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The use of placebo has been associated by patients with trickery or losing out, but some researchers are looking for something about it that can be harnessed to heal.
The placebo-controlled trial long has been the standard-bearer that provides the comparison point by which a medical intervention, particularly a drug, can be deemed to work or not.
Increasingly, though, researchers are considering the value of placebo on an entirely different level, asking whether something can be learned from the fact that beneficial effects are sometimes seen in subjects taking dummy pills and if this occurrence can somehow be translated into improved medical care.
With this article
* Take the good, but avoid the nocebo effect
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"The placebo response is important -- not because we're going to treat people with placebo, because that would be unethical -- but if we can find out what it is about placebos that helps people get better, we can try to apply it more broadly," said Andrew Leuchter, MD, professor and vice chair of the Dept. of Psychiatry at the Neuropsychiatric Institute at the University of California, Los Angeles. He has published several papers documenting differences between the brains of patients with depression who respond to placebo and those who don't.
I know that this is anectotal but I have found in the years that I have been in practice that the colour of ointments used can influence patients perceived outcome. Green ointments seem to be especially favoured by patients. Smell is also important it seems
The reason for this was to try and find out what was causing the pain.
The old girl has the X Ray and upon leaving the Xra room she said:
What marvelous machine. It must be very expensive as it has cured my pain.
Years ago when i ran the verucca clinic if the child was under 5 years i used to persuade the parent to make a real song and dance of buying the verrucca for a pound. The success rate was as good as if not better than chemical.
A child falls over and scuffs his knees and screams the house down as he is in pain.
Mmmy kisses it better the pain goes away the runs off to continue what he was doing.
You are having a bad day and your next pt is a MOANER .
You do not ask how they are but say YOU LOOK WELL TODAY AND THEY REPLY THAT TODAY IS A GOOD DAY.
We use this effect daily, and it is a very powerful tool to use in dealing with the public.
The power of suggestion can affect research which is why the placebo effect is used to assess the true results of the trail.
How many times have you heard that the generic drug is not as good as the branded drug. The reason is the pt knows the generic is cheaper so cant be as good.
If you tell a pt to buy an expensive emolient thay are more likely to use it regulRLY AS IT MUST BE BETTER THAN A SIMPLE CHEAPER CREAM WITH THE SAME ACTIVE INGREDIENT.
"If you tell a pt to buy an expensive emolient thay are more likely to use it regulRLY AS IT MUST BE BETTER THAN A SIMPLE CHEAPER CREAM WITH THE SAME ACTIVE INGREDIENT."
Better still, buy a cheap cream and sell it on at an over inflated price!
The story goes that in the 1940's in my town a well known and respected Doctor had his practice on one of our main roads. He got all sorts through the door, (Shipyard workers, factory workers, miners), he had the lot!
For a certain type of patient the Doctor had six similar sweet jars on his pharmacies shelf, each one containing the same placebo in a different colour. Each week he gave the same pills to his patients by sending a message down to the person running the pharmacy. It read, "What colour was the pills last week? Make sure you change it from 'x-colour' to 'y-colour' this week!"
His cure rate was one of the best in the town and the patients' trust was blind and total!!! The healing,(placebo effect), was all in the mind you see once he had ascertained in the original prognosis/diagnoses that nothing was likely to drop off!!! A little bit of loving-tender-kindness together with concern that he cared for them, of course together with the pills prescribed always did the, (dare I say it?) trick!
Today he would probably get arrested for malpractice or something. Some hospital information sheets can run, "Here is an information sheet which your Doctor has explained to you for you to read again later before the surgery!" On the bottom of the form in good legally thought out language it could say if translated back into basic Anglo-saxon:- "Of course 1 in a 100 of you are likely to die if you sign the bottom of the consent form!"
That is possibly why placebo effects are rather harder to achieve in this more enlightened age, with lack of trust and the suing culture thrown in!
I know that this is anecdotal but I have found in the years that I have been in practice that the colour of ointments used can influence patients perceived outcome. Green ointments seem to be especially favoured by patients. Smell is also important it seems
Hi Zaffie,
A late, late reply. Could the choice and preference of the patient for green ointments have something to do with 'like curing like'? (Homeopathy, Bach Remedies rather than Orthodox medicine?).
Not so sure I would use green ointment with confidence on green pus though, thinking about it!
Regards,
Colin.
P.S. Of course we could always pray over it. I've seen that work when all else has failed. I have been known to threaten it with the last-rights too, before? Not really trying to be flippant! No offence meant!!!!
Placebos Article by Gregory M. Lamb :- Christian Science Monitor!!!
Hi All,
A very well put together article on PLACEBOS has appeared in USA TODAY (8.4.5) by Gregory M. Lamb.
Quote: 'Most people think of placebo as harmless "sugar pills"........ But in some trials, the "placebo effect" proves to be as strong as that of the drug.' ................
..............."In a sense, placebo is the clinician's best friend," Coughlan says. "But in the scientific view of medicine, it's the enemy because we're always trying to prove that something is better than placebo". ..............
..........Perhaps 50% of the effect of seeing a physician is "based on the doctor-patient relationship, the art of medicine, and it's not acknowledged," he adds[Kaptchuk]. "And I think that's what people want the art."
My experience cross-reference postings above:- This is my regret with the way things have gone recently, the doctor-patient relationship has been destroyed by, "Thou shalt tell the truth to each and every one of your patients even, and despite the fact that doing so will probably kill him/her!!! The bedside manner is out of the window and it's cover your backs time! Mystery, art and craft gone. "And by the way your going to die! I'm telling you this just in case you suffer the misfortune of something going wrong!"
I would like to quote more of this article found in the 'USA TODAY' but it has rightly been copyrighted. "2005 The Christian Science Monitor."
Pursuing the placebo effect: What exactly is it?
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