Researchers at the universities of Oxford and Southampton have revealed that 97% of doctors in a study have prescribed placebos to patients at least once. These were impure placebos (that is, treatments unproven for the condition), including antibiotics for viral infections, non-essential scans and blood tests, and complementary or alternative medicine that was not evidence-based. Also, 12% of the doctors had prescribed pure placebos, such as sugar pills or saline injections.
It's interesting that some doctors prescribe actual sugar pills. Come to think of it, I believe I might have been sold a few at acid-house events. Joking apart, there seems to be a difference between placebos being administered in clinical trials, and ordinary patients being duped. However, according to this study, it's not perceived as deception because placebos sometimes work, even if the patients are told that that's what they're getting. Moreover, used wisely, doctors believe that they help people.
Which is one good reason why I'm not a doctor – the Hippocratic Oath be damned, I'd feel perfectly justified in using placebos just to get whingeing healthy people out of my surgery so that I could deal with the genuinely ill.
Impure placebos, pure placebos, nocebos – it's a vast, fascinating, complex subject, encompassing physiology and psychology. Where patient care is concerned, certainly no one could judge harshly the seriously ill subject who experiments with unorthodox, unproven therapies, or the physician who encourages them to remain positive and active in their treatment. Belief and a modicum of control can be powerful tools against the debilitating nature of helplessness.
However, at the less illustrious end of the scale, this surely also means physicians dealing with pest-patients who won't accept that either there's nothing wrong with them or that there is no treatment available, except for their malady to run its course while they sniffle under a duvet in front of a Breaking Bad box set.
Indeed, while the point of this study was to examine the medical profession's use of placebos, nobody seems impolite enough to point out that there are times when it's the patients' own fault if they end up smarting from a saline injection they didn't need. While nobody wants to be lied to, or patronised, the fact remains that there is no known cure for the determined hypochondriac attention-junkie.
Indeed, while people might be annoyed or alarmed at the idea of being given placebos, medics probably wouldn't need to were it not for the modern blight of the Worried Well clogging up consulting rooms. Going to see the doctor used to be an event. Now people ludicrously demand appointments for colds, rashes and random pains without even waiting to see if they clear up on their own. Many also spend inordinate amounts of time self-diagnosing, using that well-known infallible resource, the internet. Which spurs them on to demand expensive tests, investigations, and treatments and (egged on by ranting loons on forums) refuse to be "fobbed off".
Doctors must get tired of dealing with these people, so out come the sugar pills, poultices and unnecessary physical examinations. In fact, anything likely to shut them up, and who can blame them? It seems that the doctors are not at fault, but the professional timewasters. If figures could be compiled (which they never could be, because hypochondriacs are shameless liars), I would wager that it's those craving attention who are truly "overburdening the NHS" – and yet they're also probably the first to complain about the cost of treating honest smokers, drinkers and overeaters, who at least have something genuinely wrong with them. Instead of complaining about placebos, perhaps the Worried Well should be grateful that they're being wasted on them.
