Abstract
The use of placebo medication, long recognized by clinicians, often has serious practical implications, such as patient deception. Past evidence has suggested that resident physicians tend to misuse placebo medication. Interns from two consecutive years of a residency program were surveyed anonymously to assess their knowledge and use of placebos. Of the 74 interns surveyed, 44 (59%) were familiar with placebo use in patient care. Fifty percent of these interns familiar with placebo use had learned about placebos from another physician. All interns who had learned about placebos during their internships had learned from another physician, whereas interns who had gained their knowledge of placebos as medical students were as likely to have learned from the medical literature as they were to have learned from a physician (P = 0.027). Interns aware of placebo use were more likely to consider placebo administration for suspected, factitious pain (P = 0.022). The present study uncovered no relationship between interns' estimations of placebo efficacy and the utility they attributed to placebos in assessing a complaint of pain. This suggests that conceptual inconsistencies underlie their use of placebos. Interns often learn of placebos as medical students and are influenced by physician-mentors. Placebo use in patient care is an area of attention for medical educators.
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Selected References
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- BEECHER H. K. The powerful placebo. J Am Med Assoc. 1955 Dec 24;159(17):1602–1606. doi: 10.1001/jama.1955.02960340022006. [DOI] [PubMed] [Google Scholar]
- Bok S. The ethics of giving placebos. Sci Am. 1974 Nov;231(5):17–23. doi: 10.1038/scientificamerican1174-17. [DOI] [PubMed] [Google Scholar]
- Briggs G. W., Replogle W. H. Effect of communication skills training on residents' attitudes toward their patients. Acad Med. 1991 Apr;66(4):243–243. doi: 10.1097/00001888-199104000-00020. [DOI] [PubMed] [Google Scholar]
- Brody H. The lie that heals: the ethics of giving placebos. Ann Intern Med. 1982 Jul;97(1):112–118. doi: 10.7326/0003-4819-97-1-112. [DOI] [PubMed] [Google Scholar]
- Eisenthal S., Stoeckle J. D., Ehrlich C. M. Orientation of medical residents to the psychosocial aspects of primary care: influence of training program. Acad Med. 1994 Jan;69(1):48–54. doi: 10.1097/00001888-199401000-00014. [DOI] [PubMed] [Google Scholar]
- Goodwin J. S., Goodwin J. M., Vogel A. V. Knowledge and use of placebos by house officers and nurses. Ann Intern Med. 1979 Jul;91(1):106–110. doi: 10.7326/0003-4819-91-1-106. [DOI] [PubMed] [Google Scholar]
- Gray G., Flynn P. A survey of placebo use in a general hospital. Gen Hosp Psychiatry. 1981 Sep;3(3):199–203. doi: 10.1016/0163-8343(81)90002-5. [DOI] [PubMed] [Google Scholar]
- Kleinman I., Brown P., Librach L. Placebo pain medication. Ethical and practical considerations. Arch Fam Med. 1994 May;3(5):453–457. doi: 10.1001/archfami.3.5.453. [DOI] [PubMed] [Google Scholar]
- Lynöe N., Mattsson B., Sandlund M. The attitudes of patients and physicians towards placebo treatment--a comparative study. Soc Sci Med. 1993 Mar;36(6):767–774. doi: 10.1016/0277-9536(93)90037-5. [DOI] [PubMed] [Google Scholar]
- McCauley J., Kern D. E., Kolodner K., Dill L., Schroeder A. F., DeChant H. K., Ryden J., Bass E. B., Derogatis L. R. The "battering syndrome": prevalence and clinical characteristics of domestic violence in primary care internal medicine practices. Ann Intern Med. 1995 Nov 15;123(10):737–746. doi: 10.7326/0003-4819-123-10-199511150-00001. [DOI] [PubMed] [Google Scholar]
- Rosenberg M., Commerford K., Driever M. Identification of psychosocial distress: a comparison of internal medicine and family medicine residents. J Gen Intern Med. 1991 Nov-Dec;6(6):529–534. doi: 10.1007/BF02598222. [DOI] [PubMed] [Google Scholar]
- Schwartz R. K., Soumerai S. B., Avorn J. Physician motivations for nonscientific drug prescribing. Soc Sci Med. 1989;28(6):577–582. doi: 10.1016/0277-9536(89)90252-9. [DOI] [PubMed] [Google Scholar]
- Thomson R. J., Buchanan W. J. Placebos and general practice: attitudes to, and the use of, the placebo effect. N Z Med J. 1982 Jul 28;95(712):492–494. [PubMed] [Google Scholar]