Primary care providers' use of and attitudes towards placebos: An exploratory focus group study with US physicians, 2020, Bernstein et al

Andy · May 31, 2020

Objective

To examine how primary care physicians define placebo concepts, use placebos in clinical practice, and view open‐label placebos (OLPs).

Design
Semi‐structured focus groups that were audio‐recorded and content‐coded.

Methods
Two focus groups with a total of 15 primary care physicians occurred at medical centres in the New England region of the United States. Prior experience using placebo treatments and attitudes towards open‐label placebos were explored. Themes were analysed using an inductive data‐driven approach.

Results
Physicians displayed a nuanced understanding of placebos and placebo effects in clinical contexts which sometimes focused on relational factors. Some respondents reported that they prescribed treatments with no known pharmacological effect for certain conditions and symptoms (‘impure placebos’) and that such prescriptions were more common for pain disorders, functional disorders, and medically unexplained symptoms. Opinions about OLP were mixed: Some viewed OLPs favourably or considered them ‘harmless’; however, others strongly rejected OLPs as disrespectful to patients. Other issues in relation to OLPs included the following: lack of guidelines, legal and reputational concerns, and the notion that such treatments would run counter to customary medical practice.

Conclusions
A number of physicians reported prescribing impure placebos in clinical care. Although some primary care physicians were resistant to the possibility of recommending OLPs, others regarded OLPs more favourably, viewing them as potential treatments, albeit with restricted potential.
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Paywall, https://onlinelibrary.wiley.com/doi/full/10.1111/bjhp.12429
Sci hub, https://sci-hub.tw/10.1111/bjhp.12429

Snowdrop · May 31, 2020

It seems too that even if a good placebo effect is achieved for the patient -- because it is a placebo the effects will not be long lasting. So then what?

rvallee · May 31, 2020

There's a reason placebo is the control for nothing in formal trials: it is nothing. It's a measurement error that occurs only about things that can't be measured. Whenever anything is measured it disappears, because that's all it is, an imprecision from being unable to formally measure something, amplified by biased questionnaires.

One day placebos will be seen as archaic and obsolete, a dumb primitive error of magical thinking that could have been avoided entirely had the scientific method and basic common sense been applied. That day can't come soon enough.

Meanwhile there's the alternative medicine industry providing the same. Not only is it useless, it is redundant. Grandfathered debunked myths used in practice so late in the modern age is just systemic failure. I applaud those who reject it as disrespectful, it 100% is. More of this, please. Less of those who think it has value, because the only value it has is in allowing for laziness and dereliction of duty. Exactly zero of that, please.

Sean · Jun 1, 2020

Any doctor who uses placebo on me without my informed consent will be sacked the instant I find out about it, and a formal complaint made to the relevant medical licencing body (for what that is worth).

It is a lazy, arrogant, corrupt, and cruel abuse of medical authority.

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Primary care providers' use of and attitudes towards placebos: An exploratory focus group study with US physicians, 2020, Bernstein et al

Andy Committee Member

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Primary care providers' use of and attitudes towards placebos: An exploratory focus group study with US physicians, 2020, Bernstein et al

Andy Committee Member

Snowdrop Senior Member (Voting Rights)

rvallee Senior Member (Voting Rights)

Sean Moderator Staff Member

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