That’s the term some researchers are applying to the misconception experienced by some physicians wherein their expertise and treatment recommendations are perceived as more effective than they actually are, according to a new article in the New England Journal of Medicine.
Therapeutic illusion is an extension of a phenomenon called the “illusion of control,” which psychologists use to refer to actions that individuals believe influence the outcome of a situation but actually have no effect, like gamblers who have difficulty gauging the amount of control they have over odds.
“The decisions that physicians make at the bedside are both more complicated and more evidence-based than the choices of volunteers in a laboratory,” author David Casarett, MD, wrote in the article. “Nevertheless, physicians also overestimate the benefits of everything from interventions for back pain to cancer chemotherapy. And their therapeutic illusion facilitates continued use of inappropriate tests and treatments.”
Dr. Casarett writes that all outcomes are at least somewhat outside of physician control, and random chance positive outcomes can help to add to the illusion of therapeutic control. But these instincts can be counteracted by practices many clinicians already commonly defer to, such as a rule oft-repeated to medical students to avoid underdiagnosing common conditions and overdiagnosing rare ones: “When you hear hoofbeats, look for horses, not zebras.”
Additional strategies could be as simple as working with clinicians to recognize common biases that could result in therapeutic illusion.
“By evaluating their own practice, examining their own beliefs, and applying simple conscious heuristics, all physicians can contribute to more rational, evidence-based care,” Dr. Casarett wrote.
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