h a l f b a k e r yWarm and Fussy
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People´s sense of well-being can increase as a result of attention. A sense of control also helps people´s health improve. At the same time, ethics prevents a practitioner from knowingly deceiving the patient. Therefore, i can´t give my clients remedies if i don´t believe in them.
Clearly people
do sometimes need medical intervention.
Therefore, i suggest that instead of alternative therapy, set up a sceptical healthcare practice which uses neither orthodox nor complementary therapy. Carry on doing the usual stuff of health screening, differential diagnosis, clinical examination, urine tests, BP, pulse rates and the rest, but instead of then prescribing and dispensing remedies and giving lifestyle advice, just do the latter, attempt to establish a rapport, seeking to empathise and so forth. Keep monitoring the patient for clinical signs on a regular basis and even give them remedies in the form of, for example, nice-smelling coloured water, but tell them they won´t work and is nice-smelling coloured water. At the same time, emphasise the value of placebo. If something like an occipital headache causing nausea which awakens the patient happens or haematuria is detected, refer them to a GP or for investigations.
This provides a service. It keeps people away from doctors´ surgeries, particularly hypochondriacs, thereby reducing the financial drain on the NHS, it improves people´s sense of well-being, it appeals to sceptics (i hope), it harnesses the placebo effect and it provides data for a control group against which both orthodox and complementary therapies can be compared.
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So these care givers would be bound under a
hypocritical oath? + :-) |
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so this compared to modern medicinal practice is analgous to psychotherapy compared to psychiatry ?... neat [+] |
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Isn't this homeopathy? Except for the nice smelling and colored part. |
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It is also reminiscent of free clinics (this less applicable to countries with NHS) where financial limitations greatly limit available interventions. |
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something is missing here... doctors without pills and patients without illness? Hypochondriacs are going to be the first people to trick this system because that's their M/O. I suspect that placebo doctors would be seen as worthless dangerous baboons standing between you and real medical therapy. |
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They can be trained if you like. Not a problem.
I can think of certain "ailments" which are not falsifiable. The people with these can see these people and they won't be in the way. In fact, you could even target the people with non-existent health problems with the non-existent therapy.
Yes, it is very like homoeopathy, in that the dosages involved are the same.
Who cares if hypochondriacs get involved? Then it's a game. They pretend they're ill and you pretend to treat them. What are they going to do? Sue you? |
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yes. Your idea isn't clear as to who would receive this bogus care and why they would receive it instead of conventional care. The placebo effect is not a replacement for a conventional diagnosis. In cases where a diagnosis is made the mode of treatment should be entirely up to the patient, the doctor acting as a guide as to the pros and cons of therapeutic options. If patients elect for the Bozo the Clown treatment, for it's lower side effects, and price, they have always had that option. The job of doctors is not to simply "provide a service". Frequently there is nothing that they can do and they must admit it. Then they can discuss if counseling, lifestyle, or some non-medical assistance might help. This is where referral to a clown doctor might come. You are putting the cart before the horse. |
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What if pretend medicine IS the cure for pretend illness? |
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In that case, [Spacecoyote], i wish more people were deluded.
You would still get a diagnosis, it's just that nobody would do anything about it there. I envisage people going to the doctor first anyway, most of the time, or not, as they choose. |
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then i really don't understand your idea. Patients who receive ineffective treatments typically return to the doctor over and over and thus would be indistinguishable from hypochondriacs. This would increase patient load (unless people got so pissed with the system that they stopped using medical care which "fixes" "everything") and thus cost. In addition it would not harness the placebo effect because nobody would believe in the treatments. A medical system that can't help your symptoms isn't going to increase your sense of safety or well-being . Finally, because it isn't a control for either conventional (emergency cases get care) or unconventional (doctor tells patient therapy is bunk) treatment, and furthermore breaches ethical and scientific standards I'm guessing the idea is as bunk as using cool aid rather than anti-biotics. |
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not that a good shag cures cancer. A trained and
good practicioner would read history do an initial
exam-meet-n-greet. Then Rx this as an
alternative. Or am I missunderstanding where the
bennies of havving someone who can 'afford mal
preactice insurance' and can take some time to
listen outside the box awhile. while maintaining a
Doctors' mystic social standing of near god, come
from? |
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I am surprised more replies just don't get it. |
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... a doctor is not a talk therapist. When people go to the doctor they expect to receive medical advice. If during your annual visit the doctor notes that you have high blood pressure or you report symptoms that may or may not indicate a medical condition and in response the doctor gives you cool-aid brand powdered beverage you are going to benefit nil and the highly trained doctor is going to get paid for achieving nil. |
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How do you know that doesn't happen already? |
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to the extent that it does I object. both the doctors that I know personally complain fiercely that they are forced to try to treat people with problems that have nothing to do with medicine, then they treat people who didn't go to the doctor regularly because it was to expensive and now need extensive care, then they have to deal with hypochondriacs and drug addicts and that leaves them with even less time to deal with the patients who need really intense diagnostic and therapeutic work. People with non-medical problems should get care from non-medical types and doctors should be freed up to provide the care that they best provide: diagnosis, prescription, and health related advice. |
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Persons who would benefit from a bedside
manner. |
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Are indeed suffering from known medical
conditions. Sorry you feel that they are a waste of
time. You remind me of several doctors I was
lucky enough to not see for my personal needs. |
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Ans btw WcW this idea is a design to relieve
exactly what your complaining about . Well
complaining for your doctor friends behalf. |
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It's just that kind of attitude that fills wards with hypochondriacs and seasonal affective disorder wimps while shoving Ritalin and amphetamines down kids' throats. |
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Take hypos to the dentist (they probably haven't been in years) to help them regain their fear of healthcare rather than fear for healthcare. Remind them how disgusting hospitals can be and how dangerous surgery and prescriptions can be. |
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Ship the SADdies off to Tahiti for some fun in the sun (at their expense, though probably less than the cost of Prozac). |
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Finally, take the kids off Ritalin, and administer corporal punishment to the parents whenever they fail to administer corporal punishment to their kids. |
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I think you've pretty well described a GP who is the patient's family doctor and who makes house calls... a prescription is just as likely to read "stop watching 14 hours of bleedin' tube every day" or "lift with your shoulders not your back". |
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Hi from med school. So, to summarize, it is a medical practice where patients agree in advance that placebos may be used? |
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I think that ideas like this, and it is not a new concept, stem from a misunderstanding of the exact nature of the placebo effect. The idea that a sugar pill makes people feel better is part of it, of course, and studies show that many doctors use this sort of placebo effect- only with real drugs. They will give antibiotics to make people relax even when they know full well any clinical effect is impossible. |
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There is more to the placebo effect, however. The act of diagnosing someone with "you're fine" has a beneficial effect on the anxiety that keeps bringing them back, at least temporarily. |
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The recommendation in place is that such patients have a scheduled time once or twice a year when they come in for a cursory examination and have their concerns addressed. It works out to cheapest and most effective. |
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Leave the coulo(u)red water to the "fitness water" folks. |
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Taking something prescribed by a health-care specialist is a ritual, so even if the patient knows the pill's a fake, the "placebo effect" should still be in effect to a certain extent. hmmm... |
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In which case, would not the process work equally well by, for instance, placing someone who was heartily disliked by many in a large Wicker Man and burning them alive ? |
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Ha - well if it makes everyone feel better - why not! |
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So many people ridicule ancient traditions such as appeasing the gods, human sacrifice, and ritual flaying - but they fail to realise the very real placebo effects that these behaviours can bring about in a population. A well staged multi-virginal sacrifice can really energise a whole community, engendering a sense of shared purpose and wellbeing. It's an indictment of the modern era that these sort of practices are now described as "barbaric" or "completely stupid" when all the evidence suggests that these ancient and traditional rites can bring about measurably tangible benefits. |
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actually where I was going was that you could relieve some symptoms by simply going to the doctor and getting a lollipop... somewhere in the unconscious would be "I went to the doctor and he gave me something for it" despite the conscious knowing it to be ineffective: sortof a "reverse placebo" effect as well as the feeling of having Done Something. |
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Another aspect to this is that it's theatre, by which i mean that if people are going to imagine they're ill, they could be treated by therapies which are imagined to work. There are plenty of businesses which are valued by the clients and those providing the service but not so much by others, such as certain cosmetic procedures, jazz concerts, stand-up comedy and the like, but people don't look for efficacy there. This may look like a con, but in the case of imaginary illnesses the problem would be detecting if they're imaginary. If this can be done reliably, the result is that mainstream medics no longer waste their time, and in the case of publicly-funded medicine, taxpayers' money, on hypochondriacs. |
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Sorry [bigsleep] it was a bit over the top. I'm being
more sensible on the other idea, thought I'd let
myself be a bit more silly on this one. I'm not
advocating actual ritual murder, but neither am I
making an absurdist point against traditional
therapies either. |
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And, if personal therapies can benefit from the
placebo effect, then why shouldn't it work in
groups? Football crowds, theatre and cinema
goers, nightclub ravers, mob and religious
participators all benefit from engaging in a shared
experience of some sort or other. |
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