Half of American Doctors Often Prescribe Placebos 238
damn_registrars writes "'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 just quoted goes on to say that the drugs most often used as placebo are headache pills, vitamins, and antibiotics. Studies on doctors in Europe and New Zealand have found similar results."
Unfortunately, they have to. (Score:5, Insightful)
I have friends and relatives who get the Flu and run off to the doctor to get a prescription. I try to explain, that antibiotics won't help a viral infection but people just want to take a pill. It doesn't cost me any money for my time when I'm talking about it with them, but for a doctor time is money. He can lose money and potentially go out of business because every asshole who walks through the door wants or needs pills to feel better or he can just give them placebo and get on with his day.
LK
Ethical Challenges Remain (Score:5, Insightful)
So sayeth the article. But I ask you, do the ethical challenges concern doctors fobbing patients off with placebos, or the existence of an environment where a doctor is afraid or unable to legitimately tell hypochondriacs that they are not sick and send them home?
this pisses me off (Score:5, Insightful)
Antibiotics shouldn't be prescribed all willy-nilly. It just helps in the creation of super bugs.
Antibiotics?!? (Score:5, Insightful)
For the love of non-antibiotic resistant tuberculosis, WHO are these doctors STILL giving out antibiotics when they don't need to? Is it not illegal for a doctor to prescribe medicine when it's not needed, and WHY AREN'T WE PUTTING THEM IN JAIL when they give out antibiotics for the cold etc? I know it must get annoying to deal with idiots asking for drugs they don't need, but that's your damn job, it's even more annoying if you get infected with superbugs you're making. Tell your patients that a spoonfull of sugar will cure them in aproximately 1 week if you absolutely need to give them something.
Seriously, it should be a felony to be giving out antibiotics when they're not needed.
Re:this pisses me off (Score:5, Insightful)
How can doctors get away with this?
They're "getting away" with it because frequently it's in the best interest of their patients.
With the cost of medicine, how dare they make people go out and buy something they don't need.
They don't *make* people go out and do anything.
Most likely, people go to the doctor and expect to walk away with a prescription. The doctor has two choices:
1. give them a placebo, and tell them what to do to really fix the problem (bed rest or more exercise, as applicable to the situation.)
2. explain to them that a pill won't fix anything, and what they need to do to fix the problem.
If the doctor tells them 1, the patient walks away happy.
If the doctor tells them 2, the patient resents the doctor and ignores the advice about what to do to really get healthy.
How about honesty and good bedside manner?
Honesty and good bedside manner don't go very far when people are told by big pharmaceutical companies that there is a pill to cure everything.
Re:this pisses me off (Score:5, Insightful)
Re:Jail is geting off easy... (Score:5, Insightful)
It occurs to me that killing half of all doctors might have unpleasant consequences for society.
Re:Ethical Challenges Remain (Score:3, Insightful)
Part of the problem is that hypochondriacs will simply find another doctor who will give them what they "need".
Re:So? (Score:3, Insightful)
Placebos have been proven to do good for a long time. So much that they must take the placebo effect into account when pharmaceutical companies want to test new products in order to make sure their new medicine is NOT simply a placebo.
What they do is that they compare the new drug being developped to a fake drug that has no effects. So, one group of testers take the real pills, the other group takes the fake pills. Of course, nobody knows if their own pill is real.
So if the new drug is having better health benefits than a placebo, the new drug is accepted and made into an official medicine.
If the placebo effect wasn't known to be effective, they would simply compare the effect of their new drug to a group that wouldn't be taking anything.
Re:this pisses me off (Score:5, Insightful)
Antibiotics shouldn't be prescribed all willy-nilly. It just helps in the creation of super bugs.
Depending on age, 14% to 30% of patients either skip doses or do not finish their regimen of antibiotics.
That is much more worrisome than the over prescription of antibiotics, because when someone sick doesn't finish their meds, you know that whatever is leftover gets stronger.
Placebo should be the preferred treatment. (Score:1, Insightful)
Most likely, people go to the doctor and expect to walk away with a prescription. The doctor has two choices:
1. give them a placebo, and tell them what to do to really fix the problem (bed rest or more exercise, as applicable to the situation.)
But the trouble is they are not giving them a placebo at all, they giving drugs. Most often they are giving anti-biotics to cure a flu. While the effect might be a placebo, the actual drug has a high level of toxicity.
What should be allowed if for doctors to prescribe sugar-pills marketed under a fancy name, or perhaps homeopathic remedies (ie water). Yes it might be deceptive, but the very best cure is a placebo cure effected with a non active agent. The patient both gets cured and their exposure to toxicity is minimized.
Re:Unfortunately, they have to. (Score:2, Insightful)
Of course this is 100% bullshit. If you don't have a cure - just tell them so. No deception is necessary.
Modern medicine in USA is becoming shamanism. Too much uncontrolled power that people believe. No wonder medicine on Cuba is better than that of the USA.
Re:Unfortunately, they have to. (Score:4, Insightful)
No, they don't have to, they choose to. If all the doctors took the hard line when it came to not doing the things you suggested, then it wouldn't be a problem. Any doctor who is prescribing medication when they know it's unnecessary and potentially harmful because they want more business shouldn't be practicing.
Re:Many surgical provedures are placebos. (Score:3, Insightful)
The only time it is ethical to conduct a randomized controlled trial is when the outcome's risk or benefit is so unclear as to merit randomization.
To even run such a trial on cataract surgery vs placebo would be impossible due to the immediate and enormous differences between actual treatment and placebo; it may well be unethical, too.
Re:Many surgical provedures are placebos. (Score:3, Insightful)
I'm aware that anecdotes do not constitute evidence. But there's an enormous difference between taking some homeopathic remedy and "feeling better" (meanwhile thousands take them and feel nothing) and having a large and immediate success rate with something like lens replacement surgery for cataracts. Cataracts do not get better by themselves, not even with a placebo. Surgery to replace the clouded lens produces rapid and highly effective results.
To my mind, what you're saying is essentially like saying that the sun rising in the East because of the Earth's rotation is scientifically unproven because nobody has ever tried stopping the Earth's rotation to see if it actually changes anything.
I'll certainly grant that surgical procedures should be tested for validity and that there are some which do not have the desired effect or a success rate to justify performing them. But most surgeries correct blatantly obvious mechanical defects. Has anyone ever performed a scientific study on the effectiveness of replacing a worn-out car transmission? Have you ever doubted that a transmission replacement is effective when it's clear that the original transmission is broken?