Thursday, October 23, 2008

America at it's finest. I say this sarcastically. This article is for those people who naively believe that you can trust your mind, body, soul, and health to anyone other than yourself.

Survey: Half of US doctors use placebo

HOLD FOR RELEASE UNTIL 7 P.M. EDT; graphic shows results of survey on attitudes AP – HOLD FOR RELEASE UNTIL 7 P.M. EDT; graphic shows results of survey on attitudes and behaviors related …

LONDON – About half of American doctors in a new survey say they regularly give patients placebo treatments — usually drugs or vitamins that won't really help their condition. And many of these doctors are not honest with their patients about what they are doing, the survey found.

That contradicts advice from the American Medical Association, which recommends doctors use treatments with the full knowledge of their patients.

"It's a disturbing finding," said Franklin G. Miller, director of the research ethics program at the U.S. National Institutes Health and one of the study authors. "There is an element of deception here which is contrary to the principle of informed consent."

The study was being published online in Friday's issue of BMJ, formerly the British Medical Journal.

Placebos as defined in the survey went beyond the typical sugar pill commonly used in medical studies. A placebo was any treatment that wouldn't necessarily help the patient.

Scientists have long known of the "placebo effect," in which patients given a fake or ineffective treatment often improve anyway, simply because they expected to get better.

"Doctors may be under a lot of pressure to help their patients, but this is not an acceptable shortcut," said Irving Kirsch, a professor of psychology at the University of Hull in Britain who has studied the use of placebos.

Researchers at the NIH sent surveys to a random sample of 1,200 internists and rheumatologists — doctors who treat arthritis and other joint problems. They received 679 responses. Of those doctors, 62 percent believed that using a placebo treatment was ethically acceptable.

Half the doctors reported using placebos several times a month, nearly 70 percent of those described the treatment to their patients as "a potentially beneficial medicine not typically used for your condition." Only 5 percent of doctors explicitly called it a placebo treatment.

Most doctors used actual medicines as a placebo treatment: 41 percent used painkillers, 38 percent used vitamins, 13 percent used antibiotics, 13 percent used sedatives, 3 percent used saline injections, and 2 percent used sugar pills.

In the survey, doctors were asked if they would recommend a sugar pill for patients with chronic pain if it had been shown to be more effective than no treatment. Nearly 60 percent said they would.

Smaller studies done elsewhere, including Britain, Denmark and Sweden, have found similar results.

Jon Tilburt, the lead author of the U.S. study, who is with NIH's bioethics department, said he believes the doctors surveyed were representative of internists and rheumatologists across the U.S. No statistical work was done to establish whether the survey results would apply to other medical specialists, such as pediatricians or surgeons.

The research was paid for by NIH's bioethics department and the National Center for Complementary and Alternative Medicine.

The authors said most doctors probably reasoned that doing something was better than doing nothing.

In some cases, placebos were given to patients with conditions such as chronic fatigue syndrome. Doctors also gave antibiotics to patients with viral bronchitis, knowing full well that a virus is impervious to antibiotics, which fight bacteria. Experts believe overuse of antibiotics promotes the development of drug-resistant strains of bacteria.

Some doctors believe placebos are a good treatment in certain situations, as long as patients are told what they are being given. Dr. Walter Brown, a professor of psychiatry at Brown and Tufts universities, said people with insomnia, depression or high blood pressure often respond well to placebo treatments.

"You could tell those patients that this is something that doesn't have any medicine in it but has been shown to work in people with your condition," he suggested.

However, experts don't know if the placebo effect would be undermined if patients were explicitly told they were getting a dummy pill.

Brown said that while he hasn't prescribed sugar pills, he has given people with anxiety problems pills that had extremely low doses of medication. "The dose was so low that whatever effect the patients were getting was probably a placebo effect," he said.

Kirsch, the psychologist, said it might be possible to get the psychological impact without using a fake pill. "If doctors just spent more time with their patients so they felt more reassured, that might help," he said.

Some patients who had just seen their doctors at a clinic in London said the truth was paramount.

"I would feel very cheated if I was given a placebo," said Ruth Schachter, an 86-year-old Londoner with skin cancer. "I like to have my eyes wide open, even if it's bad news," she said. "If I'm given something without being warned what it is, I certainly would not trust the doctor again."


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Friday, October 17, 2008

Good news!

There is a great give-away going on right now! 4 Reluctant Entertainers blog is giving away a Fall Box which includes her homemade apple butter. All that is needed is to comment on her blog. Don't blog? That's okay too. Email her to enter to win. No pressure to start a blog with no intention of blogging! How great is that?! Winners will be announced on Monday.
We lucked out so far this fire season. Only one came close enough for me to evacuate but the fire department had it extinguished fast. Conditions should be improving by tonight. This is predicted to be the last day of red flag conditions. (Although it started out only being for Sunday night through Tuesday and here we are at Friday. Typical weather forcasting at its best.) Anyway. I hope that all of you throughout your worlds are planning a lovely weekend. Halloween is almost upon us again. Fall festivals are happening all over the country.

More coming soon. Stay tuned as we wait out this fire season to end. (And others for hurricane season to end also.)

Saturday, October 11, 2008

What a beautiful fall day we had today! I long for these days after having such a long summer. Days of 100's and 90's I enjoy the crisp coolness of 66 today. Loved every minute of it. I yearn for the day when we retire that we can move back to a part of the world where we actually experience all 4 seasons. Oh but another 8 years to go before that happens. I don't have much to write today, but I have many ideas to share with you in the coming weeks. So stay tuned. This wild and crazy ride is starting... (laughing at myself here.)

Sunday, October 05, 2008

I am sorry for the long absence. As with anyone with younger kids running afoot, you know firsthand how one catastrophe can easily lead to another! Couple that with an absent husband on a trip, and well, you know... more catastrophe. Oh how it easily flows around here! Running rampant it does.
I do want to let those of you that still actually check on me through here, that the lines of communication will be flowing again. I have found some wonderful design blogs to share.
See you on Monday.