Measuring Care

[ysabetwordsmith]

 This study noted positive effects from caring bedside manor, not just the placebo effect.  It immediately makes me wonder how much damage is done by the ruthlessly indifferent and self-centered arrogance that typifies so many doctors -- probably quite a lot of damage -- and how that might be measured.

Comments

[lyonesse.livejournal.com]

er. actually the placebo effect is considered largely to be the result of experiencing care (including self-care). otherwise you have the "null effect", not the "placebo" effect.

placebos, btw, have become increasingly good in recent years. there used to be virtually no placebo effect for depression; now there's a strong one. this presumably mirrors the development of effective placebo chemical medications, so now someone receiving care for depression can imagine getting better, whereas before it was essentially untreatable and patients knew it.

Well...

[ysabetwordsmith.livejournal.com]

>> there used to be virtually no placebo effect for depression; now there's a strong one. this presumably mirrors the development of effective placebo chemical medications, so now someone receiving care for depression can imagine getting better, whereas before it was essentially untreatable and patients knew it. <<

A huge problem with that is, it floods the market with fake drugs that don't really do anything but which cost ruinous amounts of money. Same problem as with cold meds only much worse.

Also, anyone for whom the placebo effect doesn't work, has a difficult or impossible time convincing health care providers of any kind that most medications are less effective or ineffective on their particular body. Often that means getting no treatment at all because there isn't anyone around willing or able to work with that limitation.

Re: Well...

[lyonesse.livejournal.com]

i quite disagree on your first point. since a new drug needs to be demonstrably substantially better than placebo (and with fewer undesired effects), the strengthening of the placebo places a heavier requirement on the tested drug. this is imho a good thing, and the opposite of the situation you describe.

i personally am a placebo non-responder, but i'm also an aggressive patient with a doctorate in neuroscience (including some early placebogenesis research) -- i've had the dickens of a time finding providers, but that ones i have do listen.

Re: Well...

[ysabetwordsmith.livejournal.com]

>> i quite disagree on your first point. since a new drug needs to be demonstrably substantially better than placebo (and with fewer undesired effects), the strengthening of the placebo places a heavier requirement on the tested drug. <<

You are entitled to draw your own conclusions. However, I've read a number of articles over the years regarding how certain categories contain a lot of drugs that do nothing or are so erratic they might as well do nothing. Cold meds and psychiatric drugs are the most famous of those categories. The system is supposed to ensure that doesn't happen, but it's turned into so much profiteering at this point that the protections don't always work. My description fits my observed data and research. YMMV.

Bedside Manor…

[thnidu.livejournal.com]

The state's finest assisted living facility!