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Half of American Doctors Often Prescribe Placebos
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."
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
"Hi. This is my friend, Jack Shit, and you don't know him." - Lord Kano
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?
May the Maths Be with you!
Antibiotics shouldn't be prescribed all willy-nilly. It just helps in the creation of super bugs.
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.
As the article points out, prescribing e.g. antibiotics is not truly placebo (something totally inert). Rather, they are looking for the placebo effect by prescribing something that's a real drug but not expected to help with the ailment in question.
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.
If placebos didn't work, then doctors wouldn't prescribe them. I guess the better question is how can we give people placebos without them realizing it's a placebo? I don't personally agree with giving out antibiotics as placebos. The trick is, with the internet, deceiving your patients is getting pretty hard.
It occurs to me that killing half of all doctors might have unpleasant consequences for society.
Vasectomies don't really make your little guys stop running around, they just make you think they're not supposed to anymore.
"Most people, I think, don't even know what a rootkit is, so why should they care about it?"
How can doctors get away with this?
Posting anonymously because this is kinda embarrassing, but I have suffered a bout of hypochondria recently. I'm not the type of person who runs to the doctor with every illness, and I have, in fact, gone for 5-6 years without doctor's visits (I'm in my mid-20's and in pretty good health, so I feel I can skip the check-ups).
Well, this all changed when I got some abdominal pains. Went to the doctor, he ran tests for the dangerous stuff, nothing was found. Then he ran tests for the more common stuff, nothing was found. He sent me home with instructions to wait a week to see if it got better, or to return earlier if it got worse. Naturally I got pissed off, because I was still in pain, and felt like I needed to do some research to see what it could be. I hit webmd.com
Fucking bad idea. As I found symptoms that matched mind, and read about the additional symptoms that came with the diseases, I actually started feeling the new symptoms. So I went back to the doctor with them. More tests were made, nothing was found, I would do more 'net research, start getting worse with new symptoms again, go back to the doctor run more tests, find nothing again. Eventually I realized what was happening, and calmed the fuck down. All the symptoms disappeared within a week, but not before I spent a few thousand dollars in deductibles and went through the literal pain in the ass of a colonoscopy as a 20-something year-old for no reason whatsoever.
This type of hypochondria is something medical students go through, and is something you can expect more of the general population to go through now that we all have access to things like webmd.
So when you show up at a doctor's office, and the doctor eliminated the possibility that you need urgent medical attention, and can't find anything wrong with you...there's some value to the patient in just prescribing a cheap placebo and calming him down.
Placebo(TM): the name trusted by half of America's doctors! Ask your doctor if Placebo(TM) is right for you.
I hear there is a pill for that now.
How about honesty and good bedside manner?
When drug manufacturers stop spending millions on advertising campaigns to convince patients that the latest and greatest drug (which is really exactly the same as the generic but with added ibuprofen or whatever) is essential, doctors might start getting honest information from their patients about what they really need.
About fifteen years ago, looking at med school as an option, I did work experience with a doctor. It was cold season. 95% of his patients were there because they had little more than a cold and a desire to stay home from work. He told me to watch. For the first five minutes he would do everything in his power to just give them the treatment they really needed. After that, if not satisfied, he'd write them a prescription for exactly the same thing but with a more impressive name, that they'd have to buy over the counter, that would cost them twice as much as the off the shelf for exactly the same thing.
The first five minutes they were pissed. What did he mean, he didn't think they needed a prescription?! That off the shelf drug couldn't possibly help someone as sick as them. They were angry. They were outraged.
Then he agreed with them, admitted he was wrong, that he'd underestimated and was going to write them a prescription for a new drug that's just come on to the market. With an impressive new name, essentially a reformulation of what he'd been trying to give them, they left happy.
Honesty and a good bedside manner are worth slightly less than zero when people are bombarded by dozens of commercials a day telling them how only the drug with the obviously happier people, with the cool smiling bumble bee, and the blisteringly fast side-effects in 0.001 point text can really make everything OK.
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.
[Fuck Beta]
o0t!
Nah, just a little bit off the top.
First of all, they polled internist and Rheumatologists, many of whom were treating patients with fibromyalgia. Rheumatologists often wind up treating patients that no one can figure out why they "hurt", and thus often get patients with psychosomatic illnesses. Fibromyalgia is a diagnosis that patients state they hurt in many different places in their body, and no test, MRI or CT scan can show anything wrong. These patients often have depression, and the problem is usually best treated with anti-depressant type medications.
So the population of doctors sampled in this study is not typical at all of a normal population of doctors anyway.
"Headache"pills, or anti-inflamatories, are quite useful in relieving body aches and pains, and to call them a placebo is just plain wrong. Just go tell the patient with bad bone on bone osteoarthritis that the pill really doesn't do anything, and see how wrong you are. They really work very well.
Surgeons often do peer review their procedures - at least orthopaedic ones The journals are filled with articals every month describing how well, or how poorly a technique works.
..........FULL STOP.