Placebo and the New Physiology of the Doctor-Patient Relationship
Open accessAbstract
Modern medicine has progressed in parallel with the advancement of biochemistry, anatomy, and physiology. By using the tools of modern medicine, the physician today can treat and prevent a number of diseases through pharmacology, genetics, and physical interventions. Besides this materia medica, the patient's mind, cognitions, and emotions play a central part as well in any therapeutic outcome, as investigated by disciplines such as psychoneuroendocrinoimmunology. This review describes recent findings that give scientific evidence to the old tenet that patients must be both cured and cared for. In fact, we are today in a good position to investigate complex psychological factors, like placebo effects and the doctor-patient relationship, by using a physiological and neuroscientific approach. These intricate psychological factors can be approached through biochemistry, anatomy, and physiology, thus eliminating the old dichotomy between biology and psychology. This is both a biomedical and a philosophical enterprise that is changing the way we approach and interpret medicine and human biology. In the first case, curing the disease only is not sufficient, and care of the patient is of tantamount importance. In the second case, the philosophical debate about the mind-body interaction can find some important answers in the study of placebo effects. Therefore, maybe paradoxically, the placebo effect and the doctor-patient relationship can be approached by using the same biochemical, cellular and physiological tools of the materia medica, which represents an epochal transition from general concepts such as suggestibility and power of mind to a true physiology of the doctor-patient interaction.
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Research into placebo effects suggests that the provision of care in and of itself has the potential to reduce patient distress by offering attention, support, hope (positive treatment expectations) and reassurance.
“Research into placebo effects suggests that the provision of care in and of itself has the potential to reduce patient distress by offering attention, support, hope (positive treatment expectations) and reassurance.21”
From Impact of healthcare interventions on distress following acute musculoskeletal/orthopaedic injury: A scoping review of systematic reviews (2024) · cites this paper as [21]
Benedetti highlights that the therapeutic impact of healthcare providers is not merely a function of the treatment administered but also of the psychological and emotional support conveyed through their presence and communication.
“Benedetti highlights that the therapeutic impact of healthcare providers is not merely a function of the treatment administered but also of the psychological and emotional support conveyed through their presence and communication.”
From Impact of healthcare interventions on distress following acute musculoskeletal/orthopaedic injury: A scoping review of systematic reviews (2024) · cites this paper as [21]
This contact can activate specific neurobiological pathways associated with stress reduction and improved patient outcomes.
“This contact can activate specific neurobiological pathways associated with stress reduction and improved patient outcomes.”
From Impact of healthcare interventions on distress following acute musculoskeletal/orthopaedic injury: A scoping review of systematic reviews (2024) · cites this paper as [21]
According to Benedetti's work, interactions between healthcare provider and patient are pivotal in fostering reassurance and setting positive expectations.
“According to Benedetti’s work on the placebo effect and the physiology of the doctor–patient relationship, such interactions are pivotal in fostering reassurance and setting positive expectations.21”
From Impact of healthcare interventions on distress following acute musculoskeletal/orthopaedic injury: A scoping review of systematic reviews (2024) · cites this paper as [21]
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Processing of emotion in functional neurological disorder
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Nocebo hyperalgesia: contributions of social observation and body-related cognitive styles
Vögtle, E., Kröner-Herwig, B., & Barke, A. (2016) · Journal of Pain Research · doi:10.2147/jpr.s96228 · Cited by 40 · see citing works
The effects of placebos and nocebos on physical performance
Carlino, E., Piedimonte, A., & Frisaldi, E. (2014) · Handbook of experimental pharmacology · doi:10.1007/978-3-662-44519-8_9 · Cited by 28 · see citing works
Understanding the non‐pharmacological correlates of self‐reported efficacy of antidepressants
Read, J., Gibson, K., Cartwright, C., Shiels, C., Dowrick, C., & Gabbay, M. (2015) · Acta Psychiatrica Scandinavica · doi:10.1111/acps.12390 · Cited by 20 · see citing works
Darragh, M., Yow, B., Kieser, A., Booth, R. J., Kydd, R. R., & Consedine, N. S. (2016) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/0004867415621390 · Cited by 21 · see citing works
Sim, A., McNeilage, A. G., Gholamrezaei, A., Rebbeck, T., & Ashton-James, C. (2024) · BMJ Open · doi:10.1136/bmjopen-2024-085778 · Cited by 8 · see citing works
“The methodological strategy, including the publication of an a priori protocol and the use of two researchers to screen the reviews independently, enhances the rigour of this scoping review.”
Method
- Authors
- Benedetti, F.
- Affiliations
- University of Turin (IT)
- Corresponding author
- Benedetti, Fabrizio
- ORCID
- Benedetti, Fabrizio
- Venue
- Physiological Reviews
- Publisher
- American Physiological Society
- Published
- 2013-07
- Volume
- 93
- Issue
- 3
- Pages
- 1207-1246
- ISSN
- 0031-9333 (ISSN-L)
- 1522-1210
- PMC
- PMC3962549
- OpenAlex
- W2041804519
- Cited by
- 492
- References
- 371
- Citations by year
- 2026: 21 · 2025: 42 · 2024: 60 · 2023: 48 · 2022: 29 · 2021: 33 · 2020: 48 · 2019: 42 · 2018: 38 · 2017: 27 · 2016: 36 · 2015: 35 · 2014: 29 · 2013: 4
- FWCI
- 2.97
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Physiological Reviews (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Institutional Research Information System University of Turin (University of Turin) (submittedVersion)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Pain Management and Placebo Effect
- Health Sciences › Medicine › Psychiatry and Mental health › Medicine, History, and Philosophy
- Health Sciences › Medicine › Psychiatry and Mental health › Empathy and Medical Education
- Keywords
- placebo effect, physician-patient relationship, mind-body problem, patient care, suggestibility, philosophy of medicine
- MeSH terms
- Brain, Humans, Physician-Patient Relations, Placebos, Placebo Effect
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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