Doctors say “that’s normal” to reduce patient anxiety. A study of 9,371 people found patients interpret those words as “you don’t need treatment” and stop seeking help.
In clinical medicine, reassurance is considered a core communication skill. When a patient presents with symptoms that are common, expected, or unlikely to indicate serious disease, telling them so is meant to accomplish several things at once: reduce anxiety, restore confidence, and free up the patient’s cognitive resources to engage constructively with their health. A doctor who says “what you’re experiencing is completely normal for this stage of recovery” believes they are helping.
A new study published in Nature Human Behaviour suggests that, in a significant and consistent proportion of cases, the doctor is doing the opposite.
Researchers led by Seyi Lawal at the University of California San Diego Rady School of Management ran 14 separate experiments across 9,371 participants, testing what happens when healthcare providers normalize symptoms across a wide range of health conditions. The conditions studied included menopause, migraines, dental pain after procedures, seasonal allergies, elevated blood glucose, and postoperative pain. Across all of them, the same pattern emerged: when doctors told patients their symptoms were normal, patients became less likely to seek treatment, not more.
The finding inverts the assumption that underlies one of medicine’s most commonly used communication strategies. Reassurance through normalization is not, it turns out, a neutral act. It carries an unintended signal that suppresses the very behavior it is supposed to enable.
“Doctors usually have a noble goal. They mean to ease anxiety, but somehow it backfires,” said senior author On Amir, professor of marketing at the UC San Diego Rady School of Management. “Doctors shouldn’t stop reassuring patients. But they should make their meaning unmistakable.”
What patients actually hear
The mechanism the researchers identified is not that patients become irrationally passive after hearing reassurance. It is that they are doing something entirely rational: reading their doctor’s words for implicit clinical guidance.
When a doctor says a symptom is normal, the patient is not simply receiving information. They are extracting what they believe to be a recommendation embedded in that information. And the recommendation they extract is almost never the one the doctor intended.
Patients, the researchers found, consistently interpreted normalizing language as a signal that treatment was not warranted. The logic patients appeared to apply, often unconsciously, ran something like this: if the doctor wanted me to get treatment, they would have told me to seek treatment. Instead, they told me this is normal. Therefore, this does not require treatment.
The researchers called this a “reappraisal of treatment norms.” By describing a symptom as typical, providers inadvertently communicated information about what the typical response to that symptom should be, and the typical response the patient inferred was to leave it alone.
This interpretation made patients feel better in the short term. Anxiety decreased, as reassurance is intended to produce. But the cost was that treatment-seeking intentions fell simultaneously. The patients were calmer and less likely to get help, two outcomes that should not be linked but consistently were.
The researchers also measured what healthcare providers predicted would happen when they used normalizing language. The providers expected their reassurance would either increase patient willingness to seek treatment or have no effect. In experiment after experiment, both predictions were wrong. Providers had no accurate model of how their most common reassuring phrase was being received.
“The contrast was striking,” the researchers wrote. “Providers generally predicted that reassuring patients by describing their symptoms as normal would either increase their willingness to seek treatment or have no meaningful effect. Patients, however, frequently reacted in the opposite direction.”
Where the research began
The study grew from lead researcher Seyi Lawal’s interest in the specific experience of menopause patients. People experiencing disruptive menopausal symptoms, including hot flashes, sleep disruption, cognitive changes, and mood shifts, frequently report leaving medical appointments feeling dismissed after being told their symptoms are simply a normal part of aging. The clinical intent of that reassurance is typically benign: doctors want patients to know their experience is not unusual and does not indicate serious disease.
But Lawal noticed that many patients left those conversations without requesting or receiving treatment, even when effective treatments existed. The question she began investigating was whether the reassurance itself was contributing to that outcome.
The 14 studies that followed were designed to test this possibility systematically. Rather than relying on patient recall of past appointments, the researchers constructed controlled scenarios in which participants encountered healthcare communications describing symptoms as typical or expected in a particular situation. They then measured treatment-seeking intentions before and after exposure to normalizing language, and compared them to control conditions in which the same symptoms were described without normalization.
The effect appeared immediately and consistently. Participants who were told their symptoms were normal wanted treatment less than participants who were not told this, across every health condition tested and every experimental format used.
The conditions where the effect was strongest
The suppression effect was not confined to minor or ambiguous symptoms. It appeared across conditions where effective treatments exist, where patients had already expressed interest in getting help, and where the clinical case for intervention was clear.
In the menopause studies, participants who were told that hot flashes and sleep disruption were normal for their stage of life were significantly less likely to express interest in hormone therapy or other treatments than participants in control conditions. This is clinically relevant because effective treatments for menopausal symptoms are available and widely underutilized, in part because of a history of patients feeling that their symptoms were being minimized.
In studies involving elevated blood glucose, normalizing language reduced interest in dietary changes, medication, and follow-up testing, even among participants who had initially expressed concern about their levels. In studies involving postoperative pain, patients who were told their pain was normal after a procedure were less likely to request pain management than those who received the same information without the normalizing framing.
The effect held regardless of how serious patients perceived their symptoms to be before the reassurance, regardless of their age, and regardless of whether the normalizing language was delivered by a physician, a nurse, or a written health communication.
What happened in the gap between doctors and patients
One of the study’s most striking findings concerns the gap in perspective between providers and patients, which turned out to be both large and systematic.
Healthcare providers, when shown the same normalizing communications and asked to predict patient responses, consistently expected their words to be helpful. They imagined patients would feel calmer and more empowered to take constructive action. In multiple experiments, the researchers directly compared provider predictions to patient outcomes and found the two were moving in opposite directions: providers expected treatment-seeking to stay flat or increase, patients actually sought treatment less.
This disconnect has practical consequences beyond individual appointments. If providers have no accurate model of how normalizing language functions for patients, they cannot adjust their communication style to prevent the problem. The reassurance continues to suppress treatment-seeking across millions of appointments, invisible to the people delivering it.
The finding connects to a broader cultural moment in patient-provider communication. The phrase “medical gaslighting,” describing situations in which patients feel their symptoms are being minimized or dismissed by clinicians, has entered popular conversation in recent years. The research does not suggest that doctors who use normalizing language intend to dismiss patients. But it does provide a mechanism by which well-intentioned reassurance can produce the same effect as dismissal: patients leave without treatment for conditions that could be treated.
What actually works instead
The study did not only document the problem. It tested solutions.
The researchers identified two communication strategies that preserved the reassuring function of normalizing language while closing the treatment-seeking gap.
The first was pairing normalization with an explicit treatment recommendation. Instead of “what you’re experiencing is completely normal,” providers could say: “What you’re experiencing is completely normal, and there are effective treatments available if you want to address it.” This framing maintained the anxiety-reducing effect of normalization while eliminating the inference that treatment was unnecessary.
The second strategy was explaining the purpose of the normalizing statement. Providers who clarified that they were sharing the information to help patients understand their symptoms, not to suggest treatment was unnecessary, also prevented the suppression effect. The key was making the provider’s actual intention explicit rather than leaving it for the patient to infer.
Both strategies were tested in controlled experiments and significantly reduced the gap between provider intent and patient response. They did not require longer appointments, additional clinical resources, or training programs. They required only a small change in how the normalizing information was framed.
“Doctors shouldn’t stop reassuring patients,” Amir said. “But they should make their meaning unmistakable.”
What the study cannot establish
The 14 experiments in this study were conducted primarily with online samples of general population adults encountering hypothetical healthcare scenarios. Real clinical appointments involve dynamics that controlled experiments cannot fully replicate: the authority of an in-person provider, the emotional weight of a specific health concern, the time pressure of a brief consultation, and the trust or distrust accumulated over a patient-provider relationship.
Whether the suppression effect operates at the same magnitude in real appointments as it does in experimental scenarios is a question the study cannot definitively answer. The researchers call for future work in clinical settings with actual patients to test whether the communication strategies they identified translate into measurable changes in treatment-seeking behavior in practice.
The study also focused on short-term treatment-seeking intentions measured immediately after exposure to normalizing language. Whether the effect persists over days or weeks, and whether it changes when patients have time to reflect or discuss their symptoms with others, remains to be tested.
What the study establishes with high confidence, across 14 experiments and 9,371 participants and a wide range of health conditions, is the existence and consistency of the effect: normalizing language suppresses treatment-seeking, and providers do not know it is happening. For a communication strategy deployed in millions of clinical encounters every day, that finding matters.
The study, “Reassurance through normalization inadvertently suppresses treatment”, was authored by Seyi Lawal, Brianna Chew, and On Amir at the University of California San Diego Rady School of Management, and published August 10, 2026 in Nature Human Behaviour.
Source: University of California San Diego. DOI: 10.1038/s41562-026-02542-0
