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.