Would your doctor dare give you a placebo pill and tell you its medication?

Mystery medicine

Imagine if the American Medical Association issued an official statement advising doctors to prescribe inert pills instead of drugs for certain ailments. And imagine that the AMA also advised doctors to never tell their patients they’re receiving null pharmaceuticals.

In other words: Give patients placebos, then drive home the placebo effect with a little white lie.

If you’re thinking that could never happen, you’re right. The AMA would never officially go on record with an announcement like that.

But it’s a different story in Germany.

Recently, the German Medical Association (their version of our AMA) really did advise doctors to prescribe placebo pills instead of drugs for conditions that have a psychological or subjective component–depression, chronic pain, inflammatory diseases, etc.

Do you realize what that means? In my opinion, that’s basically an outright admission from the medical mainstream that certain drugs don’t work, are not worth the cost, or have too many side effects. Or all three.

And secondly: What about that little lie? A doctor can’t undermine the placebo effect by admitting the treatment is fake. So the GMA advises doctors to describe it as a “unique remedy.”

That’s a clever spin to work around the honesty issue.

Fuzzy transparency

This advisory from Germany has U.S. medical mainstreamers swooning at the thought of doctors misleading their patients.

For instance, a Harvard professor put the placebo question in perspective for the Associated Press: “That’s what I call lying. It would be unacceptable in the U.S. In the U.S., we have a commitment to transparency. The Germans seem to be saying that it’s okay to lie a little.”

I think that’s a pretty good take on how the general population in the U.S. would probably react to being treated with a placebo without knowing it.

But it happens to be completely wrong.

A 2008 study in the British Medical Journal reveals that when it comes to placebos, the U.S. medical system is as lawless as a gold rush town in the wild west.

Led by a researcher at the National Institutes of Health (NIH), the study found that about half of the U.S. doctors surveyed “reported prescribing placebo treatments on a regular basis.”

That’s disturbing, but not nearly as disturbing as what those doctors were using as placebos.

Only a very small fraction said they used actual sugar pills, which is the classic concept of a placebo.

About 40 percent said they used over-the-counter analgesics. OTC analgesics include aspirin, acetaminophen, and ibuprofen, and I’m sure you’re aware that all three have the potential to produce adverse side effects.

That’s very unsettling (not to mention completely unethical), but here’s the worst: 13 percent of doctors said they used antibiotics, and another 13 percent said they used sedatives.

That’s just wildly irresponsible! Those doctors are putting their patients in harm’s way and should have their licenses revoked.

What I find most irritating is that a doctor might decide that he can’t effectively treat a fibromyalgia patient (for instance) with conventional drugs. So he throws in the towel and prescribes an inappropriate drug, hoping for a placebo effect.

Meanwhile, if he were to make even the most superficial attempt to investigate alternative medicine he would find a Mayo clinic study that supports acupuncture for fibromyalgia relief. Or he might try chlorella, a freshwater algae that’s been shown to improve pain and anxiety in fibromyalgia patients. Some doctors have also had success relieving fibro symptoms with magnesium and a hormone called relaxin.

About 40 percent of the doctors surveyed said they used vitamin pills as placebos, but apparently with no attempt to match a specific vitamin with a specific condition. Somewhat dismissively, the study authors refer to vitamins as “benign and safe,” and “relatively innocuous.”

If your doctor ever tries to give you pills that aren’t clearly labeled and don’t come with a detailed prescribing information insert–even if they’re “benign” vitamins–put those pills down and walk away.

And find yourself a new doctor who knows that little white lies aren’t medicine.

Sources:
“German medical group pushes placebos” Associated Press, 4/1/11, ap.org
“Mind-body: The surprising power of the placebo” Dr. Charles Raison, CNN Health, 4/4/11, thechart.blogs.cnn.com
“Prescribing ‘placebo treatments’: results of national survey of US internists and rheumatologists” BMJ, Vol. 337, 10/23/08, bmj.com