July 22, 2009

Are your prescription
drugs really drugs?

What would you do if you found out the prescription you just received from your doctor was just a simple sugar pill? Or what if your doctor prescribed a drug for you that has nothing to do with your condition? Well, there's a 50% chance your doctor has done exactly that.

A new study found that half of the doctors in the U.S. prescribe placebos. In the study, researchers randomly selected 679 internists and rheumatologists from a national list. They asked them about their placebo prescribing practices. Fifty percent of the doctors said they prescribed placebos. While your doctor may not have done this to you, he could have done it to someone else. And he might do it to you in the future.

This is a great story. You might think that I am shocked or would criticize the practice as fraud, as some medical ethicists are doing. There are ethical questions here. But I'm interested in this story for another reason. Here's why.

It proves that doctors don't have a clue about how to manage a large percentage of the cases they treat. So they provide something — some pill for their patient to pop. It makes the doctor look like he is actually doing something. Second, real placebos (truly inert pills) have a 30-40% chance of helping. Just your expectation is enough to make your body do better!

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Unfortunately, there's a dark side to this practice. In the questionnaire, the medical professionals said the most common pills they gave were headache pills and vitamins. Some also reported giving antibiotics and sedatives. They were prescribed as "a medicine not typically used for your condition but might benefit you." Only 5% of the doctors referred to their pills as a placebo.

Now I wouldn't care if the doctor gave a vitamin pill. That won't hurt you, and it could actually help! But giving headache pills and antibiotics is not placebo. These are active drugs that could definitely harm you. The doctor pulls these chemicals out of a hat considering them a placebo. Again, he looks like he's doing something. But in his ignorance of knowing how to manage a problem — a problem that doesn't have a drug to treat it — he offers another chemical as a placebo. This is a really bad practice.

It would be far better for the doctor to admit that he's offering you a nutrient that might benefit you rather than push a potentially dangerous chemical. It's far safer. But I doubt doctors will ever widely resort to vitamin placebos when the drug rep has just left them a load of toxic chemicals and plenty of perks for using them.

Action to take: Whenever your doctor offers something for a condition that baffles him, be sure you know what it is that he's offering. Using an antibiotic for a viral infection is malpractice and dangerous. Using a headache pill as a placebo for an unrelated problem might also pose risks for you. But if the ignorant doctor suggests a "special" pill that's a nutrient, well, then in his ignorance, he might actually help you.ÿ Even better, recognize this as proof that at least half of doctors realize that they don't know what they're doing.

Yours for better health and medical freedom,

Ref: BMJ, October 24, 2008.

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