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Placebo Trends across the Border: US versus Canada
Cory S Harris1, Natasha K J Campbell2, Amir Raz2,3
1Department of Biology, University of Ottawa, Ottawa, Ontario, Canada.
Physician placebo use shows minor cross-border variation despite differing healthcare systems. Impure placebos, like supplements, are common in both US and Canadian clinics, raising ethical concerns.
Area of Science:
- Medical Ethics
- Clinical Practice
- Health Services Research
Background:
- Physicians globally use placebos, but inconsistent methods hinder comparisons.
- Canadian physicians practice within a universal healthcare model, differing from the US system.
- No formal placebo policy exists in Canada, potentially influencing physician practices.
Purpose of the Study:
- To compare placebo use and perceptions between US and Canadian physicians.
- To identify cross-border differences and similarities in clinical placebo application.
- To investigate the ethical and practical implications of placebo use.
Main Methods:
- An online survey was distributed to academic physicians in Canada.
- Responses from internists and rheumatologists were extracted for analysis.
- Data were compared to parallel US data obtained through similar methodologies.
Main Results:
- Canadian physicians reported lower use of pure placebos (23±7%) compared to US physicians (45%-80%).
- A high percentage of Canadian physicians (79±7%) prescribed treatments without proven efficacy, similar to US data.
- Impure placebos (e.g., vitamins, supplements) and use as a diagnostic tool were more prevalent in Canada.
Conclusions:
- Clinical placebo use shows minor variation across US and Canadian healthcare systems.
- The prevalence of impure placebos in both countries presents ethical and practical challenges.
- Further investigation into placebo use and policy is warranted.
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