You Know It’s a Placebo. So Why Does It Still Work?
You scheduled this doctor’s Placebo appointment well in advance, took time off work, navigated the journey to the clinic, and endured the mundane paperwork with a cooking show playing on the waiting room TV. Now, seated on an examination table, your gaze lands on a jar of tongue depressors. Your doctor walks in, listens to your health concerns, and responds with an unexpected proposal: “I’m going to prescribe you something that isn’t designed to treat these symptoms but may help you feel better. It’s a placebo.”
Placebo
The notion might be perplexing, as placebos traditionally hinge on deception. In the conventional scenario, patients receive inert substances, believing them to be active treatments, subsequently experiencing a perceived improvement in their condition. However, your doctor, it seems, is not a quack. In fact, a significant number of doctors, potentially up to 97 percent according to a 2018 survey, incorporate placebos into their treatment strategies. The American Medical Association approves of placebo use as long as patients are informed and provide consent.
Your doctor’s approach involves what is known as an open-label placebo (OLP), a practice that has garnered interest and debate in the medical community. OLPs seem to exhibit efficacy in certain cases, although the underlying mechanisms remain elusive. Scientific Reports in 2021 suggested that “OLPs appear to be a promising treatment in different conditions,” ranging from menopausal hot flashes to seasonal allergies and major depression. Yet, a 2023 paper in the same journal cautioned that the “overall quality of the evidence was rated low to very low.”
The concept of the response dates back to ancient Greece, but the open-label has a more recent origin. In 1963, researchers in Baltimore explored the idea that placebos might work without the need for deception. They informed a group of neurotic patients about the potential benefits of a sugar pill, prescribing it openly.
The resulting study, published in 1965, had limitations but provided intriguing insights. Despite the small sample size, patients reported symptom improvement, some wanted the treatment to continue, and even those aware of the inert nature of the pills credited their perceived progress to the placebo—a symbol of care and attention.
