The Problem With Being Told Your Symptoms Are ‘Normal’

Visiting the doctor with a new symptom can induce anxiety, yet receiving a reassuring diagnosis that the symptom is "normal" often brings a sense of relief. However, a recent study in Nature Human Behavior suggests that while doctors' reassurances may provide comfort, they may unintentionally discourage patients from pursuing necessary treatment. This phenomenon stems from a communication gap: doctors' attempts to reassure patients by normalizing their symptoms may inadvertently convey that treatment is unnecessary.

Medical professionals often lack sufficient training in delivering reassurance, with only a few hours of instruction over four years of medical education. The skill of reassuring patients—without implying that treatment is not required—appears to be a nuanced aspect of medical practice, according to On Amir, a marketing professor at UC San Diego's Rady School of Management and co-author of the study.

Amir notes, "In the whole course of medical school, there's very little—maybe three hours in four years—that is devoted to patient reassurance."

Seyi Lawal, a graduate student at UCSD's Rady School of Management and co-author of the paper, adds that doctors' intentions in normalizing symptoms are usually positive, aiming to boost patients' mental well-being. However, this approach can be misleading. The study involved over 9,300 individuals, including doctors, medical caregivers, and members of the general public, and conducted 14 experiments.

One experiment, for instance, involved presenting 400 people with scenarios where a friend visited a doctor for menopause symptoms, such as fatigue and joint pain. In one scenario, the doctor simply recommended medication, while in the other, the doctor reassured the patient that the symptoms were normal and then offered the medication as an option.

Participants were asked to predict whether patients would take the recommended medication under these conditions. They anticipated that patients who hadn't been reassured would be more likely to take the medication than those who had been told their symptoms were normal. Despite this prediction, the simulations showed that patients whose doctors reassured them about the normalcy of their symptoms were less likely to seek treatment.

The researchers found that 84% of the surveyed doctors believed reassurance encourages patients to continue seeking treatment, while only 15% thought it would decrease their likelihood of treatment.

The study identified a more effective way to reassure patients without discouraging them from taking action. When doctors explicitly recommended treatment alongside reassurance that the symptoms were normal, predicted compliance with treatment increased. For example, a doctor could say, "You can take daily prescription medication, which I fully support as it will help you feel better, or you can deal with these normal symptoms."

This strategy—combining reassurance with explicit advice—may help doctors balance the need to reassure patients while also encouraging them to adhere to treatment protocols. Amir concludes, "Doctors have this tension—they want to give the patient choice and agency. When I grew up, that wasn't the case. Doctors just told you what to do, and that's it.

Today I think that we may have gone too far. Doctors can be clearer on what they actually recommend."