The placebo effect is real and it works. It is defined as the beneficial effect produced by a drug or treatment that is not attributable to the properties of that drug or treatment. It has been proven to exist in trials by giving a sugar pill or sham treatment and causes a positive response in at least one third of patients receiving the treatment.
Put it down to the power of positive thinking- If you believe that a drug is going to work then it is more likely to. It is also tied to the health provider- if you have one that your trust, that you have a good rapport with, then that person’s treatment is more likely to work.
The placebo effect also has in cultural variations. For example in New Zealand, the effect of a placebo injection is greater than a pill by 5-10%, but in France that effect is reversed, and pills work better.
The opposite or “nocebo effect” is also a recognized phenomenon. If the patient believes that a pill is going to cause side effects it is more likely to: if a trusted health provider casts doubt on a particular treatment then that decreases it’s benefit.
So where does that leave doctors?. Should they be prescribing treatments they know are no better that sugar pills simply to harness the placebo effect?. Should they be encouraging their patients to seek alternative treatments that have not been proven so as not to burst their placebo bubble?.
It is a difficult ethical issue, but being open and honest is the main guiding principle here. A doctor should advise their patient when a treatment is “no better than placebo” and not falsely promote a particular therapy that has not been shown to work better than a sugar pill. When I am asked about what I think about a questionable therapy provided by another health provider the right answer is even harder. In this situation I look for obvious harms- is the cost of treatment harmful to that patient? Are there potential side effects of the treatment or interactions with conventional treatments that may cause harm?. If there are none then I usually encourage my patient to go for it; hopefully I will enhance any positive effect also keep up any lines of communication if something come up that needs my advice.
Also on the positive side, almost all therapies that doctors currently use have been shown to work better than placebo in studies (i.e., better than 33%). In real life, when given by a trusted health professional who firmly believes in it themselves that additional psychological benefit is likely to be close to 50%. This means that if you believe a drug or treatment given by your doctor is going to help you, then it probably will work even before the drug actually does!.
Put it down to the power of positive thinking – if you believe that a drug is going to work then it is more likely to. Itcan also be tied to your health provider – if you have one that you trust and you have a good rapport with, then that person’s treatment is more likely to work.
The placebo effect also has in cultural variations. For example in New Zealand, the effect of a placebo injection is greater than a pill by 5-10%, but in France that effect is reversed, and pills work better.
The opposite or “nocebo effect” is also a recognised phenomenon. If the patient believes that a pill is going to cause side effects it is more likely to and if a trusted health provider casts doubt on a particular treatment then that decreases it’s benefit.
So where does that leave doctors? Should they be prescribing treatments they know are no better that sugar pills simply to harness the placebo effect? Should they be encouraging their patients to seek alternative treatments that have not been proven so as not to burst their placebo bubble?
It is a difficult ethical issue, but being open and honest is the main guiding principle here. A doctor should advise their patient when a treatment is “no better than placebo” and not falsely promote a particular therapy that has not been shown to work better than a sugar pill.
When I am asked about what I think about a questionable therapy provided by another health provider the right answer is even harder. In this situation I look for obvious harms – is the cost of treatment harmful to that patient? Are there potential side effects of the treatment or interactions with conventional treatments that may cause harm? If there are none then I usually encourage my patient to go for it; hopefully I will enhance any positive effect and keep up any lines of communication if something come up that needs my advice.
Also on the positive side, almost all therapies that doctors currently use have been shown to work better than placebo in studies (i.e., better than 33%). In real life, when given by a trusted health professional who firmly believes in it themselves, that additional psychological benefit is likely to be close to 50%. This means that if you believe a drug or treatment given by your doctor is going to help you, then it probably will work even before the drug actually does!