The edition · Family Medicine
How a doctor delivers a normal result changes whether patients believe it; shingles vaccination and nerve-pain care in a practice review
An experiment on warmth, competence and reassurance, a community trial that moved children's BMI modestly, a primary care review of foodborne illness, and the vaccination-first approach to shingles.
The edition in brief
An Annals of Family Medicine experiment showed 349 online participants with moderate somatic symptoms a video of a doctor giving normal test results. When the doctor showed high warmth and high competence, participants rated serious disease as less likely and were less inclined to seek another opinion or more tests. Diagnostic information did not speak for itself; the doctor's behaviour shaped how patients used it. It was an analog study in a young, mostly female online sample, not real consultations. In H2GO!, a cluster-randomised trial in 11 US community sites (437 children aged 8 to 13), a 12-session behavioural programme was associated with a between-group difference in 12-month BMI z score of -0.19 (95% CI -0.38 to -0.01); within-group changes were not significant and sugary drink and water intake did not differ. An American Family Physician review of foodborne illness advises guiding diagnosis and treatment by epidemiological context, host risk and severity, with rehydration central. Another review of shingles and postherpetic neuralgia notes that neuralgia follows in 10% to 18% of cases, first-line drug options for neuralgia include gabapentinoids, serotonin-noradrenaline reuptake inhibitors and tricyclics, and that recombinant zoster vaccine is recommended for adults 50 and over in US guidance. The pearl is on safety-netting a normal result.
A doctor's warmth and competence changed how patients read normal test results
When you give a normal result, combine warmth with clear reasoning; the result alone may not change the patient's beliefs.
A six-week community programme on sugary drinks was linked to a small BMI z-score difference at 12 months
A community-based behavioural programme was associated with a small BMI z-score benefit; use it as support for referral to local programmes, not as a clinic intervention.
Foodborne illness: let context, host risk and severity decide the work-up and treatment
Tailor the investigation and treatment of acute gastroenteritis to exposure history, host risk and severity, with rehydration as the foundation.
Safety-net every normal result: say what to watch for and when to come back
End every reassuring consultation with a clear plan: what to watch for, when to return and who to see.
Shingles: vaccinate eligible adults and plan for postherpetic neuralgia
Treat shingles promptly, plan for neuralgia, and bring up vaccination with older and immunocompromised patients where it is available.
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