From: drarwingnuttephd@gmail.com   
      
   Doctors prescribe drugs that don't work - Of 157 doctors surveyed, 72 per cent   
   admitted dishing out placebos   
      
   *****   
      
   Doctors prescribe drugs that don't work    
   BY RUTH HILL    
   Last updated 05:00 04/07/2009    
      
      
      
   Three out of four New Zealand doctors have prescribed placebo medications to   
   patients, new research suggests.    
      
   Medical researcher Shaun Holt said the practice could be costing the taxpayer   
   several million dollars.    
      
   Of 157 doctors surveyed, 72 per cent admitted dishing out placebos, including   
   vitamins, herbal supplements, "harmless" medications, salt water injections   
   and sugar pills.    
      
   "But what surprised us was the most commonly prescribed placebos were   
   antibiotics, which is obviously a concern because of the rise of antibiotic   
   resistance and potential side-effects for patients," Dr Holt said.    
      
   A placebo is an inert medicine intended to lead the recipient to believe that   
   it may improve their condition.    
      
   Patients' unjustified demands for medication was cited as the most common   
   reason for prescribing placebos (34 per cent), followed by non-specific   
   complaints (25 per cent), and exhausting other treatment options (24 per   
   cent).    
      
   Dr Holt, who co-authored the paper in The New Zealand Medical Journal with   
   Massey University psychologist Andrew Gilbey, said he believed placebos were   
   ethical "as long as the doctor considers them to be in the best interests of   
   the patient". "The    
   placebo effect is quite powerful," he said.    
      
   A recent New Zealand survey suggested patients accept placebo use, at least   
   when there is no available alternative. However, given the deception involved,   
   it has been suggested that placebo use could harm the doctor-patient   
   relationship. The American    
   Medical Association warns that placebos are unethical and could expose doctors   
   to malpractice suits.    
      
   Other medical authorities claim placebos are bad because they condition   
   patients to believe that pills fix every ailment.    
      
   Dr Holt, who is calling on the Medical Council to issue guidelines on   
   placebos, said the total cost to taxpayers from placebos could be "several   
   million dollars" in subsidised GP visits, medicines and pharmacy charges.   
   "There could be an argument for    
   bringing back sugar pills, which are safer, just as effective and certainly   
   cheaper."    
      
   Wellington Independent Practice Association chairman Richard Tyler, a   
   Johnsonville GP, said it was "not what you give, it's how you give it".    
      
   "A doctor that hands something over with a couple of grunts is not going to   
   get the same result as someone who listens to the patient, explains the   
   illness and the treatment. You can't separate that from the placebo effect."    
      
   Pharmac medical director Peter Moodie said data showed doctors were   
   prescribing antibiotics responsibly. He agreed it was not acceptable to waste   
   money prescribing medicines with no effect.    
      
   Both the Health Ministry and the College of General Practitioners declined to   
   comment.    
      
   PLACEBO EFFECT    
      
   A placebo is a sham medical intervention, such as a pill or even an operation,   
   intended to make patients believe it will help. If someone thinks something   
   will make them better, it sometimes does a phenomenon known as "the placebo   
   effect".    
      
   HOW DOES IT WORK?    
      
   Placebos are associated with the release of natural painkillers in the brain,   
   including dopamine. Taking a placebo creates a "self-reinforcing feedback   
   loop" in the brain: during pain an individual recalls having taken the placebo   
   and reduced pain    
   reinforces its status as a painkiller. About one-in-three people appear   
   susceptible to placebo effects.    
      
   NEGATIVE EFFECTS    
      
   The so-called "nocebo effect" occurs when patients taking placebos develop   
   side-effects associated with real treatment. Some patients suffer withdrawal   
   symptoms when they stop taking placebos.    
      
   - The Dominion Post    
      
      
   http://www.stuff.co.nz/national/health/2564342/Doctors-prescribe   
   drugs-that-don-t-work   
      
   --- SoupGate-Win32 v1.05   
    * Origin: you cannot sedate... all the things you hate (1:229/2)