Don't be a nocebo! Why healthcare organizations should value patients' expectations
Two pages on PainSci cite Poulter 2024: 1. Alternative Medicine’s Choice 2. Nocebic organizations
PainSci commentary on Poulter 2024: ?This page is one of thousands in the PainScience.com bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided wherever possible.
Can a healthcare organization be nocebic? This parper argues that organizations can make people worse, much like a careless individual professional can:
“An organization acting as a nocebo could create negative experiences along the patient’s care pathway, possibly exacerbating their symptoms and worsening their clinical condition.”
I’ve encountered many organizations that act like nocebos. 😒 Indeed, what bothers people about “mainstream medicine” has much more to do with the institutionalization of care than with medicine itself, or medical science.
Most large organizations, if they were people, would be assholes.
The lead author of this paper is David Poulter, a long-time professional acquaintance of mine, and the most tireless science educator on Twitter I know — seriously, does he sleep? — a fine example of how there are still good people there, doing good things, despite that platform’s many dysfunctions
original abstract †Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.
Although nocebo effects and expectations have been extensively investigated within experimental paradigms in the laboratory (Bagarić et al., 2022; Rooney et al., 2023) and care settings (Rooney et al., 2024), we believe there is a need to look beyond the clinician-patient interaction to embrace the complexity offered by healthcare organization at large. Accordingly, we propose that it is necessary to stimulate a debate on how different team members in a healthcare organization can inadvertently cause nocebo effects when patient expectations are either not considered or not met, along their care journey (Rossettini et al., 2020). To bridge this gap, in this opinion paper, we focus on how the organization as a collective of individuals enacting policies, practices, and processes can contribute to nocebo effects due to a disconnect in managing and meeting patients' expectations. Our main objectives are to: (1) describe potential scenarios of nocebo effects within the healthcare organization (i.e., not just individual professionals and/or the clinical interaction in isolation), and (2) suggest implications for their management.
This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights:
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