Not sure if this is in the right place so feel free to move it if you think that's appropriate

Ok, went to my NHS doctor this morning due to wimminz problems since coming off my contraception.

Doctor: Well, the first thing we would ask you to try are one of the herbal remedies that are on the market. They work for some people but not for others, if it doesn't work for you we can try other things.

Me: Ah, if you think I need medication I'd much prefer to go down the route of science based medicine, I'm very sceptical of herbal medicine.

Doctor: Well, if you were referred to a gynaecologist, that'd probably be what they would ask you to do.

Me: I can't help thinking though that if these herbal remedies work so well they would be properly clinically tested and just be 'mainstream medicine'. I think they're possibly no more than placebos.

Doctor: But placebos work.

Me: I know how the placebo effect works. Not on people like me who are pretty convinced they're useless. Look, they cost £15-£20, I don't fancy increasing the coffers of some quack.

Doctor: Yes, fair point.

Why are NHS doctors doing this?

I don't see that they as a group are, perhaps your local NHS doctor just happens to like herbal remedies or runs into enough quack patients who want to use them that he has started just telling other patients to give them a try. Or perhaps he just thinks your problem is nothing to worry about but wants to give you something so that you placebo effect it away. Either way I think that is rather bad form of the doctor.

Scarlett wrote:

Why are NHS doctors doing this?

I can imagine that for every sceptic like you they get 20 morons who insist on the effectiveness of herbal stuff. After a while a doc just gives in and goes with the flow of giving placebos.

Doctor: But placebos work.

No they don't. If they worked, they wouldn't be fucking placebos! How the fuck do you get to be a doctor without understanding the so-called 'placebo effect'?

Actually, this bit: "Me: I know how the placebo effect works. Not on people like me who are pretty convinced they're useless." is wrong. In clinical tests, placebo effects have been achieved even when the doctors said "I am going to give you sugar pills. They don't do anything, but you should take them regularly. We want to see if we can trigger the placebo effect even if the patients are aware their medications doesn't work."

@chairman bill: 1) you're commenting on details in reported speech, how do you know the doctor didn't say "the placebo effect does occur often enough that you could try it", heck even saying "placebos work" can be a shorthand for exactly that sentiment. That is the function of the statement at least - there's no need to posit that the doctor in question is ignorant about how the placebo effect works.

Scarlett wrote:
I know how the placebo effect works . Not on people like me who are pretty convinced they are useless

There is a whole chapter on the placebo effect in Thirteen Things That Don t Make Sense by Michael Brooks : Apparently it can work even where the patient knows it is been given so if you were less skeptical Paula it might have worked for you
I take your point though : There is no such thing as alternative medicine : Just medicine : Hope you get better soon

WTF? We are not allowed to prescribe 'herbal' or other forms of alternative medicine over here. Or that's what I think. A lot of the representatives of these herbal med companies used to come to the OPD with gifts and stuff. I invariably showed them the door.

No wonder I'm jobless now.

NHS is heading for privatisation.

Get out the herbal remedies it is all that most people will be able to afford.

I think he is doing a dry run for the future.

Zwaarddijk wrote:@chairman bill: 1) you're commenting on details in reported speech, how do you know the doctor didn't say "the placebo effect does occur often enough that you could try it", heck even saying "placebos work" can be a shorthand for exactly that sentiment. That is the function of the statement at least - there's no need to posit that the doctor in question is ignorant about how the placebo effect works.

Well, assuming the reported comment is accurate, my point would stand. If he did indeed say something akin to what you suggest, he's still in error. A number of things can occur and bring about effects similar to those seen in treatment groups, and thus correlate with the placebo (which is given to reduce the variables between treatment & control groups), and this is termed the placebo effect, but there is no evidence of the placebo having any effect. There's a number of explanations for the correlation, namely spontaneous improvement, fluctuation of symptoms, regression to the mean, additional treatments not allowed for by those conducting the study (and about which the subject keeps quiet), scaling biases, so-called 'answers of politeness', where patients tell the doctor what they think they want to hear), psychosomatic phenomena, misquotation, and so on. The point is, none of these things is an effect of the placebo. The 'placebo effect' is a term that does not mean the placebo has an effect, rather than it appears to (correlation). It is an ironic label.

So, if the doctor was suggesting that "Well, the herbal remedy might not work, but whilst you're taking it a number of things might occur at the same time, and if we don't enquire too deeply, we could simply (and erroneously) attribute this to the herbal stuff", he might well be right. But in that case, why bother with the herbal remedy?

The doctors' exact words were "But placebos work", and it was "she"

Nats, I wasn't being offered a prescription, those are free in Scotland incidentally, I was being told I should go and spend £15-£20 on the remedy myself. I doubt they'd be allowed to prescribe it, which makes it worse that they recommend it!

Scarlett wrote:
The doctors exact words were but placebos work

Methinks she has a vested interest here : Otherwise why the urgency to push it

You should have said to her you would try it but if it did not work she would have to reimburse you

The_Metatron wrote:You wimmin have plumbing that's just too complicated. Too complicated to maintain or operate.

Bad design I say

Women are way too complex to be designed. I think you just happened.

I think chaos theory is the appropriate scientific discipline to ask for the design spec

Well, not everything that is "herbal" is necessarily magical crap, after all aspirin was originally a herbal remedy Depending on what your problem is, it's even possible that there's a supplement on the market that might actually help (here's an example of an evidence-based review). That said, your doctor should have been way more specific if this was to be a valid recommendation rather than just another way of saying "let's wait a bit and see if it gets better by itself".

I find that 9 out of 10 people think Homeopathy is just a term for natural, herbal remedy. Quite possibly what the doc would have suggested would have turned out to be a homeopathic product.

I have had a vet try and sell me homeopathic products. Placebo once removed, the dog doesn't feel any better but you THINK the dog feels better.

Sick!

zulumoose wrote:I find that 9 out of 10 people think Homeopathy is just a term for natural, herbal remedy.

Depending on where you are, this might well be true - I know it often is in France, where "homeopathic" "remedies" often contain herbal ingredients (in non-homeopathic doses).

Homeopathic and herbal can mean two very different things.

The first is invisible medicine and the second can be ingredients that actually work.

Scot Dutchy wrote:Homeopathic and herbal can mean two very different things.

The first is invisible medicine and the second can be ingredients that actually work.

Yes, but a lot of people don't know that. My best friend thinks homeopathy is natural medicine mixed from herbs. I tried telling her about what it really entails and she was close to calling me a liar. Quacks are doing a damn fine job of hiding what they're doing.


Incidentally, I do know of at least one "medicine" in Germany that is in widespread use, claims to be homeopathic, but actually isn't (it's neither heavily dilluted, nor prepared in the typical fashion).