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Most UK GPs Have Prescribed Placebos
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."
antibiotic treatments used as placebos for vial infections
I'm sorry but a medical professional should flat out know better.
It's the UK, a similar but different culture where talking to a lawyer is often the last resort, not the first.
And did you exchange a walk on part in the war for a lead role in a cage? - Pink Floyd.
Windows 8.
ever tried to get rid of a vial? only way is to crush it and then it's no longer a viable for being a vial.
boiling doesn't work. radiating doesn't work. antibiotics don't work. hell, once I tried sulfuric acid and it had no effect!
world was created 5 seconds before this post as it is.
While antibiotics won't stop a viral infection, one thing they can help with when infected is to prevent other infections. For instance, a bad viral lung infection might be treated with antibiotics to prevent an opportunistic bacterium like pneumonia from attacking.
And yeah, pharmacies used to carry placebos. When I worked in a pharmacy long ago, I did indeed dispense them. It was labelled with the chemical name (sucrose, lactose 50mg, etc), but may have been given unlabelled as a unit dose.
The point here is that antibiotics won't do anything for a viral illness - but patients will demand antibiotics for anything and everything until they are blue in the face, many don't accept that the "wonder drug" class of antibiotics won't actually do anything for them.
My wife is a GP, and we literally just had this conversation :) GPs in the UK get 8 minutes with each patient, they can't afford to spend it arguing with the patient, so they issue antibiotics which have already lost their effectiveness due to prior overuse - we aren't talking about threatening working antibiotics.
It's a placebo in the context of the problem space, as it has no effect on it.
"To any truly impartial person, it would be obvious that I am right."
The British National Health service runs entire hospitals dedicated to placebo treatment.
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.
A family friend, an old and wise ear, nose and throat doctor, mentioned at a dinner party, that about 25% of his patients had an emotional problem, not a physical one. He lamented that younger doctors did not take time to ask patients questions about how their life, family and job status were going. The younger doctors would just try to prescribe pills too quickly, and refer the patient to a specialist, like himself. A neurologist and another doctor at the table agreed.
Of course, now many doctors have time constraints for patient visits imposed by insurance companies. So prescribing a placebo is the easier choice than really talking to the patients, and dealing with more paperwork, for an extended consultation.
That was in the US; I don't know how that is in the UK.
Schroedinger's Brexit: The UK is both in and out of the EU at the same time!
On the flip-side, many people know that a cold will go away in n days with bed rest, but they're employer requires a "note from mom" after n-x days. Once at the doctors they'll usually think, "Well, I'm here, might as well get something for this headache/sniffle/uncontrollable-drool" and flash their blood-shot puppy eyes and whimper until the doctor gives them treats.
"I propose we leave math to the machines and go play outside" -- Calvin
The major issue is that people as a rule are lazy so expect a simple quick fix to all their problems in life.
Illness, pop a pill
Fat, gastric band
etc, etc
As a previous poster mentioned most problems that a GP comes across will be fought and fixed by your body with a little assistance of paracetamol or ibuprofen to keep down temps.
We have become too reliant on an easy fix and need to return to eating properly, exercising and not being too clean.....
Build up your natural ability to fight illness, only go to a GP when you have a serious problem. The NHS generates this lazy reliance on the GP for everything!!
Being Mutual - Working together for a better society
Prescribing a placebo can heal the patient. How is that unethical?
There's strong research backing this, btw.
This is not fraud. The placebo-effect is very real.
http://en.wikipedia.org/wiki/Placebo#Placebo_effect_and_the_brain
In fact, the use of placebos in controlled studies may even harm their outcome due to this placebo effect. A good controlled medicine-effectiveness study should therefore consist of at 3 groups: one getting the drug, one getting the placebo and one getting nothing at all.
0x or or snor perron?!
As a physician, I agree.
The problem is that we are now subject to an "objective" review, where the MBA CEO's of hospitals and health care systems have to measure and quantify everything. The problem is this is not a normal customer-seller relationship....this is more like going to the lawyer for advice (Gawd, did I just compare physicians to lawyers????), you are seeking "expert advice" and when it may not be what you want or expect, a rift develops. The physician (rarely) denies something because they are being a jerk, they are (usually) doing it in the patient's best interest. However, with the need to maximize your PG scores, people are acquiescing. Yes, I know this is not a new problem and pre-dates the PG score, but this is a perfect example of "market forces" in medicine, and why people who think medicine is a business like manufacturing cars are dead wrong....it IS a business, but unlike just about any other out there.
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
It's because it is what the patient expects and not delivering that is damaging to the doctor/patient relationship. In the long run that damage can have a catastrophic impact on the patient's health.
That's incredibly short sighted. By prescribing unneeded anti-biotics you are encouraging anti-biotic resistance which in the long term can damage the health not only your patient but also of millions of others. Not only that but you risk damaging the doctor-patient relationship irretrievably because you are effectively lying to the patient that they need a treatment which they do not. If they ever find out not only have you destroyed that relationship but, if I was the patient, I'd report you to the relevant authorities.
I know that patients can be a really insistent at times - my dad was a GP - but his attitude was that he would never prescribe unneeded anti-biotics and if the patient didn't like that they could find another doctor. Speaking as a patient I'd much, much rather have a competent doctor who's primary concern is my health and not whether he might hurt my feelings by telling me I don't need a treatment. It might be irritating at the time but, as long as the decision is correct, over time those correct decisions will build trust which is a far stronger foundation for a relationship than unnecessary treatments.