
Half of US Doctors Routinely Prescribe Placebos - theoneill
http://www.nytimes.com/2008/10/24/health/24placebo.html?_r=1&em&oref=slogin
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iamelgringo
I see this all the time. (I'm an ER nurse by night, computer nerd by day).

The problem is that patients frequently demand antibiotics for infections that
don't require them and patients demand XRays for injuries that are obviously
not fractures.

If someone is going to take little Jonny to the ER at 3 in the morning because
the child has a fever and a cough, the last thing that the parents want to
hear is "give him Tylenol, push fluids, plenty of rest..." Plain and simple,
if they're going through the trouble to see the doctor, they want a
prescription. So, instead of spending 20 minutes explaining to the parents why
little Jonny doesn't need a prescription, they spend 5 minutes with them,
prescribe an antibiotic that they _might_ but probably don't need, and run off
to see the next patient.

~~~
Angostura
Err, excuse me. I've taken my daughter to A&E (the UK equivalent of ER) a
couple of time in her life due to high fever and a very nasty hacking cough.
On both occassions, they prescribed ibuprofen, liquids and on one occassion
put her in a cooling bath to reduce temperature.

On both occassions I was satisfied: I was pretty sure that it was a viral
infection, but with a temperature _that_ high, I wanted to be sure. I would be
bloody annoyed if the docs prescribed unnecessary antibiotics. Not all
patients are dense and doctors shouldn't treat us as if we are - that just
spreads ignorance.

Actually, we are lucky over here now. NHS is a really very good phone
consulting service. You phone up with a sick child and they take you through a
very VERY detailed list of symptoms and questions. This phone service has
saved me a couple of night trips to the hospital since it started.

~~~
iamelgringo
I'm sorry if I came across as condescending. That was not my intention at all.
I went to an Urgent Care 2 years ago, I waited for 2 hours, only to be told
that I should take Tylenol, get rest and drink fluids. I was very upset.

I don't think those expectations are the fault of the patient. It's a natural
extension of our drive-thru, fast-food.

At very least, I've found those expectations to be common in most of the 20+
hospitals/ER's that I've worked in over the past 15 years.

I field at least 3-4 calls a night asking for advice. I am not allowed to give
any advice over the phone because of liability reasons. People's only option
in the middle of the night is to go to the ER and wait their turn which
creates frustration and high expectations. It's a bad system, not bad
patients.

~~~
run4yourlives
_I waited for 2 hours, only to be told that I should take Tylenol, get rest
and drink fluids. I was very upset_

Why? There was nothing wrong. Would you have been happier if they diagnosed
cancer? I find the (mostly American) obsession with pills very very strange. I
hate seeing this getting imported to Canada, but more and more this seems to
be the case.

~~~
jadence
Yes, iamelgringo's reaction does seem irrational but I can relate.

I've been dealing w/ a knee injury for a year+ and recently decided to bite
the bullet (it's expensive!) and have it checked out. (Being an bootstrapping
entrepreneur tends to have the side effect of having less-than-comprehensive
health insurance) When the results of the MRI and X-Ray came in I found myself
rather disappointed that there were no tears or fractures. I guess I just
wanted a definite answer to why my knee was messed up so I could put a rehab
plan into place and get back into running and mixed martial arts. Hearing
"Don't know what's wrong. Rest it" was rather frustrating.

~~~
run4yourlives
Having seen tons of knee injuries from my army days, I would only say this:
Don't get surgery.

~~~
jadence
Not that I'm planning on getting knee surgery (more rehab . . . sigh) but I'm
intrigued.

Care you expand on that?

~~~
run4yourlives
Well, fully anecdotal here, but every guy I know (at least 10) that got knee
surgery to "correct" a problem continued to have the same problems.

It seems to me that most of them regarded this as simply a stop gap or
"treatment" and not a cure. Those that thought they would not have any more
issues with their knees were not happy. Many who got it earlier on suggested
that they would have chosen to go as long as possible without the post surgery
rehab if they could.

I've been fortunate enough not to have any knee or foot issues myself, so I'm
certainly not claiming to be an authority here.

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jbum
...and the ones that don't are doing their patients a disservice. Placebos are
safe, and can be surprisingly effective.

~~~
jwilliams
More people should demand placebos from their doctor...

 _cough_ Anyway. I found this line from the article amusing: _Only 5 percent
described the treatment to patients as “a placebo.”_

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dejb
Yes so did I. To me it means the title of the article was speculative at best.
Inaccurate is another word one could use.

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gruseom
"Antibiotics and sedatives" don't sound like placebos to me.

~~~
mechanical_fish
Tragically, antibiotics are often _used_ as a placebo. For example,
prescribing an antibiotic is a good way to get the flu patient to leave your
office in a happy mood, secure in the knowledge that Something Is Being Done,
even though antibiotics are useless against flu.

That's a big problem, because sugar pills don't breed antibiotic-resistant
bacteria. There's a serious argument to be made for homeopathy here:
homeopathic treatments don't have side effects.

~~~
LogicHoleFlaw
_homeopathic treatments don't have side effects._

Indeed. Most of us could stand to drink more water anyways.

~~~
mechanical_fish
Actually, now that you mention it, I suppose it is possible to overdose on
homeopathics.

Moreover, there is a significant side effect: A financial one. That's why I
prefer to advocate DIY homeopathics. If yours don't seem to be working, try
making them by the light of the full moon. No kidding.

~~~
ars
It would be pretty hard to overdose on homeopathics. They are basically sugar,
and they are tiny. Add in the cost, and it would cost a fortune to overdose.
You could probably clean out an entire store's inventory and not overdose.

~~~
llimllib
It's the water he's talking about:
[http://seattletimes.nwsource.com/html/nationworld/2003529990...](http://seattletimes.nwsource.com/html/nationworld/2003529990_water18.html)

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ivankirigin
This idea is related and hilarious <http://inventedbyamother.com/>

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streety
Does it have FDA approval?

~~~
jwilliams
Even better. It doesn't have FDA disapproval.

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wumi
when I had bronchitis, my doctor told me "I can give you antibiotics and it
will go away in three weeks. You can go without antibiotics and it will still
go away in three weeks. What do you want to do?"

I declined.

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bprater
Whenever I get a new prescription from a doctor, I jump online and do my
research about it.

I know there are several brand names for placebo drugs, but would it be
obvious if a doctor prescribed one to me or my family?

~~~
Raphael
Afraid it might work?

