Physician Behavior

Patient Responses

Over-investigating somatic or "organic" causes.

Adds to patient anxiety and uncertainty about the nature of their pain problems when (repeated) diagnostic tests fail to identify pathology.

Recommending measures not because of benefit, but because they feel pressured to help a desperate patient.

Fails to find a cure, and impedes on a patient's  development of pain coping skills.

Misdirecting medication use; failing to provide specific instructions and advice.

Contributes to maintenance of disability among patients; medication should be given for a duration on a regular basis, not intermittently.

Directly or indirectly expressing skepticism if pain complaint is genuine.

Reinforces the patient's determination to maintain the sick role—to behave otherwise would confirm that it is "all in the mind."
The patient feels stigmatized when physical pain is attributed to psychological causes.

Failing to offer adequate explanation for pain problems or an insufficient amount of background information.

Increases distress and anxiety levels.
"Higher levels of information-giving, discussion of preventive care, and greater interview length contributed to patient satisfaction." 

Clearly stating to the patient that appropriate investigation had been completed (and additional efforts would be fruitless).

Dissatisfied patients believed additional investigation would help, including their case histories and possible psychological problems or disorders.