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Loading ...My Placebo Effect
October 12, 2007
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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Posted in Being a Doctor
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October 12th, 2007 at 3:55 pm
Did you think that perhaps the patient has become resistant to the antibiotics?
October 12th, 2007 at 4:30 pm
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!
October 12th, 2007 at 4:34 pm
Competent? Yes. But my antibiotics do not work in 2 hours. Really, they don’t.
October 12th, 2007 at 6:32 pm
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.
October 12th, 2007 at 8:57 pm
Must be the sandals.
October 13th, 2007 at 3:13 pm
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.
October 13th, 2007 at 5:55 pm
you are truly a miracle worker!
October 13th, 2007 at 10:16 pm
Perhaps his pharmacist didn’t cast the right spell when dispensing the medication.
October 14th, 2007 at 10:11 am
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.
October 15th, 2007 at 8:49 am
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?
October 19th, 2007 at 10:37 am
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.