Survey: Half Of U.S. Doctors Give Placebos

Physicians Report Giving Vitamins Or Other Drugs They Know Won’t Help Without Telling Patients

(CBS/AP)  About half of respondents in a new survey of American internists and rheumatologists say they regularly give patients placebo treatments - usually drugs or vitamins that won't really help their condition.

And many of these doctors are not honest with their patients about what they are doing, the survey found.

That contradicts advice from the American Medical Association, which recommends doctors use treatments with the full knowledge of their patients.

Dr. Ezekiel Emanuel, co-author of the study and chairman of the Department of Bioethics at the National Institutes of Health, said he was surprised by the findings.

"It was a lot more common than I had expected," he told The Early Show anchor Harry Smith."

But Emanuel says doctors are not simply giving their patients sugar pills. "You can't write a prescription for a sugar pill," he said, "but usually they are giving something else. Typically, it's a vitamin or a nonsteroidal anti-inflammatory drug, sort of a painkiller. One of the more disturbing things, [in] not too small a percentage of cases, it's an antibiotic or sedative and that is worrisome."

"Is it ethical?" Smith asked.

"The AMA says unless you tell the patient about it, it's not ethical and that is, I think, the heart of the issue, the sort of deception."

"It's a disturbing finding," said Franklin G. Miller, director of the research ethics program at the U.S. National Institutes Health and another of the study's authors. "There is an element of deception here which is contrary to the principle of informed consent."

The study was being published online in Friday's issue of BMJ (formerly the British Medical Journal).

Placebos as defined in the survey went beyond the typical sugar pill commonly used in medical studies; a placebo was any treatment that wouldn't necessarily help the patient.

Scientists have long known of the "placebo effect," in which patients given a fake or ineffective treatment often improve anyway, simply because they expected to get better.

"Doctors may be under a lot of pressure to help their patients, but this is not an acceptable shortcut," said Irving Kirsch, a professor of psychology at the University of Hull in Britain who has studied the use of placebos.

Emanuel told Smith there are a variety of reasons why a doctor would offer a placebo. "One of the reasons may, in fact, be that nothing has worked for this patient. Both the doctor and patient want something to work and so we're going to try something and just basically do an experiment. Sometimes, it may be a difficult patient who they are not getting along with and think the best way to express that they are treating them is to give them something."

Emanuel says a more worrisome reason would be for a doctor to simply get a patient out of their office, but he warned that is not entirely the doctor's fault. "A lot of times I think we, in the public, think we're getting good care if we get something when we go out of office, so it's a bit of a conspiracy on both sides."

Researchers at the NIH sent surveys to a random sample of 1,200 internists and rheumatologists - doctors who treat arthritis and other joint problems. They received 679 responses. Of those doctors, 62 percent believed that using a placebo treatment was ethically acceptable.

Half the doctors reported using placebos several times a month, nearly 70 percent of those described the treatment to their patients as "a potentially beneficial medicine not typically used for your condition." Only 5 percent of doctors explicitly called it a placebo treatment.

Most doctors used actual medicines as a placebo treatment: 41 percent used painkillers, 38 percent used vitamins, 13 percent used antibiotics, 13 percent used sedatives, 3 percent used saline injections, and 2 percent used sugar pills.

In the survey, doctors were asked if they would recommend a sugar pill for patients with chronic pain if it had been shown to be more effective than no treatment. Nearly 60 percent said they would.

Smaller studies done elsewhere, including Britain, Denmark and Sweden, have found similar results.

Jon Tilburt, the lead author of the U.S. study, who is with NIH's bioethics department, said he believes the doctors surveyed were representative of internists and rheumatologists across the U.S. No statistical work was done to establish whether the survey results would apply to other medical specialists, such as pediatricians or surgeons.

The research was paid for by NIH's bioethics department and the National Center for Complementary and Alternative Medicine.

The authors said most doctors probably reasoned that doing something was better than doing nothing.

In some cases, placebos were given to patients with conditions such as chronic fatigue syndrome. Doctors also gave antibiotics to patients with viral bronchitis, knowing full well that a virus is impervious to antibiotics, which fight bacteria. Experts believe overuse of antibiotics promotes the development of drug-resistant strains of bacteria.

Some doctors believe placebos are a good treatment in certain situations, as long as patients are told what they are being given. Dr. Walter Brown, a professor of psychiatry at Brown and Tufts universities, said people with insomnia, depression or high blood pressure often respond well to placebo treatments.

"You could tell those patients that this is something that doesn't have any medicine in it but has been shown to work in people with your condition," he suggested.

However, experts don't know if the placebo effect would be undermined if patients were explicitly told they were getting a dummy pill.

Brown said that while he hasn't prescribed sugar pills, he has given people with anxiety problems pills that had extremely low doses of medication. "The dose was so low that whatever effect the patients were getting was probably a placebo effect," he said.

Kirsch, the psychologist, said it might be possible to get the psychological impact without using a fake pill. "If doctors just spent more time with their patients so they felt more reassured, that might help," he said.

Some patients who had just seen their doctors at a clinic in London said the truth was paramount.

"I would feel very cheated if I was given a placebo," said Ruth Schachter, an 86-year-old Londoner with skin cancer. "I like to have my eyes wide open, even if it's bad news," she said. "If I'm given something without being warned what it is, I certainly would not trust the doctor again."

[palin08o8]

You know what I changed my mind about Obama! I think he will be better for national security and the economy!

Plus sarah palin $150,000.00 on clothes, most Americans could have bought a home for that amount!

Besides I think Sarah Palin is really a Terrorist

Breaking News: The Terrorist Group AKA Alaska Independent party Calling on Russia to help secede from the Union
www.chilitoz.com
Extremists Mark Chryson and Steve Stoll former leaders of the Alaska Terrorist group AKA Independence Party and friends of Sarah Palin are calling on Russia to help them gain independence from the United States.

Watch video of Sarah palin addressing The Alaska Terrorist Group also known as The Independence party. They are calling for a civil war against the mainland.
www.chilitoz.com

[docpeter1953]

Survey: Half Of U.S. Doctors Give Placebos
_______________

And the patient gets better. Makes you wonder about the people complaining about illness.

-----------

From the above article, "Emanuel says a more worrisome reason would be for a doctor to simply get a patient out of their office, but he warned that is not entirely the doctor''s fault. "A lot of times I think we, in the public, think we''re getting good care if we get something when we go out of office, so it''s a bit of a conspiracy on both sides."

____________________

The patient is made happier when they walk out of the Dr. office with that little piece of paper in their hand, they got the "Magic bullet" to cure ll their ills.

[gop_will_win]

This proves half of the people who go to doctors arent really sick.

[docpeter1953]

This proves half of the people who go to doctors arent really sick.

Posted by gop_will_win at 10:59 AM : Oct 24, 2008
---------

This proves that half the doctors aren''''t really doctors.

Posted by Nancy_Naive at 11:05 AM : Oct 24, 2008
________________

Interesting, hmmmmmmmmmm.

From www.meriam-webster.com

Doctor:

Main Entry: 1doc7tor
Pronunciation: %u02C8ddk-t%u0259r
Function: noun
Etymology: Middle English doctour teacher, doctor, from Anglo-French & Medieval Latin; Anglo-French, from Medieval Latin doctor, from Latin, teacher, from doc%u0113re to teach

So ''Doctor'' is defined as ''teacher''.

AND

Physician:



Main Entry: phy7si7cian
Pronunciation: f%u0259-%u02C8zi-sh%u0259n
Function: noun
Etymology: Middle English phisicien, fisicien, from Anglo-French, from phisique medicine
Date: 13th century
1: a person skilled in the art of healing ; specifically : one educated, clinically experienced, and licensed to practice medicine as usually distinguished from surgery
2: one exerting a remedial or salutary influence

So, ''Physician'' is defined as ''healer"''

Just so I can set the record straight, Jesus was both doctor and phsyician.

[credibility2]

No wonder why the so-called wonder drugs never really helped me with my pain post-surgery. This should be illegal. Doctors should be forced to make full disclosure, including whether or not a prescription is a placebo. Then, the patient can rightly refuse the prescription. Why do some posters insist on going off point? Perhaps, their meds are pretend and not doing what they''re supposed?

[tngreen]

As someone who sees a rheumatologist and who lives with constant pain, I find this article both extremely troubling and enlightening. Maybe now I know why I frickin'' hurt all of the time. And all of this time I thought it was the pharmaceutical company cutting the meds with sugar to increase their profits...

[docpeter1953]

Why do some posters insist on going off point? Perhaps, their meds are pretend and not doing what they''''re supposed?

Posted by Credibility2 at 11:38 AM : Oct 24, 2008
______________

Perhaps we are not taking meds, since we recognize they are placebo and we realize we don''t need them.

[docpeter1953]

And all of this time I thought it was the pharmaceutical company cutting the meds with sugar to increase their profits...

Posted by tngreen at 11:40 AM : Oct 24, 2008
________________

Welcom to capitalism comrade, and the great profit margins of Big Pharma.

[Renegade.Rivers]

One would think that after all of these years that the medical profession has been around that their would be other ways of treating people without the use of "placebos." It seems to me that for a doctor to play "head games," with his or her patients would be at the very least cause some ethical questions. For a doctor to give a patient a sense of well being by giving them a "placebo," instead of a real medication, is akin to lying to the patient, hence giving them a false sense of well being.

The question that immediately comes to mind is; after such time when a doctor has given a patient a "placebo," how many times was the patient actually put in harms way, because the patient was given a false sense of well being. Now I realize that their are patients who are "hypochondriacs," and do imagine that they have problems, when in reality they have none, which can lead to actually heath risk, because of their imagined symptoms to an illness. How ever this is a problem created by the mind, and therefore should fall in the realm of treatment by mental health personnel. When this is the case, the doctor it seems to me should refer the patient to mental health personnel, rather than "faking them out."

[Renegade.Rivers]

(Cont)

I would also wonder how many times a patient is considered to be a "hypochondriac," and given a "placebo," when they are in fact suffering from a condition that the doctor has failed to diagnosis correctly. At which time the problem the patient has is exacerbated, causing the patient to suffering a life threating condition or even death.

Another ethical question that this brings about is when in drug studies, one patient is given a "placebo," while the other doctor is given and actually medication, and in the course of the study, the patient who was given the "placebo," dies, while the patient that was given the actual medication lives. Is even one life worth risking for such a study? Also can this be looked upon as an ethical approach to medicine, and patient treatment?

[credibility2]

When doctors prescribe a placebo, do pharmacists automatically charge the rate for the real drug so the patient is fooled into thinking their prescription is legitimate?

[docpeter1953]

When doctors prescribe a placebo, do pharmacists automatically charge the rate for the real drug so the patient is fooled into thinking their prescription is legitimate?

Posted by Credibility2 at 12:22 PM : Oct 24, 2008
_____________

Probably not. Most likely they charge double so the patient thinks "since it cost more it MUST do more good."

Welcome to capitalism.

[cdfoxtrot4]

It says a lot about doctors. Many seem to think they are "God" and refuse to inform patients about what they''re doing or treatment options. And it seems most like to hide behind "patient confidentiality" to the point of not providing test results to the patient, other than baby-talk ("the results are good, you''re good").

[ender18-2009]

This is a testament to the chronic complaints of Americans. In Europe and other countries they do not see the doctor for minor aches, pains and colds. Also they look for solutions other than a quick pill. The bottom line in likely 70% of health issues would resolve with stress reduction, diet, and exercise but this is a very bitter pill to swallow.

[ender18-2009]

I can see there is a lot of anger against physicians. Try working for 36 hours straight 1-2 times a week for several years, and deal the demanding patients all the while trying not to get sued. Its a tough job and the American public does not make it any easire. This is why less than 2% of physicians are going into general care. Soon there will be very few doctors to treat an increasingly aging and demanding population.

[ender18-2009]

I can see there is a lot of anger against physicians. Try working for 36 hours straight 1-2 times a week for several years, and deal the demanding patients all the while trying not to get sued. Its a tough job and the American public does not make it any easire. This is why less than 2% of physicians are going into general care. Soon there will be very few doctors to treat an increasingly aging and demanding population.

[darkfyreaol]

Here''s something you should always consider: For each prescription, always, ALWAYS do your research. Check online databases for the drug you''re about to purchase.

[darkfyreaol]

Oh. And when buying controlled substances like narcotics or tranquilizers, always count the pills at the counter, or ask the pharmacist to count them for you. I was shorted about half my prescription - Vicodin - by about 9 pills (enough to knock out an elephant)..I called my pharmacist, and they heatedly denied miscounting, having done so three times with someone standing by, watching..i called my doctor, and they told me that I wouldn''t need that many anyway, just take Motrin... Yeah, they don''t fight the pharmacies.

[yongamerica]

Anger against Physicians? More like anger against the AMA. The AMA allows physicians to practice medicine during a 36 hour shift. What an asinine kind of policy is that? Then there is the greed factor. At least 75% of physicians chose their career for the money And that''s why so few are going into general practice; because practicing specialized medicine can increase their pay by more than 50%. And this focus on money shows in many doctors poor attitudes and this contributes to their exorbitant amount of mistakes they make. Doctors get "disciplined" when in any other career they''d be fired. And the AMA protects these doctors, that is the worse part of it. Talk about a Guild or Union protecting its ideas of how medicine should be practiced.

[linfinster]

".... Try working for 36 hours straight 1-2 times a week for several years, and deal the demanding patients all the while trying not to get sued. Its a tough job and the American public does not make it any easire... "

Posted by ender18 at 12:58 PM : Oct 24, 2008

YES! That is a BIG, HUGE problem ... the thought of anyone caring for the health and well being after working THAT long is disgusting! It should be illegal and considered GROSS NEGLIGENCE! I cannot understand how we allow that to happen in this day and age.

[dragyn30]

This goes back to the "pink" medicine many of us got as a child when our parents took us to the doctor when we were sick no matter what we had - we always go the pink stuff. What I learned as an adult is that too much antibiotics not only harm your immune system but as a child resulted in poor quality teeth. Amoxicillin (the pink medicine)is a big culprit in poor quality teeth.

I was stupid with my first child until I found a Dr. who was honest enough to say my daughter really did not need an antibiotic as this would go away on its own and he''d mention OTC methods to help with symptoms, he would always offer a script if I wanted one or to have on hand if things changed over the course of a weekend when their office is closed.

I am fortunate to have family doctors who are honest about what treatment is the best. I always ask about medicines I or my family are given even when in the hospital and it is a nurse handing me pills - I tell them I will not take it unless they tell me what it is and what it is foras I have been given medicine that I had a known allergy to because they failed to read my chart!

When getting a new medicine they always start with samples so I do not get burned at the pharmacy if the medicine does not work and with drug allergies they are very careful with my family.

[dragyn30]

This goes back to the "pink" medicine many of us got as a child when our parents took us to the doctor when we were sick no matter what we had - we always go the pink stuff. What I learned as an adult is that too much antibiotics not only harm your immune system but as a child resulted in poor quality teeth. Amoxicillin (the pink medicine)is a big culprit in poor quality teeth.

I was stupid with my first child until I found a Dr. who was honest enough to say my daughter really did not need an antibiotic as this would go away on its own and he''d mention OTC methods to help with symptoms, he would always offer a script if I wanted one or to have on hand if things changed over the course of a weekend when their office is closed.

I am fortunate to have family doctors who are honest about what treatment is the best. I always ask about medicines I or my family are given even when in the hospital and it is a nurse handing me pills - I tell them I will not take it unless they tell me what it is and what it is foras I have been given medicine that I had a known allergy to because they failed to read my chart!

When getting a new medicine they always start with samples so I do not get burned at the pharmacy if the medicine does not work and with drug allergies they are very careful with my family.

[lanntair-2009]

Part I:

The real tragedy is the quickness of some Americans to criticize doctors for being arrogant and profit-driven based on poorly informed assumptions.

Here''s a typical doctor for you (and, no I am not a doctor, nor related to one). She took out loans to go to college, where she took much harder classes, studied far longer and earned better grades than most other students. At the same time, she contributed hundreds of hours as a volunteer in clinics, disease awareness campaigns and hospitals, and shadowed other physicians so she could begin to learn what it meant to provide healthcare to people. She was also conducting independent research for no pay and often no college credit. (Sidebar: this is a 19 or 20 year old at this point, what were you doing when you were that age?)

As she''s taking final exams in her junior year, she applies to about a dozen or more medical schools, a process that requires preparing for the hardest professional aptitude exam there is, and traveling to multiple interviews all over the country, at a cost of thousands of dollars, again paid by her or her family, most often through loans. If she doesn''t get in, she will typically spend the next year strengthening her application by doing more research and volunteering, then going through the application process again.

[lanntair-2009]

Part II:

If she finally makes it into medical school (acceptance rates currently in the single digit percentages), she then perseveres through another four grueling and often demeaning years, incurring student debts that FREQUENTLY exceed a quarter of a million dollars.

Then, if she performed well enough in medical school, she gets to go get rich as a doctor, right? Wrong. Then she''s off to a residency program. Here is where she''ll spend from 3 (uncommon) to 5+ (most common) years, earning less than minimum wage (literally) while working twice the number of hours that define your American work week. And that, friends, was just recently LIMITED to an 80-hour week: it used to be more than that. What does she do during this time? Don''t watch Grey''s Anatomy for clues. Think instead about manually disimpacting a patient who is too constipated to eliminate because of the pain medication they''re on. Or try dressing the rotting foot wound of a non-compliant diabetic patient who isn''t getting enough circulation in his extremities to heal (but will go back to eating Twinkies as soon as he''s home). That''s what residents do. For $40K, for 4000 hours per year, for three to six years, or more.

[lanntair-2009]

Part III:

After finally graduating residency, a substantial proportion of these doctors forego private practice to go into academic medicine. Why? To be able to cure and treat patients, often in underserved and uninsured populations, while passing along medical knowledge to younger aspiring doctors. Other residency graduates go into private practice, many in similar communities. After 25 years of education and hundreds of thousands of dollars in debt, and before they buy a house, mind you, it should be no surprise that 75% of them (if that statistic is even accurate) consider compensation a factor in selecting a specialty.

This article is about doctors giving a "placebo" (although it is not actually a placebo) without patient knowledge, and this is certainly an unfortunate result of the often unrealistic demands of American consumers when it comes to healthcare. We tend to demand cutting edge treatments, at affordable prices, and we want it now. Some of us want it now even when there is no treatment, or even when there''s nothing wrong with us. So half of doctors say they have given placebos at one time or another, probably to make the worst of these people happy. Admittedly, this is a breach of informed consent.

[dragyn30]

This goes back to the "pink" medicine many of us got as a child when our parents took us to the doctor when we were sick no matter what we had - we always go the pink stuff. What I learned as an adult is that too much antibiotics not only harm your immune system but as a child resulted in poor quality teeth. Amoxicillin (the pink medicine)is a big culprit in poor quality teeth.

I was stupid with my first child until I found a Dr. who was honest enough to say my daughter really did not need an antibiotic as this would go away on its own and he''d mention OTC methods to help with symptoms, he would always offer a script if I wanted one or to have on hand if things changed over the course of a weekend when their office is closed.

I am fortunate to have family doctors who are honest about what treatment is the best. I always ask about medicines I or my family are given even when in the hospital and it is a nurse handing me pills - I tell them I will not take it unless they tell me what it is and what it is foras I have been given medicine that I had a known allergy to because they failed to read my chart!

When getting a new medicine they always start with samples so I do not get burned at the pharmacy if the medicine does not work and with drug allergies they are very careful with my family.

[lanntair-2009]

Part IV:

But to those of you ready to jump on the doctor-bashing wagon, get a reality check. Here''s the bottom line: doctors are better educated, have worked harder, sacrificed more, put up with more and still plain care more about others than almost anyone else in our society. As a group, they deserve the respect and the compensation that they earn. As a group, they do not deserve to be the targets of ongoing Medicare payment cuts, and certainly do not deserve to be stereotyped as having God complexes or being greedy. And as a group, if they tend to treat you in a way that seems condescending, that''s probably because you''re the type of ignorant but demanding patient that makes them wonder sometimes if all of their sacrifices were really worth it.

[eggy1620]

From the article . . .%u201Da placebo was any treatment that wouldn''t necessarily help the patient.%u201D

So a placebo can be a real drug with real effects. It just will not do any good to the patients diagnosis. Kind of like prescribing antibiotics for a flu. You will eventually get better, but not because of the prescription.

[mrsark01]

I also as some of you have been given medications that I am known to be allergic to. Simply because the Dr does not read my chart of look at my allergy list.
I know that most Dr''s as a lot of us are is over worked and under paid for their service with the health care getting in such mess.
My insurance only pay my primary care Dr and $20.00 and my copay is $20.00 so my Dr only makes 40 for an office visit. This is what is happening to most of our Dr''s. It will get to the point where most of the Physicians will quit taking your health insurance and make you pay up front for all medical care and then you will have to deal with your insurance for the money.
I can''t blame so of the physicians for giving people fake pills because I have listened to some of them talk to these Dr''s and tell them they are useless.
Come on people they are human to be more patient with them

[mrsark01]

Basically a plumber is paid more than a Dr is paid per visit. Now go to the hospital and then you spend the money

[eggy1620]

%u201CBasically a plumber is paid more than a Dr is paid per visit%u201D

Yeah, especially when you compare their take home relative to number of jobs or patients. Dr%u2019s have to see 20 or more patients in one day to pay their bills. Plumbers may make 4 or 5 calls on a busy day.

[spadeisspade]

Ian, you need a friend, buddy! Or a cat to talk to...

If the average blue collar worker has to make that skinny latte with a dash of cinnamon, extra foam for a pain in the butt customer with a smile on their freaking face, I think doctors can muster up the ability to not act like condescending *****-and I don''t give a *** what sacrifices they make! It''s their effing job! They chose it!

[ender18-2009]

A close friend of mine opened a free clinic to provide service to the underserved. He charged a 20$ payment or a voluntary donation for what was essentially free care. After 1 year of work, he was sued 3 times. 2 cases without merit and the last went to trial and was eventually thrown out. He closed the free clinic and decided to work for a pharmaceutical company.

[adt13t]

placebo=religion=placebo
believing in something especially when one
shells out the cash typically enhances the
according posture of fulfillment/realized
or at least self percieved to have been
realized
this points out the dangers of doomsday
worshippers (armageddon hoax) and other
ridiculous irrational nonsense but with
the real danger being true believers who
posture themselves accordingly hook line
and sinker or in "w"''s case stinker

[adt13t]

this also speaks of the teeming mass
of willfully self decieved bend over
pawn sheeple who seek out the immediate
gratification fix that requires no
responsibilty or behavorial change
and according effort etc.
but demand to be spoon fed further
delusions so they can pop their pill for
obesity and indigestion while gorging on
the 3rd big mac while living emotionally
vicariously via the latest episode of
holly wood spot light w/h/o/r/e 2nd rate
hypnosis - better lookin apes saying cuter
lines (mesmerizing to the trailer park)
then of course canned laughter and cut to
the pizza commercial and the latest itchy
anal leakage magic pill
(americans are so stupid they have to be told
when to laugh by the electronic box)

[impeach__w]

This is our new health plan. Give placebos to the half of us that can''t afford to pay insurance anymore.