Brit Trogen, MD, MS
Pediatrics Resident

“Expectancy and the Placebo Effect in Child Health”

What was your topic? 
The topic of my Rudin Fellowship was the use of”open-label” placebos in pediatrics. Throughout history, there has been widespread debate over the ethical implications of using placebo treatments in clinical practice. A key premise in this debate—that placebos necessitate patient deception—has recently been challenged by the development of the “open-label placebo” methodology, in which placebos are prescribed openly with the informed consent of the patient. Open-label placebos have been suggested as a way to “harness” the placebo effect for clinical benefit. My Rudin project explored the ethical implications of using these placebos in clinical practice.

Who was your mentor?  
My mentor was Perri Klass, who gave wonderful perspective as an experienced pediatrician and also provided general guidance throughout the research and writing process. Arthur Caplan was also instrumental in helping me consider the ethical components of the topic.

What was the research experience like? 
The research experience was fascinating, and my topic ended up evolving significantly over the course of the year from a broad interest in how  positive or negative expectations can influence patient outcomes to amore narrowed focus on placebos. Having a project in the medical humanities was also a very refreshing complement to all of the basic science material I was receiving as a first-year medical student. It definitely sparked joy in an otherwise busy year.

How did the Fellowship impact your role as a physician and a writer?  
Working on this project made me consider how the placebo effect can alter patients’ experiences of illness, which has continued to influence the way I treat and respond to patients in clinical practice. From a writing perspective, it made me even more passionate about advocating for an evidence-based approach to the medical humanities, and reiterated for me how important it is to incorporate the arts and humanities into medical training as a way to improve patient care and physician well-being down the road. 

What publications and professional invitations came out of it?  
The findings of my research were published in the journal Pediatrics as “The Ethics of Open-Label Placebos inPediatrics.” The connections I made during the Rudin Fellowship have continued to be wonderful resources for staying connected with great mentors throughout residency.

What are you working on currently?
At the moment, I’m spending most of my time completing my intern year in pediatrics. From a research perspective, I’m working on a systematic review on patient-centered approaches to informed consent through the Gold Foundation’s “Mapping the Landscape” Grant. I’m hoping to continue to find space to work in the medical humanities in the future, and I’m always on the lookout for new projects to get involved in.

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