Prescribing "placebo treatments": Results of national survey of US internists and rheumatologists

Jon C. Tilburt, Ezekiel J. Emanuel, Ted J. Kaptchuk, Farr A. Curlin, Franklin G. Miller

Research output: Contribution to journalArticle

Abstract

Objective: To describe the attitudes and behaviours regarding placebo treatments, defined as a treatment whose benefits derive from positive patient expectations and not from the physiological mechanism of the treatment itself. Design: Cross sectional mailed survey. Setting: Physicians' clinical practices. Participants: 1200 practising internists and rheumatologists in the United States. Main outcome measures: Investigators measured physicians' self reported behaviours and attitudes concerning the use of placebo treatments, including measures of whether they would use or had recommended a "placebo treatment," their ethical judgments about the practice, what they recommended as placebo treatments, and how they typically communicate with patients about the practice. Results: 679 physicians (57%) responded to the survey. About half of the surveyed internists and rheumatologists reported prescribing placebo treatments on a regular basis (46-58%, depending on how the question was phrased). Most physicians (399, 62%) believed the practice to be ethically permissible. Few reported using saline (18, 3%) or sugar pills (12, 2%) as placebo treatments, while large proportions reported using over the counter analgesics (267, 41%) and vitamins (243, 38%) as placebo treatments within the past year. A small but notable proportion of physicians reported using antibiotics (86, 13%) and sedatives (86, 13%) as placebo treatments during the same period. Furthermore, physicians who use placebo treatments most commonly describe them to patients as a potentially beneficial medicine or treatment not typically used for their condition (241, 68%); only rarely do they explicitly describe them as placebos (18, 5%). Conclusions: Prescribing placebo treatments seems to be common and is viewed as ethically permissible among the surveyed US internists and rheumatologists. Vitamins and over the counter analgesics are the most commonly used treatments. Physicians might not be fully transparent with their patients about the use of placebos and might have mixed motivations for recommending such treatments.

Original languageEnglish (US)
Pages (from-to)1097-1100
Number of pages4
JournalBMJ (Online)
Volume337
Issue number7678
DOIs
StatePublished - Nov 8 2008
Externally publishedYes

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Placebos
Physicians
Therapeutics
Surveys and Questionnaires
Rheumatologists
Vitamins
Analgesics
Hypnotics and Sedatives
Motivation
Cross-Sectional Studies
Research Personnel
Medicine
Outcome Assessment (Health Care)
Anti-Bacterial Agents

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Tilburt, J. C., Emanuel, E. J., Kaptchuk, T. J., Curlin, F. A., & Miller, F. G. (2008). Prescribing "placebo treatments": Results of national survey of US internists and rheumatologists. BMJ (Online), 337(7678), 1097-1100. https://doi.org/10.1136/bmj.a1938

Prescribing "placebo treatments" : Results of national survey of US internists and rheumatologists. / Tilburt, Jon C.; Emanuel, Ezekiel J.; Kaptchuk, Ted J.; Curlin, Farr A.; Miller, Franklin G.

In: BMJ (Online), Vol. 337, No. 7678, 08.11.2008, p. 1097-1100.

Research output: Contribution to journalArticle

Tilburt, JC, Emanuel, EJ, Kaptchuk, TJ, Curlin, FA & Miller, FG 2008, 'Prescribing "placebo treatments": Results of national survey of US internists and rheumatologists', BMJ (Online), vol. 337, no. 7678, pp. 1097-1100. https://doi.org/10.1136/bmj.a1938
Tilburt JC, Emanuel EJ, Kaptchuk TJ, Curlin FA, Miller FG. Prescribing "placebo treatments": Results of national survey of US internists and rheumatologists. BMJ (Online). 2008 Nov 8;337(7678):1097-1100. https://doi.org/10.1136/bmj.a1938
Tilburt, Jon C. ; Emanuel, Ezekiel J. ; Kaptchuk, Ted J. ; Curlin, Farr A. ; Miller, Franklin G. / Prescribing "placebo treatments" : Results of national survey of US internists and rheumatologists. In: BMJ (Online). 2008 ; Vol. 337, No. 7678. pp. 1097-1100.
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