The Nocebo Effect

[Lady4]

I have to admit I had to google this again when it came up in my reading book but I am sharing because I think it was a very interesting article:

physio-pedia.com/Nocebo_Effect

The last time I received a letter from a Consultant I saw red and posted a few extracts, however what I should of done is written to the Consultant and told him how it made me feel, not to make him feel bad but worded in a way that might encourage him to re-read his letter and think how that may have come across to the patient/carer.

I think a lot of work is needed in this area to prevent Iatrogenic harm but sadly resources play a huge part (staffing/funding).

[210272]

Great article and I agree with their comments about communication style since what clinicians say to us can certainly have a negative or positive impact on our psyches at some level, especially at the point of diagnosis. We live and learn but don't always have enough spoons to contact consultants to ask them to read their letters from the patient perspective. Role plays on communication skills (involving patients, not actors) could help them avoid the iatrogenic harm from what they say to us. Yes, we know they are under resourced (and under pressure to publish, in some cases) but small tweaks in how they communicate with us can make a huge difference, as can following GMC guidelines when writing clinic letters.

[Shimmyaway]

I do know the NHS does employ actors to play the role of patients when DRs in training are observed/assessed on their interactions with patients, and how they make the patient feel is one of the criteria...of course the older Drs have never gone through this sort of assessment. I don't know about training for clinical letters, .. I was referred to in one letter to my GP as 'the woman with the functional neurological disorder' .. work in progress (probably not in progress is more like it )for that OT!

[Lady4 in reply to Shimmyaway]

Maybe they should be routinely re-trained. Sometimes, unless someone points it out, they may not realise they have picked up bad habits.