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BBC: 'Most family doctors' have given a patient a placebo drug

Discussion in 'General ME/CFS News' started by Firestormm, Mar 21, 2013.

  1. Firestormm

    Firestormm Content Team Lead

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    Gerada was on the BBC Today programme this morning (Radio), and happened to mention she had also prescribed a placebo for 'fatigue'. The other doctor (a long time GP) claimed she had never prescribed a placebo feeling to do so was deceptive.

    There is I think something to be said about any medicine (even active ones) being at least in part placebo, but I think the focus here might be whether or not 'therapies' relating to CFS/ME as well as prescribed treatments (drugs), off-label and speculative, as well as supplements and unapproved treatments - are more placebo than not.

    How can you really tell? Anyway. It was an interesting mini-debate on the Radio and I think Gerada performed poorly. The interviewer kept laughing. I mean. Medicine in this day and age prescribing (knowingly) a placebo - well, it just sucks.
    snowathlete and Valentijn like this.
  2. Valentijn

    Valentijn Activity Level: 3

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    Sounds like Mrs Gerada and Mr Gerada (nee Wesseley) have a lot in common after all. Deceiving patients is fine (as long as it's cheapier/easier than finding or explaining or treating any real problems).
  3. user9876

    user9876 Senior Member

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    Its not just about diseaving patients. A placebo can lead to patients feeling their symptoms are less but without having a physical change. So without doing any diagnostics and giving a patient a placebo for say fatigue could simply delay any real diagnosis and treatment.

    The interviews should have been asking what process did you go through before prescribing a placebo.
    snowathlete and Valentijn like this.
  4. SilverbladeTE

    SilverbladeTE Senior Member

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    It's fraud, plain and simple
    it gets in way of proper diagnosis/healing nad patient respect.

    Placebo should only be acceptable in trials, and extremis
    this shows the arrogant stinking atttude of the medial profession
    jimells, golden, Ben Howell and 2 others like this.
  5. snowathlete

    snowathlete

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    it just breaks down patient-doctor trust, and really what it is is the doctor fobbing you off because he doesn't know what to do with you, or worse, doesn't believe you. I think it's shocking.
    golden, ggingues and Valentijn like this.
  6. wdb

    wdb Admin

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    I think the BBC have somewhat sensationalised that story, there is a better article here

    In fact only 12% have used 'pure' placebos such as sugar pills.

    The 97% figure includes treatments that are unproven, such as antibiotics for suspected viral infections, or more commonly non-essential physical examinations and blood tests performed to reassure patients.
    Jarod, Firestormm and Valentijn like this.
  7. Esther12

    Esther12 Senior Member

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    Thanks for mentioning this.

    I've tried to find audio of the Gerada audio but haven't been able to.

    It starts at 1:52: http://www.bbc.co.uk/programmes/b01r9rxp

    I think that this is a really important part of the problems which surround CFS, and the matters of dishonesty, informed consent, paternalism, etc. I think that in this area the British establishment is a long way behind the British public, and also many front-line GPs. I've also noticed that those keen on biopsychosocial management tend to be those who believe that placebos are particularly effective treatments, while those sceptical about the claims of placebos leading to dramatic medical benefits also tend to be more committed to treating patients honestly.
    Shell and Valentijn like this.
  8. ggingues

    ggingues $10 gift code at iHerb GAS343 of $40

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    Scary, WTF!

    GG
  9. biophile

    biophile Places I'd rather be.

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    So according to Gerada, "fobbing off patients with an ineffectual treatment was never acceptable", but it is "perfectly acceptable to use a placebo as long as it did not cause harm and was not expensive"? Placebos are ineffective in the majority of people, and the supposed benefits of placebo are questionable.
    SOC and Shell like this.
  10. Little Bluestem

    Little Bluestem Senescent on the Illinois prairie, USA

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    I am disturbed that these doctors consider complementary medicines to be the same as a placebo. While they may be unproven in the sense of not having medical trials to back them, they often have a long history of successful use. If the doctor is not familiar with that history and considers them ineffective, he may use them inappropriately and harmfully.
  11. Valentijn

    Valentijn Activity Level: 3

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    The snippet is less than 5 minutes long, so worth listening to. But here's a transcript (no guarantees I didn't miss a word or two).

    Yup, you heard it ... vitamins are placebo! I'd like to see how good she'd be feeling if she was deficient in some vitamins :cautious:
    Jarod likes this.
  12. SilverbladeTE

    SilverbladeTE Senior Member

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    And remember, in M.E. patients, the "placebo effect" is much less than normal!
    jimells likes this.
  13. Jarod

    Jarod Senior Member

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    Good one. Don't want anybody to get any funny ideas.

    The 12% is still shocking though. My girlfriend watches this show called "house" on TV. House is a doctor (with a drug habit) who is an expert at diagnosing tough and unusual illnesses.

    House had a CFS patient propaganda episode one time that showed the Dr diagnosing a CFS patient. Dr House determined the best treatment for the CFS patient was placibos. He obtained some heavy pain killers from the pharmacy and immediately emptied the painkillers in his pocket.He then goes to the vending machine to buy skittles to refill the prescription bottle with skittles for the CFS patient.....

    Makes my stomach turn when I see my girlfriend watching those shows. Later I try to explain how something in the real world works and she tells me she "knows" because she watches another show called CSI......:ill:
    sianrecovery and Tito like this.
  14. Valentijn

    Valentijn Activity Level: 3

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    Not to get too off track, but the "CFS patient" was self-diagnosed based feeling a bit tired out. So probably not someone with ME/CFS.

    Though the aspect of getting rid of someone by using a placebo was still quite nasty. And if I got to choose the context in which ME/CFS was mentioned on House, I would have chosen a rather different scenario :rolleyes: But if your girlfriend is into the doctor shows, "Royal Pains" has an episode where CFS is briefly mentioned as a potential diagnosis for someone acknowledged to be seriously ill ... and ruled out in the context of "good news, your life isn't over."
    Jarod likes this.
  15. Hip

    Hip Senior Member

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    Patients are just as much to blame here, as patients often mistakenly believe that doctors are some kind of omniscient and omnipotent gods. We go to doctors not just for medical advice and consultation, but because we want the assurance and support of an all-knowing medical authority figure in times of personal medical crisis and sickness. I am just as much to blame in this respect as everyone else. I admit that sickness does create psychological vulnerability, and the psychological need for a supportive medical authority.

    This is not unlike the human need for a supportive religious figure. And just as Nietzsche told us that "God is dead" (what he meant was that the era in which we had a childlike reliance on a divine father or authority figure was over), likewise, we as patients need to develop maturity, and dispense with the childlike need for an all-knowing medical figure. Then doctors will not feel the need to prescribe placebos, just to create hope, and to cultivate an aura of capability.

    Because patients have this childlike psychological need, that is why we get placebos. We have got to come to terms with the fact that often doctors can do very little in the case of many diseases.
  16. Valentijn

    Valentijn Activity Level: 3

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    Seriously? If we disagree with them or even ask for clarification, then we're usually assumed to be disrespectful know-it-all hypochondriacs.
    PhoenixBurger, MeSci and SOC like this.
  17. Esther12

    Esther12 Senior Member

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    I think that informed consent is the important thing here. I never wanted reassurance or emotional support, I wanted, and want, to be able to trust that my doctor will try to communicate honestly and respectfully with me. The biopsychosocial approach to CFS makes that impossible, and this is a burden.

    If some patients want paternalism, they need to provide informed consent for it. It should not be inflicted routinely upon people without their consent.
    allyb, MeSci, Shell and 2 others like this.
  18. Jarod

    Jarod Senior Member

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    Agree doctors are people too. They have a tough job.

    I think the patients and society in general are heavily trained to consider doctors as gods. Every tool imaginable is used to do this no doubt; Including, but not limited to television.

    This puts tremendous burden on the doctors, and probably serves as a useful tool to keep the majority if doctors strickly following the official CDC treatment consensus. The CDC consensus being; treat physical disease as a mental illness for all practical purposes.

    Frustrating, but the system is changing. People are becoming more informed and this should help IMO.
  19. Jarod

    Jarod Senior Member

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    Oh no there's another one. o_O Maybe I should disconnect cable so she doesn't get anymore wrong ideas. :O)
    Valentijn likes this.
  20. Hip

    Hip Senior Member

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    It is interesting that not so many decades ago, the tact often taken by doctors was to be very judicious with the truth, when it was perceived that the truth might be too much to bear for a given patient.

    For example, certain patients who had incurable fatal diseases might not be told of the diagnosis themselves, the facts of the matter only given to some other family member. Similarly, many a person told by their doctor that they had say a fatal cancer would keep this fact to themselves, and not inform their family, because they considered it too much to bear for their family.

    Being judicious with the truth — truth management, if you like — was a very common approach to dealing with things, not only in medicine, but in many walks of life.

    It is only in recent decades that we have begun to slowly bring everything above board, making the facts of all sorts of areas of life much more visible and available. It is all part of the Information Age we have entered into. But this approach is a brave new world, and, coming back to medicine, whether it is wise to go for a "total truth" approach in medicine, or whether is wise to still keep certain details confidential, is a matter for debate.

    Perhaps sometimes certain facts are best not brought up. Nobody tells their girlfriend that their backside looks fat, even if it does.

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