A just released survey of 679 internists and rheumatologists, chosen at random from a national list, reports that more than half of responding physicians used fake medicines - placebos - to treat patients with tough to treat conditions relying on the placebo effect to make them feel better.
These physicians are drawing on information that for a given medical condition, it's not unusual for one-third of patients to feel better after being treated with a placebo.
If you believe you will get better, chances are, you will.
"Twenty to thirty percent of the benefit seen in rheumatism drug studies are due to the placebo effect. Real changes in health go along with the belief that patients will get better," says researcher Jon C. Tilburt of the Mayo Clinic. Thanks to today's brain imagery techniques, the theory that thoughts and beliefs affect your psychological state, and cause the body to undergo real biological changes has been shown to be true.
Known to science as the placebo effect, this phenomenon has long been observed in clinical trials where patients who were taking an inactive compound reported real improvements, more improvement than patients getting no treatment at all. Placebos can either be a pill made from inactive substances or a sham procedure meant to imitate the real one but with no specific therapeutic activity that a patient accepts as therapy. Any subsequent therapeutic effect is based on the power of suggestion.
Using a placebo is a strategy if a physician is treating a problem that doesn't have proven treatments. Despite the drug companies' best efforts, new medications take time to develop, test and get to market. So many conditions aren't fully understood, or show different symptoms in different people that you can see why treating a chronic problem can be a challenge for your doctor.
According to the American Medical Association, using a placebo without telling the patient undermines trust and compromises the relationship between doctor and patient. The patient should know if a drug is a placebo, and should never be given a prescription just because they are seen as a difficult or demanding patient.
How do doctors explain a placebo to patients? The AMA wants physicians to tell patients that placebos help better understand a condition by allowing them to try different medications. Typically a practitioner will say something about using a medication that's not often used for your problem, but might benefit you. If you agree, the doctor doesn't have to identify which medicine is a fake.
If you're feeling a bit deceived by all of this, the doctors who follow this line of reasoning are quick to point out that they always have the best interest of the patient at heart.
Even so, it's not surprising patients feel betrayed when they learn that they were given a placebo, A sensitive doctor can explain, "Just because the placebo worked doesn't mean you're crazy. You were in distress and thus more prone to reacting to anything with the potential to help."
It goes to show that use of the placebo effect by an authority figure like a doctor has the power to heal or hurt.
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