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Have you come across the nocebo effect? For example the messages that doctors give at the point of diagnosis of a chronic illness is like a curse that becomes self-fulfilling, telling the patient they can't get better and it is all downhill from here. I have to spend a lot of time undoing this and giving people back hope before they can even start getting better.

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Absolutely, nonspecific effects (both placebo and nocebo) often take up a large portion of the effect size of any physical therapy plan of care. Mindset and beliefs also impact compliance with the plan so really there is a bidirectional relationship that is impossible to completely disentangle. One of the most helpful things PTs can do for patients when consulted by primary care is address those messages that doctors give that you allude to on day one. One of the most common things we see in the PT world not necessarily dealing with chronic illness is folks that have been nocebo'd with respect to their diagnostic imaging for musculoskeletal issues. Primary care docs love to say all kinds of crazy shit for some reason about how "you have a 50 y/o shoulder" or its "bone on bone" and patients latch on to these kinds of expressions like you wouldn't believe. Almost always there is some amount of loading and exercise that the patient can tolerate without aggravating symptoms no matter how gnarly the imaging might look. There have been efforts to educate primary care with respect to the damage this type of fear mongering causes, but old habits die hard and it is an uphill battle. The thing that complicates matters further is that you need to adjust how you talk about this stuff to the individual patient based on their personality. Some patients actually do need to hear stuff that isn't completely positive to manage their expectations, while others need only positive reinforcement. It really depends on their beliefs and personality. Wow, that kind of turned into a rant TL;DR yup, very aware of nocebo and counsel patients and other providers on it regularly.

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Good answer :-)

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That made my day! Thank you for taking the time to read and consider.

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Lovely no-shit self-help pamphlet! 👌

As they say, should ten doomy silhouettes cross the edge of sight from black-swan habitat, you can be sure nine will run into ditch early. While the one finally at your doorsteps won’t look remotely like the disastrous picture in your head 🙂

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October 28, 2022
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I’m Catholic I get to point out optimistic, or Optimystic matters Catholic

Like nuns building churches in marble no less with BTC

https://bitcoinmagazine.com/culture/catholic-nuns-building-church-with-bitcoin

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