Expectations about pain and analgesic treatment depend on medical providers’ facial appearances

There is a robust link between patients’ expectations and clinical outcomes, as evidenced by the placebo effect. These expectations are shaped by the context surrounding treatment, including the patient-provider interaction. Prior work indicates that the provider’s behavior and characteristics, including warmth and competence, can shape patient outcomes. Yet humans rapidly form trait impressions of others prior to any in-person interaction. Here, we tested whether trait-impressions of hypothetical medical providers, based purely on facial images, influence participants’ choice of medical providers and expectations about their health following hypothetical medical procedures performed by those providers in a series of vignettes. Across five studies, participants selected providers who appeared more competent, based on facial visual information alone. Further, providers’ apparent competence predicted participants’ expectations about post-procedural pain and medication use. Participants’ perception of their similarity to providers also shaped expectations about pain and treatment outcomes. Our results suggest that humans develop expectations about their health outcomes prior to even setting foot in the clinic, based exclusively on first impressions. These findings have strong implications for health care, as individuals increasingly rely on digital services to choose healthcare providers, schedule appointments, and even receive treatment and care, a trend which is exacerbated as the world embraces telemedicine.