Physicians must be careful about how they convey information to patients and understand their own powers of suggestion, says Arthur J. Barsky, M.D., of the department of psychiatry at Brigham and Women’s Hospital in Boston.
What doctors tell patients can make a difference when it comes to factors such as their symptoms, the adverse effects of drugs and the pain they experience after a procedure, Barsky writes in JAMA.
“Several common clinical scenarios exemplify the iatrogenic potential of the physician’s words—for example, instituting a new medication regimen, reviewing an informed consent document, presenting ambiguous laboratory test information and preparing patients for painful procedures,” he writes.
For example, one randomized study found that women receiving an epidural for childbirth reported significantly more pain when told the injection of a local anesthetic would “feel like a bee sting” than those told simply that it would numb the area.
Likewise, when patients learn that a drug can cause fatigue and dizziness, the knowledge increases the frequency with which those symptoms are experienced and reported, he says. It’s a balancing act between obtaining informed consent and providing patients with complete information and recognizing the potential of some information to cause illness, he concludes.