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Most UK GPs Have Prescribed Placebos

samzenpus posted 1 year,26 days | from the balance-the-humors dept.

Medicine 240

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."

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240 comments

Antibiotic Placebo? (5, Informative)

thegarbz (1787294) | 1 year,26 days | (#43243877)

antibiotic treatments used as placebos for vial infections

I'm sorry but a medical professional should flat out know better.

Re:Antibiotic Placebo? (5, Insightful)

Inoen (590519) | 1 year,26 days | (#43243905)

A friend of mine is currently in the hospital with a simple infection, that would normally be easily treated with antibiotics. But this one has been resistant to everything they've tried. Worst case, they will have to take off his leg.

I agree; using antibiotics where they aren't needed is despicable.

Re:Antibiotic Placebo? (2)

Bearhouse (1034238) | 1 year,26 days | (#43244873)

Have they tried:

http://en.wikipedia.org/wiki/Sulfonamide_(medicine) [wikipedia.org]

If not, Phage therapy.

http://en.wikipedia.org/wiki/Antibiotic_resistance [wikipedia.org]

Good luck to your friend.

Re:Antibiotic Placebo? (1)

Electricity Likes Me (1098643) | 1 year,26 days | (#43245031)

Have they tried:

http://en.wikipedia.org/wiki/Sulfonamide_(medicine) [wikipedia.org]

If not, Phage therapy.

http://en.wikipedia.org/wiki/Antibiotic_resistance [wikipedia.org]

Good luck to your friend.

Phages are very bacteria specific though. You have to isolate one that infects that specific strain of bacteria, which is hard to do since there's a hell of a lot (they just all used to die to penicillin - hyperbolically speaking).

Re:Antibiotic Placebo? (0)

Anonymous Coward | 1 year,26 days | (#43243907)

antibiotic treatments used as placebos for vial infections

I'm sorry but a medical professional should flat out know better.

I agree. This happened to me before, but it was an ear infection and I guess the doctor didn't know if it was viral or bacterial, so maybe he was just using a "shotgun technique".

Re:Antibiotic Placebo? (5, Informative)

Anonymous Coward | 1 year,26 days | (#43243975)

I think it's more down to the public not knowing what antibiotics are used for and demanding them where they are not needed.

Re:Antibiotic Placebo? (5, Informative)

Let's All Be Chinese (2654985) | 1 year,26 days | (#43244183)

The problem with antibiotics, rather, is that you have to finish the entire run lest you'll end up merely training your infection to become resistant. So it's not strictly a problem of prescribing the stuff too often; it's that plus far too many people starting to feel fine then not finishing the cure.

Re:Antibiotic Placebo? (3, Insightful)

Joce640k (829181) | 1 year,26 days | (#43244215)

It's both of those things.

Re:Antibiotic Placebo? (2)

kleuske (796202) | 1 year,26 days | (#43244953)

All three in fact. The use of antibiotics in animal husbandry is a significant factor in creating resistant pathogens, too. One that is forgotten about, but of a much larger scale than human (ab)use of these pharmaceuticals.

Re:Antibiotic Placebo? (2)

dj245 (732906) | 1 year,26 days | (#43244871)

The problem with antibiotics, rather, is that you have to finish the entire run lest you'll end up merely training your infection to become resistant. So it's not strictly a problem of prescribing the stuff too often; it's that plus far too many people starting to feel fine then not finishing the cure.

Moreover, recent studies show that antibiotics kill a lot of the "good" bacteria in the gut, and it takes some time to recover, if at all. During that time, the patient is vulnerable to various other diseases. Some might even be caused by a lack of the right bacteria.

See poop transplants [nature.com]

Re:Antibiotic Placebo? (1)

Electricity Likes Me (1098643) | 1 year,26 days | (#43245047)

The problem with antibiotics, rather, is that you have to finish the entire run lest you'll end up merely training your infection to become resistant. So it's not strictly a problem of prescribing the stuff too often; it's that plus far too many people starting to feel fine then not finishing the cure.

Moreover, recent studies show that antibiotics kill a lot of the "good" bacteria in the gut, and it takes some time to recover, if at all. During that time, the patient is vulnerable to various other diseases. Some might even be caused by a lack of the right bacteria.

See poop transplants [nature.com]

There are "balancing" antibiotics which are actually used for this purpose as well - two separate ones with different effects. I've been on them in fact, and it did wonders for some persistent issues I'd been having.

Re:Antibiotic Placebo? (4, Insightful)

Anonymous Brave Guy (457657) | 1 year,26 days | (#43244321)

No qualified doctor should be prescribing medication just because a patient "demands" it. That would be both a fundamental failure of their duty of care to the patient and an abuse of their authority to legally prescribe controlled substances.

All of this goes double for antibiotics, because there is a real danger of overuse combined with people's tendency not to complete full courses of treatment contributing to the development of resistant strains like MRSA.

Re:Antibiotic Placebo? (5, Insightful)

bigtomrodney (993427) | 1 year,26 days | (#43244363)

That's exactly how I feel, but moreover logically that is why these medicines are prescription only.

As a European I was horrified to see that prescription medicines are routinely and frequently advertised on television in the USA instructing the viewer to ask their doctor to prescribe the medicine.

Re:Antibiotic Placebo? (4, Insightful)

dcollins117 (1267462) | 1 year,26 days | (#43245071)

As a European I was horrified to see that prescription medicines are routinely and frequently advertised on television in the USA instructing the viewer to ask their doctor to prescribe the medicine.

As an American I am equally horrified. Advertising by big pharma companies is one of the reasons medications are so expensive here. Also, I can't imagine telling a doctor what to prescribe. If he/she doesn't know already, then I'm going to the wrong doctor.

Re:Antibiotic Placebo? (2)

Arterion (941661) | 1 year,26 days | (#43244413)

Antibiotics and most medications are not controlled substances. It is not illegal to purchase or possess them. What is controlled, however, is the SALE of antibiotics for human medical use. So this means you can import them from some jurisdiction where you can purchase them (the internet, or across the Mexican border), or possibly get the same medication from a agricultural supply company intended for veterinary use.

This is quite different from "controlled substances" such as amphetamines, narcotics, benzodiazepines, and of course, illegal street drugs (cocaine, heroine, marijuana, etc.)

Re:Antibiotic Placebo? (0)

Anonymous Coward | 1 year,26 days | (#43244417)

Rationally, yes.

When dealing with a needy, insistent patient who wants some love? It's the medical equivalent of coming to their desk to turn their computer off and on again.

(Tee hee: Captcha: "futility")

Re:Antibiotic Placebo? (1)

rhsanborn (773855) | 1 year,26 days | (#43244977)

Unfortunately, in the United States, these doctors are working for themselves, for partnerships, doctors groups, or health systems, all of which are run like a business. Part of that mentality is that customer satisfaction is essential. People are irrational when it comes to health, and if you don't give them the antibiotic they demand, then they go find another doctor who will, or their patient satisfaction ratings go down... I'm not saying it's right, but it's among the things that need to be addressed to improve healthcare. I know this article is from the UK, I'm not sure if they have similar pressures.

Re:Antibiotic Placebo? (1)

Secret Agent Man (915574) | 1 year,26 days | (#43245027)

That's how I feel too. And that's why I cringe whenever I think about how drug companies can advertise their medicines on TV, saying "talk to your doctor about DrugXYZ." That is, "bug your doctor about our product instead of letting them decide what's best for you."

Re:Antibiotic Placebo? (4, Insightful)

Jherek Carnelian (831679) | 1 year,26 days | (#43244009)

I agree. This happened to me before, but it was an ear infection and I guess the doctor didn't know if it was viral or bacterial, so maybe he was just using a "shotgun technique".

Yes. I doubt that doctors are insincerely prescribing antibiotics as placebos. I expect it is more of a case of not being able to fully rule out a bacterial infection so they prescribe the anti-biotics to cover all their bases and to help the patient feel like their problems are being taken seriously.

My guess -- it is most common with ear infections for kids (which are the most common reason kids to go to the doctor). Societal pressure on mothers nowadays is super intense - it is hard for a mom to accept doing nothing but wait for the viral infection to run its course when their kid is crying all the time. And since a minority of ear infections really are bacterial, but testing for the type of infection is difficult, the doctor prescribes a mild anti-biotic (usually amoxicillin). That makes mom feel like she's done everything she can for her kid and if it really was bacterial it actually helps, if it wasn't bacterial the side-effects are rare and mild so the risk of making the kid worse is tiny. It is a win-win except for the long-term affect on rates of anti-biotic resistance.

I say this having seen my sister, a recent mother go through this stuff. Before the kid was born she was super on board with all the free-range kids type stuff, but once that baby popped out and she had to experience it first hand, it was a different story. To her credit she's been able to back off the helicopter type stuff as unavoidable accidents have happened and she saw that the kid came out fine. But the pressure from society to be a perfect mom teams up with those mom hormones and long-term thinking tends to be the loser. She still hasn't given the kid peanut butter, she's waiting to do it when she's in the lobby of the pediatrician's office - and now the research is starting to suggest the longer you wait to expose them, the more likely the kid is to develop a peanut allergy...

Re:Antibiotic Placebo? (5, Informative)

Anonymous Coward | 1 year,26 days | (#43244311)

The reason doctors prescribe antibiotics inappropriately in family medicine is almost never due to ignorance. 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.

Source: I'm a doctor.

Re:Antibiotic Placebo? (1)

Anonymous Coward | 1 year,26 days | (#43244697)

now the research is starting to suggest the longer you wait to expose them, the more likely the kid is to develop a peanut allergy

If that's a concern, give'em a regular dose of M&Ms.

Re:Antibiotic Placebo? (3, Interesting)

TheRaven64 (641858) | 1 year,26 days | (#43244861)

I expect it is more of a case of not being able to fully rule out a bacterial infection so they prescribe the anti-biotics to cover all their bases and to help the patient feel like their problems are being taken seriously.

It's not just that. One of my colleagues was given antibiotics for flu a few years ago. He asked the doctor why they were giving him antibiotics for a viral infection, and the doctor told him that there was a bacterial chest infection going around and people whose immune systems were weakened by the flu weren't able to fight it off. Having two lung infections in a row could easily cause serious damage, and so they prescribed antibiotics to avoid this.

Re:Antibiotic Placebo? (1)

zazzel (98233) | 1 year,26 days | (#43244865)

Yes. I doubt that doctors are insincerely prescribing antibiotics as placebos. I expect it is more of a case of not being able to fully rule out a bacterial infection so they prescribe the anti-biotics to cover all their bases and to help the patient feel like their problems are being taken seriously.

That's happening everywhere. The problem is partly with the patients being quite impatient with their doctors. All *my* doctor did when I came to him with e.g. a a severely sore throat or a sinusitis was to tell me that yes, he could give me antibiotics, but he would recommend I try some other things first: inhalation, drinking a lot of water, avoiding eating and drinking anything the most common bacteria would love. Basically for a sore throat: no dairy products, no sugar, instead sour food and drinks.

Of course, if you can't work and don't want to call in sick, he prescribes antibiotics.
Sometimes also as part of the diagnosis, since testing in the lab cuts deeper into his budget than a test drive with antibiotics. So, it's the health provider's fault: Lab testing: expensive and therefore evil. Antibiotics: cheap way to go.

Re:Antibiotic Placebo? (3, Interesting)

Inda (580031) | 1 year,26 days | (#43244989)

We went through this with our daughter when she was still in pre-school. Constant ear infections, with no evidence of such. We thought our daughter was trying it on and so did our doctor.

I'll always remember the look my UK doctor and I shared. It was pure mutual understanding. He said "we'll try these homeopathic pills" and then we shared eye contact. I knew the pills were bollocks; he knew they were bollocks.

We both explained to my daughter that these pills would cure her forever and the nice white sugar pills in the fancy packet did just that. She hasn't complained of an ear infection since.

It's all good.

Editors schmeditors (1)

Hognoxious (631665) | 1 year,26 days | (#43244163)

antibiotic treatments used as placebos for vial infections

I'm sorry but a medical professional should flat out know better.

Indeed. The correct way to deal with dirty bottles is to run them through the dishwasher.

Re:Antibiotic Placebo? (2, Insightful)

scamper_22 (1073470) | 1 year,26 days | (#43244041)

Of course they know better.

It's that they choose to do it so it makes it easier to deal with patients.

The irony of professional regulation is that we restrict medical professionals, grant them monopolies, impose excess educational requirements... and then it turns out most of them don't practice to that level.

Sure your family doctor might theoretically be better than say a nurse practitioner, but most barely spend any time with you to actually be better (at least in Canada).

Sure theoretically, they are guardians of the medical system, but they will prescribe antibiotics when not needed, sign fraudulent sick/massage forms...

The same goes for lawyers, engineers....

Once in a while, one is held accountable, but in general there's enough power in place to make sure it doesn't happen all that often.

Re:Antibiotic Placebo? (1)

schizz69 (1239560) | 1 year,26 days | (#43244293)

An antibiotic with a viral infection is not a terrible idea. A virual infection will reduce your immune system opening yourself up to all sorts of bacterial infections, With the added effect of placebo, the patient will be feeling fine in no time.

Re:Antibiotic Placebo? (1)

Anonymous Coward | 1 year,26 days | (#43244317)

I had to have an emergency appointment with my GP middle of last year for a really bad chest infection.

If I lay down I could hardly breathe, and certainly couldn't get to sleep.

So I went there next morning, got seen to, checked my breathing, could barely move the little tube thing. Listened to how my lungs sounded etc.

Doctor decided to give me an inhaler, a course of Steroids and a course of antibiotics - just in case it was a bacteria. So that when I came back a couple of days later whatever it was should be gone. THEN they would check to make sure I hadn't developed asthma.

I initially refused the antibiotics, but even after consulting with the head GP, she made a concerted push to get me to take them. I eventually caved because I was feeling so bad I just wanted to get out of there and get anything to make me feel better.

When I went back, I was pretty much cleared up (infact, just taking the inhaler and the steroids cleared it up enough that I crashed on the couch when I got home).

I'm still not sure what to think - whether it was a good idea to cave and take the antibiotics (it might have taken alot longer to heal otherwise) - or if it was a bad thing to gamble on it *possibly* not being a virus.

Re:Antibiotic Placebo? (1)

tbird81 (946205) | 1 year,26 days | (#43244577)

If you'd never had asthma, and could barely breathe, then I'd go with the antibiotics. (You you were an asthmatic, the steroids would probably have helped by themselves.)

Even bronchitis is usually viral and pneumonias can be too, but if something's interfering with your ABCs (airway, breathing, circulation) then it's best to be safe.

But yours was a relatively rare (for an individual person) case. Often it's guys who say "I've had 2 days of a sore throat and runny nose, and I want something to make me feel better because I've got a meeting" who are the problem.

Re:Antibiotic Placebo? (0)

Anonymous Coward | 1 year,26 days | (#43244633)

When it comes to chests, take the antibiotics. You really, really, really, do not want a series bacterial chest infection to develop. That's the sort of thing that lead to stuff like sepsis or having bits of your lung surgically removed.

Re:Antibiotic Placebo? (1)

gnasher719 (869701) | 1 year,26 days | (#43244881)

I'm still not sure what to think - whether it was a good idea to cave and take the antibiotics (it might have taken alot longer to heal otherwise) - or if it was a bad thing to gamble on it *possibly* not being a virus.

Did you actually finish the treatment? By what you are saying, it was "pretty much cleared up", not "cleared up". If antibiotics kill "pretty much" all the bacteria but not all of them, the survivors have a chance to produce resistant bacteria. If you kill all of them, no chance of producing resistant bacteria. People who stop their treatment as soon as they feel better and not follow through to the end are the ones causing the problems with bacteria resistant to antibiotics.

Re:Antibiotic Placebo? (1)

xQx (5744) | 1 year,26 days | (#43244645)

Absolutely! This is bloody disgraceful!

There are side effects that can be caused by unnecessarily prescribing antibiotics. Furthermore, they're a bloody expensive form of placebo.

Doctors that prescribe placebos should be prescribing actual placebos - pills or injections that are inert (and cheap to by wholesale). This to do otherwise is in violation of the Hippocratic oath.

There's nothing wrong with a doctor prescribing inert placebos though. A doctor is employed to use science to help sick people and there is huge body of evidence that says that prescribing a placebo is more effective in the treatment of almost anything than prescribing nothing at all.

However, we the public shouldn't be paying for it. In fact the worst thing we could do is make placebos NHS/Medicade/Medicare funded. The effectiveness of a placebo has a correlation with the patient's perception of price. It is in the interests of patient care that private clinics charge exorbitant amounts for their placebos, and they force patients to pay the full fee. (evidence here: http://www.medicalnewstoday.com/releases/99532.php ).

It's called science people.

You don't have a problem telling a dying relative in ICU that "they'll be fine", why do you have a problem if your doctor lies to you to get a better medical outcome? I employ my doctor to fix me, not make me feel good.

Re:Antibiotic Placebo? (2)

digitig (1056110) | 1 year,26 days | (#43245005)

I'm not sure a UK doctor can prescribe medically inert placebos, at least not on the National Health Service. As I understand it, what they can prescribe is decided by the National Institute for Health and Clinical Excellence (NICE), and their list is supposed to be evidence based. Although I suppose that doesn't stop the doctor saying something like, "Look, I could prescribe something, but, here's the thing, the best thing for you is something I'm not allowed to prescribe. You know what a stranglehold the pharmaceutical giants have? Well, here's what I think you should do: go down to the pharmacy, and on the homeopathy counter you'll find..."

Re:Antibiotic Placebo? (0)

Anonymous Coward | 1 year,26 days | (#43244869)

This is DEFAULT behavior for infections until blood results come back. Some people might not have the time to wait for those blood results and CAN die.
And it can infect others, which is the worst part. One life next to a room or ward of lives is nothing.

There are new blood-testing machines developed just recently that are coming in to the commercial market that cuts blood tests down to hours for a bunch of infections, but that might take a few years to a decade to make it around the country.
Hopefully this test will prevent a massive abuse of antibiotics that was only required because shared wards.

Being a person that has to go in to hospital around every 1.2-1.5 years due to my crappy body, I welcome this new system. Oddly the ward that is used for highly infectious patients is on the same area as every other ward, using the same elevators.

Re:Antibiotic Placebo? (0)

Charliemopps (1157495) | 1 year,26 days | (#43244937)

antibiotic treatments used as placebos for vial infections

I'm sorry but a medical professional should flat out know better.

I think the problem with this entire article is the Doctors already think they know better. It's something that's happening in this country to. Doctors think their job is to make medical decisions for you, rather than give you information and advice based on their experience and letting you decide for yourself. In England, if you argue with the Doctor too much they can actually suspend your medical coverage. Sad but true.

Re:Antibiotic Placebo? (1)

digitig (1056110) | 1 year,26 days | (#43244951)

Medical professionals do know better. They also know that some patients can cause a lot of trouble if they don't get what they want, and like pretty much everybody else they sometimes take the broad path that leadeth to destruction.

antibioticas for viral = bad (0)

wjh31 (1372867) | 1 year,26 days | (#43243879)

im all for giving a placebo to people where appropriate, they have been shown to be a powerful cure-all. However using antibiotics to treat a viral infection is only going to hasten antibiotic immunity, sure a doctor should know better than that.

Also, does this mean that pharmacists keep a stock of placebos?

Re:antibioticas for viral = bad (4, Informative)

bugnuts (94678) | 1 year,26 days | (#43244005)

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.

Re:antibioticas for viral = bad (1)

Let's All Be Chinese (2654985) | 1 year,26 days | (#43244445)

Add a bittering agent to make the thing taste bad. It's not that otherwise it won't work, just that if it tastes foul enough (but not too foul) it'll work better.

In a sense there really should be a nicely packaged version with the usual warning sheet and everything. Possibly even a "low dosage" variant you can get at the druggist without prescription.

I'd start a venture producing them (already have a nice product name) if not for the heaps of regulatory red tape and the trouble with the required testing. Before I know it I'd get sued by animal welfare groups for needless animal cruelty or something.

Re:antibioticas for viral = bad (1)

sFurbo (1361249) | 1 year,26 days | (#43244515)

im all for giving a placebo to people where appropriate, they have been shown to be a powerful cure-all.

PLacebos have been shown to be effective at reducing patient reported symptoms. They are not very effective at reducing measurable symptoms, and not effective at improving outcomes.

On the other hand, they are effective at reducing the patient's trust in their doctor, and bringing back the doctor paternalism of yore.

Measurable outcomes vs Perceived outcomes (1, Troll)

xQx (5744) | 1 year,26 days | (#43244665)

"They are not very effective at reducing measurable symptoms, and not effective at improving outcomes. "

While we're on the topic why don't we just get it all out:

Mental illness is not a real illness.

People who suffer mental illness should just get the f*ck over it.

Real illness can be seen, touched, measured.

Placebos don't work, subjects just overwhelmingly report that they do.

Re:Measurable outcomes vs Perceived outcomes (1, Redundant)

inflex (123318) | 1 year,26 days | (#43244745)

"People who suffer mental illness should just get the f*ck over it."

I used to be like you. Sincerely hoping you get through life without finding out first hand how wrong your statement is.

One day I was just stressed, it's life, keep strong, get over it, the next I was a man grasping for a chance for the rational mind to regain control. I'd love nothing more than to just get the f*ck over it.

Re:Measurable outcomes vs Perceived outcomes (0)

Anonymous Coward | 1 year,26 days | (#43244991)

*Woosh*

Re:Measurable outcomes vs Perceived outcomes (1)

sFurbo (1361249) | 1 year,26 days | (#43244751)

Is anything I wrote factually wrong? Or can you only accuse me of wrongdoing by wild extrapolation?

I wrote nothing about mental illness. Mental illness is certainly real illness, and the fact that it is looked upon as "not real illness" leads to no end of hurt, like people refusing to get the treatment that could help them because "are you saying I'm CRAZY??!!?!" in addition to "why don't they just get the f*ck over it".

Is this reflected in your medical records? (0)

Anonymous Coward | 1 year,26 days | (#43243899)

How do you explain it to a patient without incurring a law-suit?

- A.B

Re:Is this reflected in your medical records? (4, Insightful)

TapeCutter (624760) | 1 year,26 days | (#43243945)

It's the UK, a similar but different culture where talking to a lawyer is often the last resort, not the first.

Re:Is this reflected in your medical records? (1)

Anonymous Coward | 1 year,26 days | (#43244011)

How about "I could have prescribed you the anti-depressant but I was worried about the small suicide risk so I gave you an equally effective sugar pill instead."

Not a Placebo (1, Insightful)

Rinnon (1474161) | 1 year,26 days | (#43243933)

By definition, antibiotics are NOT placebos. A placebo must have no pharmacological effect to be designated as such; which clearly rules out antibiotics. Full disclosure: I'm not a doctor. Not that one needs to be to understand what a bloody placebo is supposed to be.

Re:Not a Placebo (5, Informative)

Richard_at_work (517087) | 1 year,26 days | (#43244073)

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.

Re:Not a Placebo (1)

Aggrajag (716041) | 1 year,26 days | (#43244219)

Taking a rapid CRP test from a patient should give your wife and other GP's the argument against/for antibiotics. CRP 10 = no antibiotics.

Re:Not a Placebo (0)

Anonymous Coward | 1 year,26 days | (#43244237)

Lets hope that the GP hasn't miss diagnosed and then prescribe a 'blacebo' which actually fixed what was actually wrong.

Lets hope that seline injections didn't just cure everyone with an electrolyte imbalance.

Re:Not a Placebo (0)

flimflammer (956759) | 1 year,26 days | (#43244341)

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.

Well that's their problem? If doctors are going to be that wishywashy about dishing out antibiotics just to appease the ridiculous notions of their patients claiming to have more medical experience than their doctors, then they might as well just start giving out narcotic pain killers to everyone who stubs their toe as well.

Re:Not a Placebo (1)

Richard_at_work (517087) | 1 year,26 days | (#43244429)

You realise that if you present the right symptoms to a doctor, they will give you the drugs you want even if they think you are exhibiting drug-seeking behaviour?

Patients go elsewhere until they get what they want - I have a fantastic story about that, but thats for another day.

Re:Not a Placebo (-1)

Anonymous Coward | 1 year,26 days | (#43244599)

"GPs in the UK get 8 minutes with each patient"

Wait a tic. I though you brits had this wonderful socialised medical system that was so super awesome and above anything the west has and that we would be stupid to not go down this same path. I can see my GP almost as much as I want when I have an appointment, certainly more than eight minutes and I know they are not tied to any ridiculous arbritrary timetable. Of course they try and maximize the number of patients they can see but to me that is just part of being efficient.

What's more I watched this moronic show last night for a short time 'Bang Goes The Theory', basically Mythbusters for grade school children (which is not to say Mythbusters is advanced science mind you), and they had a segment showing an OR in, presumably a British hospital, or as you Brits call it 'in hospital'.

Depressing. I could clearly see the difference between this OR and what we have here in the states in the form of the number of people performing the work, the amount and quality of the supporting equipment around the room, the general appearance of the cleanliness and sterility of the room (there was a whiteboard in there with dry erase markers of all things.)

So this is what we have to look forward to thanks to the radical socialists.

Fuck soclialism.

Re:Not a Placebo (0)

Anonymous Coward | 1 year,26 days | (#43244669)

Sorry, did you just compare UK and US medicine on the basis of "I watched a kids TV show the other day"?

Re:Not a Placebo (0)

Anonymous Coward | 1 year,26 days | (#43244613)

It is a bit different here in Germany and from what I read in US too. This said my good ol' GP asks me every time. The one that deals with kids is also reluctant to give antibiotics and explains that why it is not needed. In times of google and wikipedia (yes I know some articles are inaccurate - so are the ones in 'real' encyclopedia) that is easy to verify.

As usual ignorance wins and costs us dearly. Who might have thought.

Re:Not a Placebo (1)

Hognoxious (631665) | 1 year,26 days | (#43244251)

Whether it's a placebo or not rather depends on what you're trying to treat. Sugar pills aren't a placebo if you're hypoglycemic.

disclosure: I'm not a doctor.

No shit.

Re:Not a Placebo (1)

lxs (131946) | 1 year,26 days | (#43244435)

A placebo must have no pharmacological effect to be designated as such

I guess you've never heard of an active placebo [wikipedia.org]? Those have a definite pharmacological effect, just not the main effect of the drug being mimicked.

Re:Not a Placebo (1)

TheLink (130905) | 1 year,26 days | (#43244631)

What do you mean by no pharmacological effect though?

See: "Neurobiological Mechanisms of the Placebo Effect"
http://www.jneurosci.org/content/25/45/10390.full [jneurosci.org]

In an experimental model of pain (Amanzio and Benedetti, 1999), the placebo response could be blocked by naloxone if it was induced by strong expectation cues, whereas if the expectation cues were reduced, it was insensitive to naloxone. In the same study, if the placebo response was obtained after exposure to opioid drugs, it was naloxone reversible, whereas if it was obtained after exposure to non-opioid drugs, it was naloxone insensitive.

Vial infections (1, Funny)

rossdee (243626) | 1 year,26 days | (#43243935)

"such as antibiotic treatments used as placebos for vial infections.""

With proper sterilization techniques, you wouldn't get infections from vials in the first place.
(or use new vials so there's no risk of contamination - which they do in US hospitals since they charge so much they have new everything.
I guess that might not be an option on the NHS

Re:Vial infections (1)

bugnuts (94678) | 1 year,26 days | (#43243963)

Heh. Your response made sense, except that it was probably a typo of "viral infection".

Re:Vial infections (2)

gl4ss (559668) | 1 year,26 days | (#43243991)

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!

Re:Vial infections (0)

Anonymous Coward | 1 year,26 days | (#43244135)

My tip for getting rid of pesky vials is to soak them for a few days in Hydrofluoric Acid. [wikipedia.org]

Re:Vial infections (0)

Anonymous Coward | 1 year,26 days | (#43244181)

Meh, molten or even just hot NaOH solution will do the trick.

Re:Vial infections (0)

Anonymous Coward | 1 year,26 days | (#43244061)

> With proper sterilization techniques, you wouldn't get infections from vials in the first place.

Actually proper hygiene would be a good start. Such as warm water to wash your hands (instead of a 2 tap choice of boiling or freezing), paper towels instead of blow driers, and toilet doors you do not need to touch. The list goes on - when it comes to basic hygiene, the NHS is still in the 1920s.

Re:Vial infections (1)

JakartaDean (834076) | 1 year,26 days | (#43244167)

"such as antibiotic treatments used as placebos for vial infections.""

With proper sterilization techniques, you wouldn't get infections from vials in the first place. (or use new vials so there's no risk of contamination - which they do in US hospitals since they charge so much they have new everything. I guess that might not be an option on the NHS

I think you are misinterpreting the summary. I suspect the author was editorializing a bit and meant to talk about "vile infections." God knows they can knock you around, even with a good placebo.

Re:Vial infections (0)

Anonymous Coward | 1 year,26 days | (#43244175)

Asceptic techique... lol!

Re:Vial infections (1)

c0lo (1497653) | 1 year,26 days | (#43244223)

"such as antibiotic treatments used as placebos for vial infections.""

With proper sterilization techniques, you wouldn't get infections from vials in the first place.

You entirely missed the point: vials are the infecting bit, not the vector/carrier. As in: "crawling with or being overwhelmed by vials".

And, yes, antibiotics are useless for this case, as vials are usually made of glass and glass is not affected by antibiotics. A better treatment is the copious application of vigorous hammer strokes over all the vial infected parts of the patient.

Re:Vial infections (1)

wonkey_monkey (2592601) | 1 year,26 days | (#43244239)

With proper sterilization techniques

Woah, hey, sounding dangerously Daily Mail there...

you wouldn't get infections from vials in the first place.

Oh. That kind of sterilization. Okay.

Placebo Effect (1, Insightful)

CuteSteveJobs (1343851) | 1 year,26 days | (#43243983)

In Dr Irving Kirsch's book "The Emperor's New Drugs Exposed" he described how they are as effective as a class of anti-depressants, and of course they have fewer side effects! http://healthimpactnews.com/2012/fact-antidepressant-drugs-no-better-than-placebos/ [healthimpactnews.com] Ben Goldacre in "Big Pharma" has written similar stories. http://www.huffingtonpost.com/irving-kirsch-phd/antidepressants-the-emper_b_442205.html [huffingtonpost.com]

Quacks of the worst kind. (0)

xatxtal (2824645) | 1 year,26 days | (#43244091)

I believe that any Doctor that has prescribed placebos are "Quacks of the worst kind." I suffered from such quacks for 20 odd years for a lung infection, it took a young newly registered doctor that took his Hippocratic Oath serious to Diagnose, prove, and treat a fungal infection. It is no wonder so many so called doctors do not want patients to see their records.

Using antibiotics (1)

Anonymous Coward | 1 year,26 days | (#43244117)

as a placebo for viral - I'm assuming the OP had a typo - infections is a deplorable practice. However, many antibiotics once considered mainline treatments are now practically useless against many types of bacteria. Aside from the gastrointestinal side-effects and subsequent bacterial imbalance in the gut, they basically are placebos now. The side-effects themselves give a patient the feeling of "real" medication.

This seems quite similar to articles describing the side-effects of SSRIs (nausea, headache, libido changes) giving an impression of efficacy without actually relieving depression in many patients, though I know many people who do find they help depression and anxiety.

Fraud (0)

Anonymous Coward | 1 year,26 days | (#43244155)

The Royal College of GPs says there is a place for placebos in medicine.

The only place for placebos is in a controlled study where the patients understand they are part of a study. Prescribing a sugar pill to an actual patient while telling them it's anything else is outright fraud.
 
The reason doctors began wearing white coats was because there were so many mystics and quacks claiming to be doctors and healers, they found that this uniform brought the public's trust. It's a ruse designed to gain trust they haven't earned... the coat itself is a placebo.

Re:Fraud (4, Insightful)

DaPhil (811162) | 1 year,26 days | (#43244225)

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.

Re:Fraud (1)

Big Hairy Ian (1155547) | 1 year,26 days | (#43244389)

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.

Can we give them a cyanide placebo in these instances?

Obviously these are the sort of idiots who should be culled for the benefit of the rest of us who have positive IQ's :D

Re:Fraud (0)

Anonymous Coward | 1 year,26 days | (#43244853)

There is a huge difference between being an idiot, and being misinformed. Most of these people who want some kind of treatment are simply misinformed. You, on the other hand, are an idiot. Obviously they should not be killed, merely sterilized.

Re:Fraud (2)

Zipster (555990) | 1 year,26 days | (#43244419)

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.

Re:Fraud (0)

Anonymous Coward | 1 year,26 days | (#43244923)

Eh not so much homoepathic to be honest, everybody knows happiness and love solves everything.
Have you even watched Doctor Who?

No tests any more just stuff (0)

Anonymous Coward | 1 year,26 days | (#43244159)

I visited a UK GP recently with a stomach bug recently, I received a week supply of penicillin, laxatives and an Xray at the local hospital, No swabs stools sample. Never quite got that one.

Doctors need to really talk with their patients (4, Interesting)

PolygamousRanchKid (1290638) | 1 year,26 days | (#43244279)

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.

Re:Doctors need to really talk with their patients (0)

Anonymous Coward | 1 year,26 days | (#43244939)

The worst times I've had with doctors is when I can't find physical evidence that I'm ill. I'm not about to die, but my quality of life is shot to hell. I spent five years with a horrible cough before someone finally admitted I had asthma. No one took me seriously, probably because I was young and only complaining about a cough which can't be measured. If your doctor is wrong about those 25% and it's really only 20% he's causing a lot of problems in this world. It's really hard to be sick and be told there's nothing wrong. Autoimmune diseases are very weird. I had to track down headaches to a necklace containing nickel, but at least no one said it was fake that time.

Unethical (0)

DrXym (126579) | 1 year,26 days | (#43244455)

I realise that some patients could be annoying hypochondriacs and very persistent, as well as people showing chronic conditions which don't respond to anything. But I see no reason that a GP in the course of his regular appointments (i.e. not clinical trials or whatever) should prescribe placebos that the illness does not warrant.

It's completely unethical IMO - almost as bad as if a GP prescribed someone homoeopathic medicine. Perhaps some GPs consider it the lesser of two evils, that if they prescribe the person the placebo they're saving them from the potential side effects and risk that a real drug might bring along with it and also saving the NHS some money at the same time. Regardless of the reason, the proper answer is the GPs should work on their "bedside manner" to convey that there is nothing to be gained from prescribing something if the illness is either psychosomatic or wouldn't respond.

Perhaps the only way to stop it from happening is for chemists to refuse to fill such prescriptions or for the government to ban them from doing so except for clinical trials.

Re:Unethical (2)

Cederic (9623) | 1 year,26 days | (#43244783)

Prescribing a placebo can heal the patient. How is that unethical?

There's strong research backing this, btw.

Re:Unethical (0)

Anonymous Coward | 1 year,26 days | (#43245013)

I agree.

Scientists tend to dismiss the placebo effect. We should be studying it. Trying to understand the mechanisms behind it, instead of taking more potentially harmful substances into our bodies.

Cultural thing... (-1)

Anonymous Coward | 1 year,26 days | (#43244481)

I moved to the UK from Australia 8 years ago.

British people love to complain about everything, and above all they always need someone to blame.

It doesn't surprise me that GPs write prescriptions just to shut people up.

Health Ignorant Public (2)

bigbrownepaul (794162) | 1 year,26 days | (#43244657)

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!!

Placebos Work. (0)

Anonymous Coward | 1 year,26 days | (#43244935)

Why placebos are dismissed by scientists and doctors is a mystery to me. We should be studying the mechanisms behind placebos, working out why a form of "positive thinking" (unfortunately that phrase has many new age connotations) works, and using the results to our benefit.

Potentially cheaper and less toxic than any other medication.

Of course they have - so what? (0)

Anonymous Coward | 1 year,26 days | (#43244973)

I'm astounded that anyone thinks this is an issue. Let's be clear of three things.

First and foremost. A doctor's job is to look after the health of their patient. There's nothing in the act of giving a placebo that goes against that.

Second. Giving a placebo is NOT "doing nothing". There's a huge body of research evidence that a placebo, given to the right person at the right time, can have positive clinical results, and in some cases results as good as any other available treatment. Which makes the placebo a tool in the clinician's armoury, and the considered prescribing of a placebo a perfectly reasonable medical choice.

Third. The moral issue - should your doctor ever lie to you? Dumb question. Unless you're a highly trained clinician yourself, your doctor *always* lies to you, if only by omission. Do they really tell you how unsure they are of what the problem is? No. Do they tell you all the obscure possibilities that occur to them? No. Do they mention all the unlikely complications that might occur? No. They tell you what they feel you need to know and can understand and handle, and no more. Sure, patients have a right to be involved in their treatment. But there's a real conflict of patient interest when the best treatment is either to do nothing for a while, or to head off behaviour that the patient is clearly reluctant to avoid. There's nothing inherently wrong or immoral in saying "I'm going to prescribe you some tablets," when the unspoken subtext is, "A placebo is as good a shot as any right now, and I can't come right out and tell you that, by definition."

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