What Doctors Really Mean When They Say A Symptom’s ‘Normal’

Let’s say you go to your doctor with a documented, ongoing case of psoriasis. You might complain of itchy and flaky skin.

To your surprise, though, your GP tells you these symptoms are “normal”. You might feel dismissed or as if your problems can’t be addressed; maybe you’ll be less likely to seek treatment.

At least, that’s what a recent study published in Nature Human Behaviour suggests.

It said that, while doctors might hope to reassure patients by calling well-understood symptoms “normal,” data shows it could actually make people with health issues think nothing can be done about their problems.

That might mean they don’t look for or ask about solutions like medications, even when they may be both available and useful.

Professor On Amir, the study’s senior author, told Pulse Today: “Doctors shouldn’t stop reassuring patients. But they should make their meaning unmistakable”.

So, HuffPost UK spoke to Dr Dominic Greenyer, a GP and director at The Health Suite, about what “normal” means to a doctor.

I’ll be honest: I always thought being told an issue is “normal” by a doctor meant everything was OK, and nothing more could be done.

But sometimes, Dr Greenyer said, that’s a miscommunication.

“When a doctor describes a symptom as ‘normal’, they will often mean that it’s common, expected in a particular situation, or consistent with a certain stage of life. It does not necessarily mean the symptom is insignificant, imaginary or something the patient simply has to tolerate,” he said.

For instance, hot flushes are “normal” during menopause and perimenopause, and pain is “normal” after surgery. However, the GP said that doesn’t mean they need to be tolerated or that they can’t be addressed with appropriate medication.

“’Common’ and ‘untreatable’ are two very different things,” he added.

And, the doctor said, doctors might say lab results or exams that fall within an expected range are normal.

“In that context, it may reassure us that we have not found evidence of a particular disease, but it does not automatically explain why someone feels unwell or mean that no further help is available,” he claimed.

“This study highlights how easily well-intentioned reassurance can be misunderstood. A doctor may be trying to say, ‘This is recognised, and you are not alone’, while the patient hears, ‘There is nothing wrong, and nothing can be done’. Clinicians need to make that distinction explicit.”

In the Nature study, the authors tested two ways to close that communication gap: asking doctors to explain what “normal” means in a medical sense when using the word, and offering some next steps to patients after normalising their symptoms.

Both appeared to lead to better results.

Dr Greenyer said: “Ideally, reassurance should be followed by a clear plan. That might involve discussing treatment options, explaining how long the symptom is expected to last, arranging follow-up or telling the patient what changes should prompt them to seek help again.”

And if that doesn’t happen, it might be worth your while taking the lead.

“Patients should not be afraid to ask, ‘When you say normal, do you mean it is harmless, or simply that it is common?’. They can also ask whether treatment is available and what they should do if the symptom persists, worsens, or begins affecting everyday life,” the GP concluded.

“Being told something is normal should never be interpreted as an instruction to ignore a significant change in your health. If symptoms are severe, persistent, worsening or accompanied by warning signs such as unexplained weight loss, unusual bleeding, a new lump, chest pain or breathing difficulties, further medical advice may still be needed.”