Usually when we think placebos, we think of sugar pills.
Fake drugs that, when taken, improve people’s symptoms just because they believe they’re
taking real pharmaceuticals.
But it turns out surgery can be a placebo as well…
When surgeries were first used their sole purpose was to save lives.
So, it was pretty obvious when operations worked as intended and when they didn’t.
But today we’ve developed procedures that aren’t designed to to save patients, but
to improve quality of life.
Opening the door to whole new kind of surgeries that might take advantage of the placebo effect.
The Placebo Effect we’ve talked about a lot, it’s the idea that you feel better
because you got some medical attention, even if that isn’t necessarily medical treatment.
The classic example is the administration of a sugar pill instead of a drug.
Even though there was no drug involved, patients will sometimes report that they feel better,
and can walk away “cured.”
It may be hard to think of a surgery as just a placebo, because after all, when you go
under the knife, you’re going UNDER a KNIFE.
A surgeon is actually doing something; they’re slicing and dicing, but it turns out, because
surgery is so serious and there’s all this prep many have the mindset that ‘if it’s
surgery it’s meaningful.’
And that is exactly what makes surgery a great placebo.
In fact, studies on the placebo effect found that invasive surgery has a stronger effect
than non-invasive, injections are better than sugar pills.
Which may help explain why procedures like acupuncture will sometimes test as no more
effective than a placebo.
One researcher wrote that injections “seem to associate with higher placebo effects and
more ‘magic’” They test this by performing both real and
sham surgeries on test subjects.
A sham surgery is procedure designed to make the patient think they’re having the real
operation, but no real treatment is done.
There ARE real surgeries that are actually done every year, that test as no better than
a placebo -- One of these is arthroscopic surgery for osteoarthritis of the knee; 692,000
were performed in 2010.
Patients who undergo these treatments usually report feeling better afterwards, even if
they were only given the “sham” surgery.
And that’s not the only one, a vertebroplasty where cracked vertebrae are filled in with
bone cement to alleviate back pain, and percutaneous myocardial laser revascularization were both
tested against placebos and found no more effective than shams!
The placebo illusion is even more convincing when patients can watch a live feed of their
operation and have a little souvenir scar when it’s all over.
Before the pretend surgeries were shown to be placebos hundreds of thousands of people
in the United States had them done each year at a cost of billions of dollars.
So, now that we have evidence that they might not work, is it ethical to keep doing them?
Is it ethical to TRICK people into thinking they got effective surgery?!
It’s a tough cookie either way you slice it.
The kicker: there are even ethical problems with TESTING surgeries against a placebo in
the first place.
It’s hard to do a double-blind study on surgery where both the patient and surgeon
have no idea if they’re administering the treatment or a placebo, because a surgeon
knows if they cut you up or not, right?
There are examples -- but the ethics are closely watched.
Drugs have to prove they’re more effective than a placebo in order to be approved by
the FDA, but a 2014 systematic review of almost 3,000 surgical trials found only 53 were tested
against sham operations.
Again, because of ethics.
Sham surgeries CAN help determine if a procedure is actually doing something.
BUT, anytime you slice into someone you’re introducing a lot more risk than there is
in a sugar pill, especially if anesthesia is involved.
On the other hand, if a surgery was widespread but later proved ineffective, then didn’t
performing all those operations expose more people to risk than if a small trial had the
placebo option?
Placebo surgery is a tough question that the medical community is still grappling with
today, and regardless, it looks like you can chalk up one more big win for the placebo
effect.
One thing that’s not a placebo, is your very own website.
Visit Domain dot com today to claim yours.
Fun fact: before arthroscopic knee surgery was shown to be as effective as a placebo
it was the most common orthopedic procedure in the US.
For more on crazy surgeries how about a full body transplant, what some people call a head
transplant.
Check it out Crystal’s video on it here.
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