Half of Doctors Routinely Prescribe Placebos

[groovedaddy]

Half of all American doctors responding to a nationwide survey say they regularly prescribe placebos to patients. The results trouble medical ethicists, who say more research is needed to determine whether doctors must deceive patients in order for placebos to work.

The study involved 679 internists and rheumatologists chosen randomly from a national list of such doctors. In response to three questions included as part of the larger survey, about half reported recommending placebos regularly. Surveys in Denmark, Israel, Britain, Sweden and New Zealand have found similar results.

The most common placebos the American doctors reported using were headache pills and vitamins, but a significant number also reported prescribing antibiotics and sedatives. Although these drugs, contrary to the usual definition of placebos, are not inert, doctors reported using them for their effect on patients’ psyches, not their bodies.

In most cases, doctors who recommended placebos described them to patients as “a medicine not typically used for your condition but might benefit you,” the survey found. Only 5 percent described the treatment to patients as “a placebo.”

http://www.nytimes.com/2008/10/24/health/24placebo.html?th&emc=th

[liberal N proud]

1. Mind over body

[Fire_Medic_Dave]

9. Using painkillers to treat arthritis related pain and calling it a placebo.

That mind really is something. At least the mind it takes to make that logical connection is.

David

[cosmik debris]

2. “The problem is

that most of those people are very difficult patients..."

[Mojorabbit]

3. Or the problem

is the doc has failed to make an accurate diagnosis.

[cosmik debris]

4. I quoted the NY Times.

Where do you get your information?

[Mojorabbit]

5. personal experience

plus twenty years in the health care field. :)

[cosmik debris]

6. That certainly demonstrates the value of

anecdotal evidence.

[Warpy]

10. More often, there is a diagnosis

but no real treatment, so the doc prescribes a reasonably benign pill with an off label use for the condition and hopes for the placebo effect.

See: diabetic neuropathy.

[Fire_Medic_Dave]

8. How is that a problem?

[cosmik debris]

11. Here is the context for that quote.

“This is the doctor-patient relationship, and our expectations about being truthful about what’s going on and about getting informed consent should give us pause about deception,” said Dr. Miller, director of the research ethics program in the department of bioethics at the National Institutes of Health.

Dr. William Schreiber, an internist in Louisville, Ky., at first said in an interview that he did not believe the survey’s results, because, he said, few doctors he knows routinely prescribe placebos.

But when asked how he treated fibromyalgia or other conditions that many doctors suspect are largely psychosomatic, Dr. Schreiber changed his mind. “The problem is that most of those people are very difficult patients, and it’s a whole lot easier to give them something like a big dose of Aleve,” he said. “Is that a placebo treatment? Depending on how you define it, I guess it is.”

But antibiotics and sedatives are not placebos, he said.

[Fire_Medic_Dave]

12. Long term use of high doses of NSAIDs is definitely unhealthy and violates the hippocratic oath.

Wonderful quote though. So he doesn't think it's real so then it's okay to lie to patients. I had a family practice doc tell me he didn't believe in depression so he didn't prescribe those drugs. Besides the anti-inflammatory effect of Aleve, couldn't possibly have a positive effect on someone with undiagnosed inflammatory disease of some kind could it. Sorry the guy you quoted was either done a horrible diservice by the writer or he is a biased jerk with no business practicing medicine. At least he's right when he says that antibiotics, sedatives aren't placebos. In this study 67% of the placebos were either antibiotics, sedatives or painkillers. That should put this study in the proper perspective.

David

[strategery blunder]

7. If a doctor is going to willingly prescribe placebos,

then the doctor should pay for it.

Now I guess I'm going to have to bluntly ask that question whenever I am prescribed medicine...because I will not pay for shit that will not work. Doctors may not think they're breaking the "Do no harm" bit of the Hippocratic Oath, but every time they prescribe something they believe will have no effect other than the "placebo" effect, they are doing harm to the patient's wallet.

If they want to prescribe placebos, they should have "free drug samples" of sugar pills to hand out for that purpose.

[question everything]

13. If the placebo was instead of antibiotics to treat a viral infection

like the common cold, then these doctors provided a huge service to all of us.

In the past 30 years, or so, we have seen the proliferation of antibiotic resistance bacteria that appeared as a result of over using antibiotics.