Doctors who intentionally or unintentionally communicate to patients that they do not believe or understand them could be causing patients’ symptoms to worsen, suggests an article in the American Journal of Medicine.
The researchers from the universities of Exeter and Southampton “recorded and analysed consultations at a pain management clinic involving five women with chronic wide-spread pain,” stated a press release about the study. “During subsequent interviews patients reported feeling dismissed and disbelieved by healthcare providers, encountering providers who did not invest in them or show insight into their condition… Patients described feeling hopeless and angry after invalidating consultations, feeling an increased need to justify their condition or to avoid particular doctors or treatment altogether.”
These findings built on a connected study by the researchers showing that people who feel “disbelieved” can develop “increased anger and stress,” and that this negative effect on their overall well-being “was much more powerful than positive reinforcement, the well-known “placebo” effect,” stated the press release.
One of the researchers commented that problems often even emerge unintentionally in physicians’ misunderstanding of the relationships between physical and psychological problems: “This study is really about humanity in healthcare. We have found that patients perceive a lack of empathy and understanding, even when the doctor is trying to be comforting. Comments such as ‘there’s no physiological reason that you’re experiencing pain’ seek to reassure, but can be perceived as patronising or disbelieving.””
Negative patient-doctor communication could worsen symptoms (University of Exeter press release on ScienceDaily, January 28, 2015)
Greville-Harris, Maddy, and Paul Dieppe. “Bad Is More Powerful than Good: The Nocebo Response in Medical Consultations.” The American Journal of Medicine 128, no. 2 (February 1, 2015): 126–29. doi:10.1016/j.amjmed.2014.08.031. (Abstract)
