The researchers ran three experiments focusing on how a doctor’s beliefs, when reflected to the patient, can affect the patient’s response to painful stimuli. First, to rule out possible explanations for a placebo effect — basically, to ensure there was no personality type or experience level that could explain the results — the authors randomly assigned 194 participants the role of “doctor” or “patient.” Then, the researchers gave each doctor two creams to administer to the patients, who had been exposed to thermal pain (hot temperatures on their forearms).
The important part of the study happened in conditioning the doctors’ beliefs about the creams. While both creams were actually placebos (meaning they wouldn’t actually affect a patient’s pain), Chang and his colleagues told the doctors that one was a placebo and one was effective for reducing pain.
Patients — who knew they weren’t being treated by real doctors — consistently reported lower pain levels with creams that the doctors believed would work. Because the researchers observed that the doctor participants’ facial expressions changed according to the cream they applied, Chang thinks how much a doctor believes in the efficacy of a given treatment could make a difference in patient outcomes.
“If I as a clinician really believe and trust a treatment and think it will work really well with a patient, I’ll have a complete difference in response to pain than if I act like I’m not sure.”advertisement
Chang’s findings also suggest that bedside manner, which includes “soft skills” like empathy, communication, and friendliness, could play a significant role in patient outcomes — and he’s excited to see how it all translates to a real clinical environment.
“It’s one thing if you’re in our lab, and it’s another thing if you’re in a hospital setting,” Chang says. “In a real clinic, where your physician has had a decade of school and there’s all these other contextual factors, like fancy machines and a nice building, all these things could contribute even more to the effects we saw. We are hoping to explore that in the future.”