The Rheumatologist
COVID-19 News
  • Connect with us:
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Feed
  • Home
  • Conditions
    • Rheumatoid Arthritis
    • SLE (Lupus)
    • Crystal Arthritis
      • Gout Resource Center
    • Spondyloarthritis
    • Osteoarthritis
    • Soft Tissue Pain
    • Scleroderma
    • Vasculitis
    • Systemic Inflammatory Syndromes
    • Guidelines
  • Resource Centers
    • Ankylosing Spondylitis Resource Center
    • Gout Resource Center
    • Rheumatoid Arthritis Resource Center
    • Systemic Lupus Erythematosus Resource Center
  • Drug Updates
    • Biologics & Biosimilars
    • DMARDs & Immunosuppressives
    • Topical Drugs
    • Analgesics
    • Safety
    • Pharma Co. News
  • Professional Topics
    • Ethics
    • Legal
    • Legislation & Advocacy
    • Career Development
      • Certification
      • Education & Training
    • Awards
    • Profiles
    • President’s Perspective
    • Rheuminations
  • Practice Management
    • Billing/Coding
    • Quality Assurance/Improvement
    • Workforce
    • Facility
    • Patient Perspective
    • Electronic Health Records
    • Apps
    • Information Technology
    • From the College
    • Multimedia
      • Audio
      • Video
  • Resources
    • Issue Archives
    • ACR Convergence
      • Systemic Lupus Erythematosus Resource Center
      • Rheumatoid Arthritis Resource Center
      • Gout Resource Center
      • Abstracts
      • Meeting Reports
      • ACR Convergence Home
    • American College of Rheumatology
    • ACR ExamRheum
    • Research Reviews
    • ACR Journals
      • Arthritis & Rheumatology
      • Arthritis Care & Research
      • ACR Open Rheumatology
    • Rheumatology Image Library
    • Treatment Guidelines
    • Rheumatology Research Foundation
    • Events
  • About Us
    • Mission/Vision
    • Meet the Authors
    • Meet the Editors
    • Contribute to The Rheumatologist
    • Subscription
    • Contact
  • Advertise
  • Search
You are here: Home / Articles / Prescribing Hope: The Placebo Effect Endures

Prescribing Hope: The Placebo Effect Endures

June 21, 2018 • By Philip Seo

  • Tweet
  • Email
Print-Friendly Version / Save PDF
rzstudio / shutterstock.com

rzstudio / shutterstock.com

“Wait. I can explain.”

You Might Also Like
  • Placebo Outperforms Glucosamine/Chondroitin Sulfate for Knee OA
  • Some Placebos More Effective Than Others in Osteoarthritis
  • Brain Connectivity Predicts Placebo Response in Chronic Pain Patients
Explore This Issue
June 2018
Also By This Author
  • Physician-Editor Discusses Lessons Learned after 1 Year on the Job

One could imagine this phrase coming up under many conditions in daily life. When I first became a physician, however, I would never have expected to use this phrase in my clinic.

ad goes here:advert-1
ADVERTISEMENT
SCROLL TO CONTINUE

In medical school, I was taught the importance of dialogue in establishing a relationship with a patient. Statistics indicate physicians allow patients to speak for only a few minutes before being interrupted. This leaves the patient with the impression that he or she has not been heard. For physicians, the process of gathering the history of present illness is pragmatic. It is goal directed. For patients, however, the goal is the process. It is an unburdening, a medical confession of past sins and future worries that needs time, and moments of silence, to be allowed to breathe.

When it comes time to lay out a treatment plan, however, the dialogue transforms into a monologue. “Let me go first,” I say. “Give me a chance to go through everything. Then, when I am finished, you can ask your questions.”

ad goes here:advert-2
ADVERTISEMENT
SCROLL TO CONTINUE

I am sure my clinical skills preceptor would be horrified, but I developed this system after years of watching the horrified expressions on my patient’s faces when they heard what I was recommending. Cytotoxic agents. Repurposed cancer medications. Hemorrhagic cystitis. Progressive multifocal leukoencephalopathy. Anemia. Liver failure. The list goes on.

So I developed a different approach. Wait, I can explain. This is the drug I want to use. These are the awful things you will read about this drug on the Internet. This is why I don’t want you to worry. Like the feedback sandwiches we are taught to deliver to trainees, I try to end on a high note, emphasizing why the bad isn’t all that bad and why the plan is the plan.

I use the same approach when I sell patients on glucosamine and chondroitin sulfate.

ad goes here:advert-3
ADVERTISEMENT
SCROLL TO CONTINUE

Wait. I can explain. I know there are multiple, well-designed, clinical trials demonstrating that glucosamine and chondroitin sulfate don’t work for the treatment of osteoarthritis. They are not disease modifying.

And yet, years ago, I attended a lecture on psoriatic arthritis. I no longer remember the name of the speaker, but he mentioned that not only had he studied psoriatic arthritis, but he was also afflicted with the disease. He also mentioned that he took glucosamine and chondroitin sulfate, and he wanted all of us to stop telling him it didn’t work. Because it did, at least for him, and he was tired of his colleagues telling him otherwise.

Pages: 1 2 3 4 5 | Single Page

Filed Under: Rheuminations Tagged With: patient communication, patient management, placeboIssue: June 2018

You Might Also Like:
  • Placebo Outperforms Glucosamine/Chondroitin Sulfate for Knee OA
  • Some Placebos More Effective Than Others in Osteoarthritis
  • Brain Connectivity Predicts Placebo Response in Chronic Pain Patients
  • Rheuminations: The Power of the Placebo

Rheumatology Research Foundation

The Foundation is the largest private funding source for rheumatology research and training in the U.S.

Learn more »

Meeting Abstracts

Browse and search abstracts from the ACR Convergence and ACR/ARP Annual Meetings going back to 2012.

Visit the Abstracts site »

Simple Tasks

Learn more about the ACR’s public awareness campaign and how you can get involved. Help increase visibility of rheumatic diseases and decrease the number of people left untreated.

Visit the Simple Tasks site »

The Rheumatologist newsmagazine reports on issues and trends in the management and treatment of rheumatic diseases. The Rheumatologist reaches 11,500 rheumatologists, internists, orthopedic surgeons, nurse practitioners, physician assistants, nurses, and other healthcare professionals who practice, research, or teach in the field of rheumatology.

About Us / Contact Us / Advertise / Privacy Policy / Terms of Use

  • Connect with us:
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Feed

Copyright © 2006–2021 American College of Rheumatology. All rights reserved.

ISSN 1931-3268 (print)
ISSN 1931-3209 (online)

loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.
This site uses cookies: Find out more.