Half of doctors routinely prescribe placebos
 

http://www.nytimes.com/2008/10/24/he...tml?ref=health

What does everyone think about this? I have my thoughts, but I'm curious to hear the patient side.

I think this makes you quacks history's greatest monsters.

P.S. I have no problem with this. Whole lotta self-diagnosis and hypochondria going on out there.

I don't see this as something to worry about. If the patient feels that the treatment is sufficient, I say go for it.

I agree with landpoke in that there seems to be a lot of hypochondria out there.

Exactly. I have a hard time believing a doctor would ever prescribe a placebo for any serious illness. It's those high-maintenance patients that feel like they need something for everything that are getting placebos. It's better than giving them expensive and sometimes dangerous workups, and they're not going to accept the explanation that we're giving them a placebo and they'll get better just as quickly.

Here's a little trickier example for you, though. There are multiple studies that show no advantage to taking an antibiotic over placebo for bronchitis. Similar studies exist for sinusitis. Yet there certainly is a placebo effect, meaning that patients who take SOMETHING get better than not taking anything at all. This one's tricky, because there are occasional serious side effects that occur from antibiotics.

My father in law is a doctor and he has vented on a couple of occasions about times that no matter what he did or said some of his patients insisted that they had something wrong with them and wouldn't leave his office until something was done. He never revealed any info more than that or told me what the end result was but I could tell how frustrated he has gotten with patients insisting on some sort of treatment. There are some real whack jobs out there.

I would also think that addiction comes into play somehow.

The numbers of people addicted to prescription drugs leads desperate people to many Doctors offices for any little "sniffle" or "ache" trying to get their fix.

And some Doctors either not wanting to be a part of it or just wanting to get them out of the office prescribe the placebo.

Not all drugs are physiologically dependency creating. Some are only psychologically so.

how exactly do you prescribe a placebo?

If they mean prescribing an antibiotic when you are 99% sure the patient just has a viral infection, then I'm sure a lot of MDs prescribe placebos in that sense. I guess when you know it's not likely to have any effect, it is basically a placebo. But I don't ever lie to patients -- I would tell them it was not likely to work.

I saw a Lutheran Priest in a Minnesota urgent care several years ago who got laryngitis 3 days before Easter Sunday. He demanded an antibiotic. I told him antibiotics don't work for laryngitis -- it's a viral illness. He insisted that if I didn't give him an antibiotic he wouldn't be able to preach his sermon on Easter Sunday and it would be a disaster for his church. He asked me where I was from and figured out I was LDS. Then he thought I was holding back on giving him medication for religious reasons. I finally relented and gave him an antibiotic prescription while telling him it wasn't going to work. But as I think about that I don't consider that using a placebo because I didn't pretend like I thought it would work. I didn't lie to him.

A lot of docs use IV Toradol as basically a placebo for pain relief in the ER. It has the same pain relieving ability as ibuprofen, but because it is an IV medication, patients think they're getting the really good stuff. I've used that trick a lot. Again, I'm not sure it's a placebo because it is an active pain medication, just not the narcotic that patients are thinking they are getting.

It really depends on how you define a placebo. I imagine that very few doctors actually give a sugar pill and tell the patients it's an active medication. I don't even know how you could arrange that -- maybe give people gummy bears or something?