Health Care

How your doctor might accidentally make your symptoms worse

Ever try to explain to your doctors exactly what that weird symptom you are experiencing feels like, and sense they aren’t quite catching your drift? Those little misunderstandings might have some unintended side effects, according to a new study published in the American Journal of Medicine.

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Researchers from the University of Southampton and University of Exeter Medical School monitored five women’s doctor-patient consultations at a pain-management clinic. Each was there to discuss her chronic, widespread pain. The healthcare providers often used, what they deemed comforting, phrases like, “There’s no physiological reason that you’re experiencing pain.”

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However, these reassurances were not taken so kindly; during the follow-up interviews, patients thought their docs were actually dismissing their symptoms, or patronizing them. On the flip side, docs reported pushback from patients, who didn’t seem to believe their diagnosis. Basically, everyone felt upset in the end, and this negative feedback could be extremely problematic. “Our work indicates that the effects of patients feeling that their doctor doesn’t believe or understand them can be damaging both emotionally and physiologically. This could lead to worsening of illness,” says lead study author Maddy Greville-Harris, a psychology professor at the University of Southampton, in a press release.

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The worsening of symptoms caused by negative feedback is something researchers call the “nocebo response.” Whereas the placebo effect is a kind of positive reinforcement, where people think their conditions will improve with treatment—even if they haven’t actually been given said treatment—the “nocebo” does the opposite. It’s a perception that they are not being believed, leading to anger and worsening symptoms. Although the current study is small, the scientists say the results of negative-feedback need to be examined closer.

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