US doctors regularly prescribing placebo treatments

Results of a recent survey of US doctors have revealed that one in two doctors regularly prescribe "placebo treatments" to their patients.

Dr Jon Tilburt and colleagues sent a confidential survey about the use of placebos to 1200 randomly selected practicing general internal medicine physicians and rheumatologists. Of the 679 doctors who returned the survey half said that they prescribed “placebo treatments” to their patients on a regular basis, and 62% said that they believed the practice was ethically acceptable and that they were happy to recommend or prescribe placebos. Furthermore, 68% of those who admitted to prescribing placebo treatments said that they typically describe the treatment to patients as "a potentially beneficial medicine or treatment not typically used for their condition", only a small minority of respondents said that they would tell the patient that they were prescribing them a placebo.

Over the counter painkillers and vitamins were the placebo treatments of choice, with 41% of doctors opting for painkillers and 38% for vitamins. However, 13% said that they had given patients antibiotics and another 13% said that they had prescribed sedatives. Just 2% prescribed sugar pills.

The researchers concluded: “Few of the physicians we surveyed recommend inert placebo treatments. Recommending relatively innocuous treatments such as vitamins or over the counter analgesics to promote positive expectations might not raise serious concerns about detrimental effects to patients' welfare. Prescribing antibiotics and sedatives when they are not medically indicated, however, could have potentially important adverse consequences for both patients and public health.”

Tilburt JC, Emanuel EJ, Kaptchuk TJ, Curlin FA, Miller FG.Prescribing "placebo treatments": results of national survey of US internists and rheumatologists. BMJ 2008;337:a1938