The topic of today’s comic comes to us via one of our readers, Harry Clark. Granted, he sent it in last month, but hey, I’ve been busy. I had written the joke before realizing that the whole PLOS One article was available for reading (shame on me), and as I find myself standing on the precipice of an epic rant, I’m realizing that I drew the wrong comic. So I hope you’re reading this, because I dun goofed.

The headline: A survey conducted in the UK and published in PLOS One, found that up to 97% of family doctors had used placebos to treat their patients.

Now, before we get too much further, there are some issues with how a placebo is defined in the survey. Only 1% of practitioners reported administering ”pure” placebos: saline injections, sugar pills, etc. Were we to take only the textbook definition of a placebo into account, we’d have a much less exciting headline. But the researchers also included what they call “impure” placebos, which they define as,

“…interventions with clear efficacy for certain conditions but are prescribed for ailments where their efficacy is unknown, such as antibiotics for suspected viral infections.”

Based on their example alone, I’m beginning to get uneasy, and Scott Gavura over at Science-Based Medicine has a great in-depth look at how their definition of a placebo could skew the results. Read it here.

I’ll defer to him on the subtleties around how a placebo is defined and how it affects the study results. In the meantime, I’d like to call attention to the problematic nature of some of these so-called impure placebos. Starting with their example in the definition, prescribing antibiotics willy-nilly is a big problem in medicine. Many types of bacteria are now resistant to penicillin, and  superbugs like MRSA and tuberculosis are a huge problem for hospitals.

That isn’t all. Check out their list of what they considered impure placebos:

journal.pone_.0058247.t0021

(Click to enlarge, and pay special mind to the frequency in which they were administered and whether the survey taker considered it a placebo at all.)

If you look at the list, it includes complementary and alternative medicine, “whose effectiveness is not evidence-based” and “nutritional supplements for conditions unlikely to benefit from this therapy (such as vitamin C for cancer)”.

Holy. Shit.*

C’mon, guys. You’ll never get the public to realize that CAM treatments don’t work and vitamin C won’t cure your cold you treat it like they will. Granted, the use of CAM as a placebo isn’t exactly rampant, but from a public education perspective, this is kind of a big deal. Instead of administering homeopathy or unnecessary chest x-rays in a bid to ease the mind of a patient, we need to educate them on why antibiotics aren’t going to help their flu symptoms or why getting x-rayed all the time isn’t a good idea.

I understand, doctors are busy. Which is why I feel even worse for missing the mark today: I went for the yuk-yuks instead of dropping a learn-hammer on you all, and I’ll be on the lookout for further research around this topic to give it the treatment it deserves. Because this was the comic you probably wanted, but not the one you need.

 

*I’m not even going to get started on “non-essential technical examinations”