Placebos Please

From WebMD...

50% of Doctors Prescribe Placebos
by Daniel J. DeNoon

Some excerpts and highlights...

"More than half of doctors offer fake prescriptions to make patients feel better -- and that's OK, most doctors say."

"The hard-to-accept truth is that doctors don't have proven treatments for many of the ills that plague their patients."

• British Medical Journal study based on a survey of 679 internists and rheumatologists, specialties where patients with chronic illnesses may not have a cure.

• Sometimes placebos, or inactive medicines, make such patients feel better. Placebos harness the body's psychological mechanisms, i.e. the power of suggestion the medicine will help.

• More than 2/3 of the doctors told patients they were getting "medicine not typically used for your condition but which might benefit you."

Doctors can't write a prescription for a placebo; they can only prescribe an active medicine. Every active medicine carries some risk. Doctors will write for a medicine that should have less of a risk than the benefit of the hoped-for placebo effect. Baby aspirin, for instance.

"'What you can use as a placebo is complicated. I have seen people dispensing antibiotics as placebo for mothers who want something for their kids' flu,' [University of Pennsylvania medical ethicist Arthur] Caplan says. 'Not only does this not help, but it does build up drug resistance and may have some serious side effects for the child.'"

(Read the whole WebMD article at http://www.webmd.com/news/20081023/50percent-of-doctors-give-fake-prescriptions. Read the BMJ study abstract at http://www.bmj.com/cgi/content/short/337/oct23_2/a1938.)

The headline implies doctors are maliciously misleading patients, which is not my take on what's happening.

Patients desperately want help. Patients desperately want to DO something. Doctors are doing what they can to help. As long as they disclose that it's a medicine that may not alter the disease process but might offer some help to the patient, they are not misleading.

The placebo effect is a powerful thing. Studies have shown people with pain, depression, some heart ailments, gastric ulcers and other stomach complaints can respond to placebos. And about one third of the population is susceptible to placebo effects. Unfortunately, placebo effects eventually wear off. But think how much money we would save on drugs if we knew how to harness placebos consistently to make ourselves better.