and repeated assurances were made by the doc.

Plus, you know the night-and-day difference between visiting a doctor who really seems to care about your condition, versus one who’s just ticking the boxes.

It makes a difference to how positive you feel at the end of the consult, and it seems it might help you get better, faster, too.

Last Reviewed: 20/02/2020

© Norman Swan Medical Communications.



References

For reference: Leibowitz, et al. (2019). Physician Assurance Reduces Patient Symptoms in US Adults: an Experimental Study. Journal of General Internal Medicine doi: 10.1007/s11606-018-4627-z.

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