Psychologic influences on illness are well recognized but infrequently addressed in the interactions of hand surgeons and patients. This study assessed the attitudes of hand surgery patients and hand surgeons regarding psychologic influences on illness and compared their attitudes with those of the general population.

An 8-question survey regarding participant's attitudes toward psychologic influences on illness was given to the general public (people waiting in an airport), patients presenting to a hand surgery practice, and members of the American Society for Surgery of the Hand.

A total of 474 surgeons, 85 patients, and 42 public participants completed the survey. There were no notable differences between patients and the general public, but the surgeons' attitudes were markedly different from both patients and the general public with respect to 4 items: the surgeons underestimated the openness of patients and the general public to discussing psychologic influences and willingness to see a psychologist or psychiatrist; and they were more supportive than the general public or patients regarding the opinion that the placebo effect reflects the strong influence of psychologic factors in healing and that psychologic stress often is expressed as a physical complaint. The distribution of patient responses showed 2 subgroups with respect to the idea that psychologic stress often is expressed as a physical complaint and with regard to willingness to see a mental heath professional, reflecting that a subset of patients with a hand illness may be resistant to these concepts.

Hand surgery patients and the general public are not as aware of the psychologic influences on illness as are hand surgeons, but they are more willing to consider and discuss psychologic factors-and even psychologic treatment-than their surgeons realize. Surgeons' views may be colored by a few negative interactions with challenging patients, but a dialogue with our patients regarding the influence of psychologic issues on illness will be well received by most patients and may facilitate recovery.

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