Art and Science of Providing Reassurance

Eliza H. Hutchinson, MD
Ebony M. White-Manigault, MD, MPH
Christopher J. Frank, MD, PhD

American Family Physician. 2026;113(5):498-500.

Author disclosure: No relevant financial relationships.

ELIZA H. HUTCHINSON, MD, and EBONY M. WHITE-MANIGAULT, MD, MPH, Department of Family Medicine, University of Michigan, Ann Arbor

CHRISTOPHER J. FRANK, MD, PhD, Department of Family Medicine and Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor

Address correspondence to Christopher J. Frank, MD, PhD, at cfrank@med.umich.edu.

Author disclosure: No relevant financial relationships.

  1. 1.Finley CR, Chan DS, Garrison S, et al. What are the most common conditions in primary care? Systematic review. Can Fam Physician. 2018;64(11):832-840.
  2. 2.van der Weijden T, van Velsen M, Dinant GJ, et al. Unexplained complaints in general practice: prevalence, patients’ expectations, and professionals’ test-ordering behavior. Med Decis Making. 2003;23(3):226-231.
  3. 3.Linton SJ, McCracken LM, Vlaeyen JWS. Reassurance: help or hinder in the treatment of pain. Pain. 2008;134(1):5-8.
  4. 4.Pincus T, Holt N, Vogel S, et al. Cognitive and affective reassurance and patient outcomes in primary care: a systematic review. Pain. 2013;154(11):2407-2416.
  5. 5.van Ravesteijn H, van Dijk I, Darmon D, et al. The reassuring value of diagnostic tests: a systematic review. Patient Educ Couns. 2012;86(1):3-8.
  6. 6.Sapira JD. Reassurance therapy. What to say to symptomatic patients with benign diseases. Ann Intern Med. 1972;77(4):603-604.
  7. 7.Chen WG, Schloesser D, Arensdorf AM, et al. The emerging science of interoception: sensing, integrating, interpreting, and regulating signals within the self. Trends Neurosci. 2021;44(1):3-16.
  8. 8.Lucock MP, Morley S, White C, et al. Responses of consecutive patients to reassurance after gastroscopy: results of self administered questionnaire survey. BMJ. 1997;315(7108):572-575.
  9. 9.Rief W, Heitmüller AM, Reisberg K, et al. Why reassurance fails in patients with unexplained symptoms—an experimental investigation of remembered probabilities. PLoS Med. 2006;3(8):e269.
  10. 10.Lam JH, Pickles K, Stanaway FF, et al. Why clinicians overtest: development of a thematic framework. BMC Health Serv Res. 2020;20(1):1011.
  11. 11.Kathol RG. Reassurance therapy: what to say to symptomatic patients with benign or non-existent medical disease. Int J Psychiatry Med. 1997;27(2):173-180.
  12. 12.Verghese A, Brady E, Kapur CC, et al. The bedside evaluation: ritual and reason. Ann Intern Med. 2011;155(8):550-553.
  13. 13.Van Boven K, Dijksterhuis P, Lamberts H. Defensive testing in Dutch family practice. Is the grass greener on the other side of the ocean?. J Fam Pract. 1997;44(5):468-472.
  14. 14.Rolfe A, Burton C. Reassurance after diagnostic testing with a low pretest probability of serious disease: systematic review and meta-analysis. JAMA Intern Med. 2013;173(6):407-416.
  15. 15.Traeger AC, Hübscher M, Henschke N, et al. Emotional distress drives health services overuse in patients with acute low back pain: a longitudinal observational study. Eur Spine J. 2016;25(9):2767-2773.
  16. 16.Traeger AC, Hübscher M, Henschke N, et al. Effect of primary care–based education on reassurance in patients with acute low back pain: systematic review and meta-analysis. JAMA Intern Med. 2015;175(5):733-743.
  17. 17.Traeger AC, O’Hagan ET, Cashin A, et al. Reassurance for patients with non-specific conditions—a user’s guide. Braz J Phys Ther. 2017;21(1):1-6.
  18. 18.Burton C, Mooney C, Sutton L, et al. Effectiveness of a symptom-clinic intervention delivered by general practitioners with an extended role for people with multiple and persistent physical symptoms in England: the Multiple Symptoms Study 3 pragmatic, multicentre, parallel-group, individually randomised controlled trial. Lancet. 2024;403(10444):2619-2629.

Case scenarios are written to express typical situations that family physicians may encounter; authors remain anonymous. Send scenarios to afpjournal@aafp.org. Materials are edited to retain confidentiality.

This series is coordinated by Caroline Wellbery, MD, associate deputy editor.

A collection of Curbside Consultation published in AFP is available at https://www.aafp.org/afp/curbside.

Copyright © 2026 by the American Academy of Family Physicians.

This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. See permissions for copyright questions and/or permission requests.