Surgeons’ behaviors and beliefs regarding placebo effects in surgery

Authors

  • Karin Jensen Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Program in Placebo Studies, Beth Israel and Deaconess Hospital, Harvard Medical School, Boston, MA, USA
  • Annelie Rosén Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
  • Lisbeth Sachs Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
  • Amanda Ekdahl Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
  • Andreas Westberg Department of Orthopedic Surgery, Capio Sankt Göran Hospital, Stockholm, Sweden
  • Paul Gerdhem Department of Reconstructive Orthopedics, Karolinska University Hospital, Stockholm, Sweden; Department of Clinical Science Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
  • Ted J Kaptchuk Program in Placebo Studies, Beth Israel and Deaconess Hospital, Harvard Medical School, Boston, MA, USA

DOI:

https://doi.org/10.1080/17453674.2021.1941627

Abstract

Background and purpose — Emerging evidence from sham-controlled trials suggest that surgical treatment entails substantial non-specific treatment effects in addition to specific surgical effects. Yet, information on surgeons’ actual behaviors and beliefs regarding non-specific treatment and placebo effects is scarce. We determined surgeons’ clinical behaviors and attitudes regarding placebo effects.

Methods — A national online survey was developed in collaboration with surgeons and administered via an electronic link.

Results — All surgical clinics in Sweden were approached and 22% of surgeons participated (n = 105). Surgeons believed it was important for them to interact and build rapport with patients before surgery rather than perform surgery on colleagues’ patients (90%). They endorsed the importance of non-specific treatment effects in surgery generally (90%) and reported that they actively harness non-specific treat- ment effects (97%), including conveying confidence and calm (87%), building a positive interaction (75%), and making eye contact (72%). In communication regarding the likely outcomes of surgery, surgeons emphasized accurate scientific information of benefits/risks (90%) and complete honesty (63%). A majority felt that the improvement after some currently performed surgical procedures might be entirely explained by placebo effects (78%). Surgeons saw benefits with sham-controlled surgery trials, nevertheless, they were reluctant to refer patients to sham controlled trials (46%).

Interpretation — Surgeons believe that their words and behaviors are important components of their professional competence. Surgeons saw the patient–physician relation- ship, transparency, and honesty as critical. Understanding the non-specific components of surgery has the potential to improve the way surgical treatment is delivered and lead to better patient outcomes.

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Published

2021-06-24

How to Cite

Jensen, K., Rosén, A., Sachs, L., Ekdahl , A., Westberg, A., Gerdhem, P., & Kaptchuk, T. J. (2021). Surgeons’ behaviors and beliefs regarding placebo effects in surgery. Acta Orthopaedica, 92(5), 507–512 . https://doi.org/10.1080/17453674.2021.1941627