Skip to main content
Top
Published in: Journal of General Internal Medicine 1/2008

01-01-2008 | Original Article

Academic Physicians Use Placebos in Clinical Practice and Believe in the Mind–Body Connection

Authors: Rachel Sherman, John Hickner, MD, MSc

Published in: Journal of General Internal Medicine | Issue 1/2008

Login to get access

Abstract

Background

The placebo and the placebo effect are often investigated in the context of clinical trials. Little data exist on the use of placebos in the course of routine health care.

Objective

The aim of this study is to describe a group of academic physicians’ use of placebos and their knowledge, attitudes, and beliefs about placebos and the placebo effect.

Design

A 16-question anonymous web-based survey of physicians from Internal Medicine departments of 3 Chicago-area medical schools was used.

Results

There were 231/466 (50%) physicians who responded; of these, 45% reported they had used a placebo in clinical practice. The most common reasons for placebo use were to calm the patient and as supplemental treatment. Physicians did not widely agree on the definition of a placebo and had a variety of explanations for its mechanism of action. Ninety-six percent of the respondents believed that placebos can have therapeutic effects, and up to 40% of the physicians reported that placebos could benefit patients physiologically for certain health problems. Only 12% of the respondents said that placebo use in routine medical care should be categorically prohibited. Regarding “placebo-like” treatment, 48% of respondents reported giving at least 1 type of treatment in a situation where there was no evidence of clinical efficacy.

Conclusion

Nearly half of the respondents use placebos in clinical practice and most believe in the mind–body connection. The results of this study, based on retrospective self-reported behavior, are subject to recall bias and may not be representative of American physicians.
Literature
1.
go back to reference Benedetti F, Amanzio M. The neurobiology of placebo analgesia: from endogenous opioids to cholecystokinin. Prog Neurobiol. 1997;52(2):109–25.PubMedCrossRef Benedetti F, Amanzio M. The neurobiology of placebo analgesia: from endogenous opioids to cholecystokinin. Prog Neurobiol. 1997;52(2):109–25.PubMedCrossRef
2.
go back to reference Benson H. Timeless healing: the power and biology of belief. New York: Simon and Schuster; 1996. Benson H. Timeless healing: the power and biology of belief. New York: Simon and Schuster; 1996.
3.
go back to reference Berger JT. Placebo medication use in patient care: a survey of medical interns. West J Med. 1999;170:93–6.PubMed Berger JT. Placebo medication use in patient care: a survey of medical interns. West J Med. 1999;170:93–6.PubMed
4.
go back to reference Brody H. Placebos and the philosophy of medicine. Chicago: University of Chicago Press; 1980. Brody H. Placebos and the philosophy of medicine. Chicago: University of Chicago Press; 1980.
5.
go back to reference Ernst E, Abbot NC. Placebos in clinical practice: results of a survey of nurses. Perfusion. 1997;10:128–30. Ernst E, Abbot NC. Placebos in clinical practice: results of a survey of nurses. Perfusion. 1997;10:128–30.
6.
go back to reference Goldberg RJ, Leigh H, Quinlan D. The current status of placebo in hospital practice. Gen Hosp Psych. 1979;1(3):196–201.CrossRef Goldberg RJ, Leigh H, Quinlan D. The current status of placebo in hospital practice. Gen Hosp Psych. 1979;1(3):196–201.CrossRef
7.
go back to reference Goodwin JS, Goodwin JM, Vogel AV. Knowledge and use of placebos by house officers and nurses. Ann Intern Med. 1979;91(1):106–10.PubMed Goodwin JS, Goodwin JM, Vogel AV. Knowledge and use of placebos by house officers and nurses. Ann Intern Med. 1979;91(1):106–10.PubMed
8.
go back to reference Gray G, Flynn P. A survey of placebo use in a general hospital. Gen Hosp Psych. 1981;3(3):199–203.CrossRef Gray G, Flynn P. A survey of placebo use in a general hospital. Gen Hosp Psych. 1981;3(3):199–203.CrossRef
9.
go back to reference Bok S. Ethical issues in use of placebo in medical practice and clinical trials. In: Guess HA, Kleinman A, Kusek JW, Engel LW, eds. The science of the placebo: toward an interdisciplinary research agenda. London: BMG Books; 2002, pp. 53–74. Bok S. Ethical issues in use of placebo in medical practice and clinical trials. In: Guess HA, Kleinman A, Kusek JW, Engel LW, eds. The science of the placebo: toward an interdisciplinary research agenda. London: BMG Books; 2002, pp. 53–74.
10.
go back to reference Harrington A. “Seeing” the placebo effect: historical legacies and present opportunities. In: Guess HA, Kleinman A, Kusek JW, Engel LW, eds. The science of the placebo: toward an interdisciplinary research agenda. London: BMJ Books; 2002:35–53. Harrington A. “Seeing” the placebo effect: historical legacies and present opportunities. In: Guess HA, Kleinman A, Kusek JW, Engel LW, eds. The science of the placebo: toward an interdisciplinary research agenda. London: BMJ Books; 2002:35–53.
11.
go back to reference Hofling CK. The place of placebos in medical practice. GP. 1955;11(6):103–7.PubMed Hofling CK. The place of placebos in medical practice. GP. 1955;11(6):103–7.PubMed
12.
go back to reference Hrobjartsson A, Gotzsche PC. Is the placebo powerless? An analysis of clinical trials comparing placebo with no treatment. N Engl J Med. 2001;344(21):1594–602.PubMedCrossRef Hrobjartsson A, Gotzsche PC. Is the placebo powerless? An analysis of clinical trials comparing placebo with no treatment. N Engl J Med. 2001;344(21):1594–602.PubMedCrossRef
13.
go back to reference Hrobjartsson A, Norup M. The use of placebo interventions in medical practice—a national questionnaire survey of Danish clinicians. Eval Health Prof. 2003;26(2):153–65.PubMedCrossRef Hrobjartsson A, Norup M. The use of placebo interventions in medical practice—a national questionnaire survey of Danish clinicians. Eval Health Prof. 2003;26(2):153–65.PubMedCrossRef
14.
go back to reference Moerman D. Explanatory mechanisms for placebo effects: cultural influences and the meaning response. In: Guess HA, Kleinman A, Kusek JW, Engel LW, eds. The science of the placebo: toward an interdisciplinary research agenda. London: BMJ Books; 2002:77–108. Moerman D. Explanatory mechanisms for placebo effects: cultural influences and the meaning response. In: Guess HA, Kleinman A, Kusek JW, Engel LW, eds. The science of the placebo: toward an interdisciplinary research agenda. London: BMJ Books; 2002:77–108.
15.
go back to reference Moerman D, Jonas W. Deconstructing the placebo effect and finding the meaning response. Ann Intern Med. 2002;136(6):471–7.PubMed Moerman D, Jonas W. Deconstructing the placebo effect and finding the meaning response. Ann Intern Med. 2002;136(6):471–7.PubMed
16.
go back to reference Nitzan U, Lichtenberg P. Questionnaire survey on use of placebo. Br Med J. 2004;329(7472):944–6.CrossRef Nitzan U, Lichtenberg P. Questionnaire survey on use of placebo. Br Med J. 2004;329(7472):944–6.CrossRef
2.
go back to reference Harrington A, eds. The placebo effect: an interdisciplinary exploration. Cambridge: Harvard University Press; 1997. Harrington A, eds. The placebo effect: an interdisciplinary exploration. Cambridge: Harvard University Press; 1997.
3.
go back to reference Kendler KS. A psychiatric dialogue on the mind–body problem. Journal of American Psychiatry. 2001;158(7):989–1000.CrossRef Kendler KS. A psychiatric dialogue on the mind–body problem. Journal of American Psychiatry. 2001;158(7):989–1000.CrossRef
4.
go back to reference Lynoe N, Mattsson B, Sandlund M. The attitudes of patients and physicians towards placebo treatment—a comparative study. Soc Sci Med. 1993;36(6):767–74.PubMedCrossRef Lynoe N, Mattsson B, Sandlund M. The attitudes of patients and physicians towards placebo treatment—a comparative study. Soc Sci Med. 1993;36(6):767–74.PubMedCrossRef
5.
go back to reference Shapiro AK, Struening EL. The use of placebos: A study of ethics and physician attitudes. Psychiatr Med. 1973;4:17–29.CrossRef Shapiro AK, Struening EL. The use of placebos: A study of ethics and physician attitudes. Psychiatr Med. 1973;4:17–29.CrossRef
6.
go back to reference Thomson RJ, Buchanan WJ. Placebos and general practice: attitudes to, and the use of, the placebo effect. NZ Med J. 1982;95(712):492–4. Thomson RJ, Buchanan WJ. Placebos and general practice: attitudes to, and the use of, the placebo effect. NZ Med J. 1982;95(712):492–4.
Metadata
Title
Academic Physicians Use Placebos in Clinical Practice and Believe in the Mind–Body Connection
Authors
Rachel Sherman
John Hickner, MD, MSc
Publication date
01-01-2008
Publisher
Springer-Verlag
Published in
Journal of General Internal Medicine / Issue 1/2008
Print ISSN: 0884-8734
Electronic ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-007-0332-z

Other articles of this Issue 1/2008

Journal of General Internal Medicine 1/2008 Go to the issue

Reflection

Goats

Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.