title: Placebo prescription and empathy of the physician: A cross-sectional study.
abstract: BACKGROUND
  Empathy in the patient-physician relationship is a major component in an effective placebo treatment, as in every medical treatment. Understanding the role of empathy of the physician in the placebo effect may help dissect some of the context variables responsible for the effectiveness of the placebo.
  
  
  OBJECTIVE
  To determine the frequency of placebo prescription, doctors' beliefs, motivation, and attitudes to placebos in general practice in northern Portugal and to test the association between placebo prescription and physician empathy.
  
  
  METHODS
  A cross-sectional study was conducted between November 2014 and January 2015 among general practice specialists and interns from 14 health centres in a northern Portuguese health region. The self-report questionnaire included the Portuguese version of the Jefferson scale of physician empathy (JSPE) and a questionnaire about placebo prescription. Associations between demographic variables, JSPE score, prescription of placebo, and the attitudes to placebo score were tested with the chi-squared statistic, student t-tests for independent samples, and Pearson correlation.
  
  
  RESULTS
  The study included 93 general practitioners (GP) (response rate: 74%). Placebos were prescribed by 73% (n = 68) of the respondents. GPs who prescribe placebo are significantly younger (mean age = 38.4 years; SD = 11.1; t (90) = 2.98, P <.05, d = 0.67) than non-prescribers (mean age =46.5 years; SD =13.3). Favourable attitudes towards placebo prescription are associated with higher empathy scores (R = 0.310, P <.01).
  
  
  CONCLUSIONS
  Placebo prescription is frequent and associated with empathy from the prescriber, especially among younger GPs.
authors.affiliation: a Life and Health Sciences Research Institute (ICVS), School of Medicine , University of Minho , Braga , Portugal.|b Alto Minho Local Health Unit EPE , Viana do Castelo , Portugal.
authors.forename: João
authors.initials: J
authors.lastname: Braga-Simões
authors.affiliation: a Life and Health Sciences Research Institute (ICVS), School of Medicine , University of Minho , Braga , Portugal.|c ICVS/3B's-PT Government Associate Laboratory , Braga/Guimarães , Portugal.|d Faculty of Psychology and Educational Sciences , University of Porto , Portugal.
authors.forename: Patrício Soares
authors.initials: PS
authors.lastname: Costa
authors.affiliation: a Life and Health Sciences Research Institute (ICVS), School of Medicine , University of Minho , Braga , Portugal.
authors.forename: John
authors.initials: J
authors.lastname: Yaphe
mesh_terms: D000328:Adult; D000367:Age Factors; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D004645:Empathy; D005260:Female; D058005:General Practitioners / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D010820:Physicians / Q000523:psychology*; D015990:Placebo Effect; D011174:Portugal; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires
keywords: Placebo prescription; general practice; physician empathy