Most UK GPs Have Prescribed Placebos 240
Techmeology writes "In a survey of UK GPs, 97% said they'd recommended placebo treatments to their patients, with some doctors telling patients that the treatment had helped others without telling them that it was a placebo. While some doctors admitted to using a sugar pill or saline injection, some of the placebos offered had side effects such as antibiotic treatments used as placebos for viral infections."
Re:Antibiotic Placebo? (Score:5, Insightful)
I agree; using antibiotics where they aren't needed is despicable.
Not a Placebo (Score:2, Insightful)
Re:Is this reflected in your medical records? (Score:5, Insightful)
Placebo Effect (Score:2, Insightful)
Re:Antibiotic Placebo? (Score:5, Insightful)
I agree. This happened to me before, but it was an ear infection and I guess the doctor didn't know if it was viral or bacterial, so maybe he was just using a "shotgun technique".
Yes. I doubt that doctors are insincerely prescribing antibiotics as placebos. I expect it is more of a case of not being able to fully rule out a bacterial infection so they prescribe the anti-biotics to cover all their bases and to help the patient feel like their problems are being taken seriously.
My guess -- it is most common with ear infections for kids (which are the most common reason kids to go to the doctor). Societal pressure on mothers nowadays is super intense - it is hard for a mom to accept doing nothing but wait for the viral infection to run its course when their kid is crying all the time. And since a minority of ear infections really are bacterial, but testing for the type of infection is difficult, the doctor prescribes a mild anti-biotic (usually amoxicillin). That makes mom feel like she's done everything she can for her kid and if it really was bacterial it actually helps, if it wasn't bacterial the side-effects are rare and mild so the risk of making the kid worse is tiny. It is a win-win except for the long-term affect on rates of anti-biotic resistance.
I say this having seen my sister, a recent mother go through this stuff. Before the kid was born she was super on board with all the free-range kids type stuff, but once that baby popped out and she had to experience it first hand, it was a different story. To her credit she's been able to back off the helicopter type stuff as unavoidable accidents have happened and she saw that the kid came out fine. But the pressure from society to be a perfect mom teams up with those mom hormones and long-term thinking tends to be the loser. She still hasn't given the kid peanut butter, she's waiting to do it when she's in the lobby of the pediatrician's office - and now the research is starting to suggest the longer you wait to expose them, the more likely the kid is to develop a peanut allergy...
Re:Antibiotic Placebo? (Score:3, Insightful)
Of course they know better.
It's that they choose to do it so it makes it easier to deal with patients.
The irony of professional regulation is that we restrict medical professionals, grant them monopolies, impose excess educational requirements... and then it turns out most of them don't practice to that level.
Sure your family doctor might theoretically be better than say a nurse practitioner, but most barely spend any time with you to actually be better (at least in Canada).
Sure theoretically, they are guardians of the medical system, but they will prescribe antibiotics when not needed, sign fraudulent sick/massage forms...
The same goes for lawyers, engineers....
Once in a while, one is held accountable, but in general there's enough power in place to make sure it doesn't happen all that often.
Re:Antibiotic Placebo? (Score:4, Insightful)
It's both of those things.
Re:Fraud (Score:5, Insightful)
Here's the rub. A lot of people show up at the doctor for things which will take n days to go away - with or without treatment. The common cold, for example. They won't accept NOT getting any prescription and will hop from doctor to doctor until they get one.
Now the best thing would be educating the public about this issue. This is very, very hard to do. Barring that, it is actually better for the patients and cheaper to just prescribe placebos - they DO work in this case! (up to the placebo effect, as any other medicine would).
Unfortunately there is another issue involved: Most placebos (at least in Germany) are homeopatic. This lends credibility to the whole homeopatic industry, and THEY are nothing but quacks. And THAT is a bad thing.
So - either way you lose.
Re:Antibiotic Placebo? (Score:5, Insightful)
No qualified doctor should be prescribing medication just because a patient "demands" it. That would be both a fundamental failure of their duty of care to the patient and an abuse of their authority to legally prescribe controlled substances.
All of this goes double for antibiotics, because there is a real danger of overuse combined with people's tendency not to complete full courses of treatment contributing to the development of resistant strains like MRSA.
Re:Antibiotic Placebo? (Score:5, Insightful)
As a European I was horrified to see that prescription medicines are routinely and frequently advertised on television in the USA instructing the viewer to ask their doctor to prescribe the medicine.
Re:Antibiotic Placebo? (Score:5, Insightful)
As a European I was horrified to see that prescription medicines are routinely and frequently advertised on television in the USA instructing the viewer to ask their doctor to prescribe the medicine.
As an American I am equally horrified. Advertising by big pharma companies is one of the reasons medications are so expensive here. Also, I can't imagine telling a doctor what to prescribe. If he/she doesn't know already, then I'm going to the wrong doctor.
I'd bet that 25% is actually 0%. (Score:2, Insightful)
I'd bet that 25% is actually 0%.
Psychology got its start from a doctor who found a cure for some particular illness, but found that only about half of his patients responded to the cure and improved. So what did he take from this? Was his cure only effective half of the time? Did the other patients actually have some other illness that simply had the same symptoms? No, nothing like that. Instead, he assumed, there was actually nothing wrong with the patients at all, and it was all psychological.
Of course, science eventually figured out that the remaining 50% actually were ill, but by then the "science" of psychology had already been created. No longer did doctors have to deal with patients with problems they could not diagnose. Instead, if they couldn't figure out what was wrong, then indeed nothing was wrong. Suddenly every doctor could be a super-doctor who was never stumped by any case. Instead, the only thing that varies between doctors now is the percentage of their patients with psychological problems.
I got to deal with this a few years ago.
One day I get this sudden sharp pain between my thorax and my abdomen. So I go to the hospital, and an hour later when they finally get around to seeing me, the pain has disappeared. Fearful of a large hospital bill, after a previous encounter with the hospital in which they padded the bill with every test they could think of, only to come up with nothing, I elect to leave immediately.
However, I return in a few days with the same problem. Again, after waiting an hour to see a doctor, the problem has gone away, but I stay this time in order to see what they can figure out. They ask some questions, poke at me a bit, then one of the doctors spots on my chart that when I was in the hospital a decade earlier I was on an antidepressants and an antipsychotic. Then they conclude that I probably just had heartburn and overreacted, and recommend antacids, even though, not being a moron, I tried them both times the problem occurred and they had no effect whatsoever.
I return a few days later, and again, wait an hour to see a doctor (yes, this is the emergency room I'm talking about) who looks at my chart and concludes that I have really bad heartburn. They mention that they might have to run a scope down my throat at some point, but for the time being, just prescribe some more medications.
I return a few days later, and again, wait an hour to see a doctor, who again, looks at my chart and comes to the same conclusion, tells me to keep taking the medications, and sends me on my way.
I return a few days later, and again, wait an hour. Again, problem goes away, and I just get up and leave since there's essentially no point in staying.
I return a few days later, but this time just pace around the hospital debating whether or not I should even bother to check in. After an hour passes, the pain goes away, and I leave.
A few days later, it happens again, but this time far worse than before. I immediately get someone to drive me to the hospital again, and along the way feel as if my abdomen is about to explode. I vomit on the way to the ER examination room. There I lie on a bed, screaming from the pain, for half an hour, until it finally ceases. I then lie for another half an hour, so weak and exhausted from the intense muscle contractions of my body attempting to deal with the problem that I can barely roll myself over when I feel the need to move.
Finally a doctor comes to examine me, and in doing so, pressing on my abdomen in random places, finds that at one point it actually hurts, but not when he presses, but rather, when he releases. This gets his attention enough that he orders a CT scan, at which point they discover that the problem is gall stones. Apparently there's some blood test for the body's reaction to gall stones for which I'd later just about set a record.
So why did I have to wait until the things just about killed me to get a diagnosis? Well, the doctors clearly suspected gall
Re:Antibiotic Placebo? (Score:5, Insightful)
The problem isn't that antibiotics are used in animal husbandry. I have no problem with a vet prescribing antibiotics to save a sick cow or horse. Treat the cow the same way you would a human and it will be fine in a few days. The problem occurs when they chronically give antibiotics to a lot of animals that aren't sick. First, that's abuse of the drugs and the animals. Second, it doesn't kill off all the bacteria. It just gives a slight advantage to bacteria that are more resistant, thus creating the selection pressure to create resistant strains. Third, the antibiotics get in the milk and meat so resistant bacteria grow in that.
The law should say: (1) you can't give antibiotics to animals that are not sick (2) you can't sell edible animal products from animals that have been treated with antibiotics until after a waiting period (e.g. 10 days) to ensure that the antibiotics have cleared from their systems. (There would have to be randomized testing of products to enforce this.) (3) FDA clearance should be required to use drugs in animals at all and it wouldn't be given for classes of drugs that are needed to fight otherwise-resistant strains in humans.