Abstract
THEORETICAL FRAMEWORK Physicians attempt to fulfill patients’ expectations that they use scientific principles in the diagnosis and treatment of illness. Cognitive dissonance may be produced if the physician acknowledged that the effect of his treatment was due to nonspecific of placebo effects. The dissonance would be intensified if the physician were strongly committed to, invested in and financially dependent on a specific theory and practice of medicine. This conflict, when it involves the placebo or placebo effect, can be resolved in several ways. The use of placebos by a physician can be denied, considered unethical, attributed to other physicians, and lead to a narrow definition of the placebo which excludes the physician’s specialty from the definition. Such physicians are likely to have a low tolerance for ambiguity and to specialize in fields with more specificity and closure in treatment. Another possible resolution would be to acknowledge the nonspecific nature of treatment and the use of placebos, and become a researcher or an eclectically oriented practitioner. Young physicians should have less conflict about specificity and placebos because they are less committed to, invested in, and financially dependent on a specific theory and practice of medicine.6*’
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