Why Would Doctors Write A Placebo Prescription? The Patient/Consumer Flaw.

There was a news story that hit the web recently that I found disturbing.  A survey of doctors was conducted, in which researchers were interested in their prescribing of placebo treatments.  A majority admitted to prescribing placebo treatments to patients!  Treatments suggested/prescribed were primarily vitamins, OTC analgesics (i.e. Tylenol), antibiotics, and sedatives.  Doctors did not seem to see an ethical problem with this approach to patient care.  That fact disturbs me, and prompted me to try understanding why a doctor would engage in that type of behavior.

Why Would Doctors Write A Placebo Prescription?

After getting over my initial outrage at this finding, I suppose I can almost understand (from a practical standpoint), why a doctor might write a prescription, knowing it wouldn’t actually do anything for the patient.  It’s our addiction to “the quick fix.”  In today’s world, many of us are addicted to the idea that we can get a pill to fix our problems.  If our kids aren’t behaving how we think they should, we give them a pill to calm them down.  If we have aches and pains from the flu, a shot and dose of vitamins should make it all better.  So, if we take the time out of our schedule to wait in line at the doctor’s office (an all-day affair much of the time), and spend the cash on a co-pay, then by gosh, we expect to them to do something.  And if they don’t, then maybe they aren’t competent, right?  Chances are, as consumers, that will make us angry, and we’ll look for another doctor that will do something.  Even if that something doesn’t make any sense.

If that’s the line of reasoning patients take, then I can understand why doctors would feel pressured to give their patients something for each and every visit.  Since patients are consumers, this becomes a business decision, and doctors end up feeling as if they need to give their patients added value.  If this is what is happening, then we have a flaw in the business model of healthcare.  (I think we can all agree that the U.S. healthcare system has many, many flaws.)

Unfortunately, what may make the consumer feel as if they’re getting value works against what is best for the public at large, and perhaps for the individual as well.  For instance, it is well documented that many bacteria are rapidly gaining resistance to our most commonly prescribed antibiotics.  The prescription of an antibiotic as a placebo only hastens this process.  It could also create other problems.  For instance, the use of an antibiotic sometimes leads to yeast infections in patients.  Improper or unwarranted use of any substance can lead to injury.

As consumers of healthcare, we need to be more knowledgeable about the subject when we visit the doctor, and adjust our quick-fix mentality.  Doctors also need to (as a group), be more willing to uphold their ethics, and not prescribe treatments that are not warranted.  Problems like this are part of the reason our medical costs are on a never-ending upward spiral, and will eventually lead to the development of medical problems that we can not treat (i.e. staph infections).

Has anyone had experience with this?  As a patient, do you always expect your doctor to prescribe something?  As a doctor, do you feel pressured to write prescriptions?

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