Placebo and the doctor–patient interaction and communication

A main pathway of placebo and nocebo effects occurs via communication in patient–provider interactions. It is therefore of crucial importance to get insight into how positive or (unintendedly) negative expectancies about treatments are induced during healthcare provider–patient interaction and how possible undesired and unnecessary treatment outcomes can be altered. In this chapter, we outline the theoretical background of placebo effects and patient–provider interactions from the perspective of medical communication and placebo research as well as the functions of medical communication. We subsequently summarize the evidence on patient–provider interactions that alter placebo and nocebo effects, with a specific focus on the existing evidence in neurologic disorders. Specifically, we focus on different phases of patient–provider interactions during the consultations, such as outline of the treatment rationale, doses and efficacy of treatments, medical procedures as well as side-effects and risks. Eventually, the chapters focuses on possibilities for education and training of patient–provider interactions to increase knowledge, create awareness, and practice skills of optimizing placebo effects and minimizing nocebo effects during patient–provider interactions, by making use of advanced technological developments, such as Virtual Reality.