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My Placebo Effect

by Rob on October 12, 2007 · Comments

in Being a Doctor

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149 One of our physicians saw a patient of mine last week.  He has sinusitis, or something else that did require an antibiotic. 

The patient then called my nurse the next morning.  "I saw Dr. B yesterday and he gave me an antibiotic, but today I am getting worse."

"It hasn’t been long enough for the medication to work," my nurse answered, "just give it a few more days.  You have only taken one dose."

"I want Dr. Rob to treat me.  Whenever he gives me an antibiotic, it works in two hours."

My nurse reassured him that the prescription does take time even for those that I give.  When she related this story to me later, I told her to tell the patient that I have a much stronger placebo effect than the other physicians.

I actually think there is some truth in that.  My own patients trust me a lot.  They are convinced that I will fix their problem, and so they feel better just for getting the treatment.  It is nice to have that trust, but I do feel uncomfortable with such high expectations.

I just misplaced my magic wand.  If only I could find that dang thing…

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  • Did you think that perhaps the patient has become resistant to the antibiotics?
  • Wolley
    Dr. Rob, give it up, you are a very competent physician.

    I certainly am willing to put my wellfare in your hands.

    You should see some of the people I've had to deal with in the past.

    No one is perfect, and I don't expect perfection, but you are very competent. Period!
  • Rob
    Competent? Yes. But my antibiotics do not work in 2 hours. Really, they don't.
  • Ileana
    I think some doctors are like this... Hey, in the past, with bloodletting and all the stuff they were doing nobody would get better, right? How were doctors trusted at all?

    My doctor has something that I call youthful healing energy. I feel instantly better just seeing him coming through the door. I had so many appointments where I would go and talk about my complaints and end up with: and I feel so much better since yesterday when I called for an appointment.
  • Must be the sandals.
  • The endorphins released as patients--particularly female ones--swoon in your presence act synergistically with the abx to radically shift the pharmacokinetics such that Tmax can be reached w/in 2h. Publish this, and you'll make a fortoonah. Certainly enough for a lifetime sandal supply. ;)
  • you are truly a miracle worker!
  • jmb
    Perhaps his pharmacist didn't cast the right spell when dispensing the medication.
  • There is something of this with neurologists. We walk into the patient's room and a thoroughly delirious patient suddenly becomes coherent, pupillary asymmetry disappears, unresponsiveness gives way to an alert patient sitting up eating or clamoring for breakfast.
    Of course, it would be hard to be a neurologist if this happened all the time, but faith healing might be looking like an option.
  • Dont you love that your patients think so highly of you? I would just take it as a really good compliment. As for antibiotics though, I remember when we were kids and mother took us to the doctor and they always gave us a shot of antibiotics, never a prescription to take orally for days. by the next day it always seemed we were much much better. Why do doc's not give these injections of antibiotics anymore?
  • Paul Rogers
    I find trust very important in my pediatric practice. An important part of good communication with patients ( and their parents) starts with the trust patients place with their providers. I agree we need to be wary, though. I had one young school age girl start making up symptoms so she could come in to see me! I had to make arrangements for my partner to see her for a few visits.
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