The Finnish patients who received sham surgery (and recovered) | Nudge Newsletter


Placebos And Marketing

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From December 2007 to January 2012, 146 men participated in an eye-opening study¹.

All men had persistent knee pain.

All had visited public hospitals in Finland and asked for help.

Here's where the study started.

Half underwent arthroscopic partial meniscectomy (removal of damaged meniscus tissue). That's the appropriate treatment.

The other half underwent sham surgery (anaesthesia and incisions but no tissue removed). It was a placebo surgery.

The sham group believed they'd had tissue removed, even though they hadn't.

So, what happened?

After 12 months, there was no difference between those who had real surgery and those who only thought they had surgery.

Both had the same amount of reduced pain.

Five years later, researchers followed up and found the same result.

The placebo group recovered 1) at the same rate, and 2) to the same degree.

The expectation of treatment was as effective as the treatment itself.

Is marketing a placebo?

That fake surgery is a type of marketing.

It built expectations around the service, which influenced the perceptions.

Similarly, Anton de Craen² reviewed 12 studies and found red painkillers are perceived as more potent than white ones.

The two painkillers are the same, but the colouring influences perception.

Despite this, only 14% of painkillers in pharmacies are red.

We assume customers are rational.

We think there's no way a headache can be cured by colouring.

But the sham surgery proves that's not true. Marketing alters our perception.

My point is, if Finnish blokes can psychically recover from knee pain with a sham surgery, imagine how good marketing could change how people enjoy you: food, software, guitar lessons, art, pottery, conference talks, etc.

What do you think? — Phill

P.S. Thanks to Gareth Harvey for sharing this study on LinkedIn.

¹Sihvonen, R., Paavola, M., Malmivaara, A., Itälä, A., Joukainen, A., Kalske, J., Nurmi, H., Kumm, J., Sillanpää, N., Kiekara, T., Turkiewicz, A., Toivonen, P., Englund, M., Taimela, S., & Järvinen, T. (2013). Arthroscopic partial meniscectomy for a degenerative meniscus tear: A 5-year follow-up of the placebo-surgery controlled FIDELITY (Finnish Degenerative Meniscus Lesion Study) trial. British Journal of Sports Medicine.

²Shotton, R. (2018). The choice factory: 25 behavioural biases that influence what we buy. London: Harriman House.

As a behavioural science practitioner, I believe in the peak-end rule*

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