TY - JOUR T1 - Beyond the placebo: understanding the therapeutic context JF - British Journal of General Practice JO - Br J Gen Pract SP - 6 LP - 7 DO - 10.3399/bjgp15X683017 VL - 65 IS - 630 AU - Frede Olesen Y1 - 2015/01/01 UR - http://bjgp.org/content/65/630/6.abstract N2 - An old but still relevant study by Thomas, conducted in 45 different general practice settings, explored 200 British patients in whom no definite diagnosis could be made. All patients were randomly selected for one of two procedures: either they were given a symptomatic diagnosis and medication, or they were told that no treatment was required as there was no evidence of disease. No differences were found in outcomes with respect to reported symptoms and number of new contacts to the GP within a month.1Thomas later wrote in the Lancet: ‘The placebo effect in general practice is the power of the doctor alone to make the patient feel better, irrespective of medication. It is one of the most important factors in the consultation, yet generally it is neglected, unrecognized, and untaught. A better appreciation of this power would change doctors’ attitudes to the consultation and would result in the making of less illness, the prescribing of less medication, and a better understanding by the patient of his or her condition.’2More than ever, Thomas’s study and the statement are relevant. New research has documented the therapeutic power of placebo defined as the effect of the meeting between the doctor and the patient, and the context in which the specific treatment is given.3–5 Nevertheless, three major obstacles seem to prevent a more targeted use of the placebo effect in general practice.The first obstacle is the term ‘placebo’. In basic scientific training, we learn that placebo is inert: a fake pill or something to do with deception. This impact must be eliminated when we study the specific treatment … ER -