Journal of General Internal Medicine

, Volume 23, Issue 1, pp 7–10 | Cite as

Academic Physicians Use Placebos in Clinical Practice and Believe in the Mind–Body Connection

  • Rachel ShermanEmail author
  • John Hickner
Original Article



The placebo and the placebo effect are often investigated in the context of clinical trials. Little data exist on the use of placebos in the course of routine health care.


The aim of this study is to describe a group of academic physicians’ use of placebos and their knowledge, attitudes, and beliefs about placebos and the placebo effect.


A 16-question anonymous web-based survey of physicians from Internal Medicine departments of 3 Chicago-area medical schools was used.


There were 231/466 (50%) physicians who responded; of these, 45% reported they had used a placebo in clinical practice. The most common reasons for placebo use were to calm the patient and as supplemental treatment. Physicians did not widely agree on the definition of a placebo and had a variety of explanations for its mechanism of action. Ninety-six percent of the respondents believed that placebos can have therapeutic effects, and up to 40% of the physicians reported that placebos could benefit patients physiologically for certain health problems. Only 12% of the respondents said that placebo use in routine medical care should be categorically prohibited. Regarding “placebo-like” treatment, 48% of respondents reported giving at least 1 type of treatment in a situation where there was no evidence of clinical efficacy.


Nearly half of the respondents use placebos in clinical practice and most believe in the mind–body connection. The results of this study, based on retrospective self-reported behavior, are subject to recall bias and may not be representative of American physicians.


placebo use placebo effect clinical practice mind–body connection 



Many thanks to Sinan Kermen, Sandy Cook, Sandy Smith, and Jamie Cohen-Cole for their support.

Conflict of Interest

None disclosed.


  1. 1.
    Benedetti F, Amanzio M. The neurobiology of placebo analgesia: from endogenous opioids to cholecystokinin. Prog Neurobiol. 1997;52(2):109–25.PubMedCrossRefGoogle Scholar
  2. 2.
    Benson H. Timeless healing: the power and biology of belief. New York: Simon and Schuster; 1996.Google Scholar
  3. 3.
    Berger JT. Placebo medication use in patient care: a survey of medical interns. West J Med. 1999;170:93–6.PubMedGoogle Scholar
  4. 4.
    Brody H. Placebos and the philosophy of medicine. Chicago: University of Chicago Press; 1980.Google Scholar
  5. 5.
    Ernst E, Abbot NC. Placebos in clinical practice: results of a survey of nurses. Perfusion. 1997;10:128–30.Google Scholar
  6. 6.
    Goldberg RJ, Leigh H, Quinlan D. The current status of placebo in hospital practice. Gen Hosp Psych. 1979;1(3):196–201.CrossRefGoogle Scholar
  7. 7.
    Goodwin JS, Goodwin JM, Vogel AV. Knowledge and use of placebos by house officers and nurses. Ann Intern Med. 1979;91(1):106–10.PubMedGoogle Scholar
  8. 8.
    Gray G, Flynn P. A survey of placebo use in a general hospital. Gen Hosp Psych. 1981;3(3):199–203.CrossRefGoogle Scholar
  9. 9.
    Bok S. Ethical issues in use of placebo in medical practice and clinical trials. In: Guess HA, Kleinman A, Kusek JW, Engel LW, eds. The science of the placebo: toward an interdisciplinary research agenda. London: BMG Books; 2002, pp. 53–74.Google Scholar
  10. 10.
    Harrington A. “Seeing” the placebo effect: historical legacies and present opportunities. In: Guess HA, Kleinman A, Kusek JW, Engel LW, eds. The science of the placebo: toward an interdisciplinary research agenda. London: BMJ Books; 2002:35–53.Google Scholar
  11. 11.
    Hofling CK. The place of placebos in medical practice. GP. 1955;11(6):103–7.PubMedGoogle Scholar
  12. 12.
    Hrobjartsson A, Gotzsche PC. Is the placebo powerless? An analysis of clinical trials comparing placebo with no treatment. N Engl J Med. 2001;344(21):1594–602.PubMedCrossRefGoogle Scholar
  13. 13.
    Hrobjartsson A, Norup M. The use of placebo interventions in medical practice—a national questionnaire survey of Danish clinicians. Eval Health Prof. 2003;26(2):153–65.PubMedCrossRefGoogle Scholar
  14. 14.
    Moerman D. Explanatory mechanisms for placebo effects: cultural influences and the meaning response. In: Guess HA, Kleinman A, Kusek JW, Engel LW, eds. The science of the placebo: toward an interdisciplinary research agenda. London: BMJ Books; 2002:77–108.Google Scholar
  15. 15.
    Moerman D, Jonas W. Deconstructing the placebo effect and finding the meaning response. Ann Intern Med. 2002;136(6):471–7.PubMedGoogle Scholar
  16. 16.
    Nitzan U, Lichtenberg P. Questionnaire survey on use of placebo. Br Med J. 2004;329(7472):944–6.CrossRefGoogle Scholar
  17. 17.
    Perseus web-based survey solutions. Available at


  1. 1.
    Brown WA. The placebo effect. Sci Am. 1998;278:68–73.CrossRefGoogle Scholar
  2. 2.
    Harrington A, eds. The placebo effect: an interdisciplinary exploration. Cambridge: Harvard University Press; 1997.Google Scholar
  3. 3.
    Kendler KS. A psychiatric dialogue on the mind–body problem. Journal of American Psychiatry. 2001;158(7):989–1000.CrossRefGoogle Scholar
  4. 4.
    Lynoe N, Mattsson B, Sandlund M. The attitudes of patients and physicians towards placebo treatment—a comparative study. Soc Sci Med. 1993;36(6):767–74.PubMedCrossRefGoogle Scholar
  5. 5.
    Shapiro AK, Struening EL. The use of placebos: A study of ethics and physician attitudes. Psychiatr Med. 1973;4:17–29.CrossRefGoogle Scholar
  6. 6.
    Thomson RJ, Buchanan WJ. Placebos and general practice: attitudes to, and the use of, the placebo effect. NZ Med J. 1982;95(712):492–4.Google Scholar

Copyright information

© Society of General Internal Medicine 2007

Authors and Affiliations

  1. 1.University of Chicago Pritzker School of MedicineChicagoUSA

Personalised recommendations