Table 1 Responses by doctors and nurses

Doctors (n=55) / Nurses (n=27) / p
Would never dispense/prescribe a placebo / 72.2% / 77.8% / 0.86
Mode of action of placebos / Psychological / 72% / 62% / 0.07
I don’t know / 12% / 30%
Placebo prescription should be banned / 30% / 6.6% / 0.007
Comments indication for the use of a placebo / Supplement to a medication (86.1%) / Calming the patient (43%) / 0.01
What do you tell the patient when giving a placebo? / It is a placebo / 70% / 29% / 0.07
I say nothing / 2% / 42%
It is a medication / 28% / 29%
Placebos are usually or sometimes effective. / 84% / 63% / 0.01

62% of nurses and 73% of doctors believed that the mode of action of a placebo is through a psychological mechanism (p=0.16). More nurses (30%) than doctors (12%) admitted that they did not know the mode of action of placebos (p=0.07) (Table 1)

50.0% of the doctors thought that there is no gender difference in the response to placebos, whereas 38.6 % thought that placebos are more effective in women while 11.4% thought that they are more effective in men.

Five times as many nurses (30%) as doctors (6.6%) believed that placebo prescription should always be prohibited (p=0.007).

The commonest indication for prescribing a placebo by doctors was as a” supplement to a medication” (86.1%) and for nurses was to “calm the patients” (43%) (p=0.01)

The responses by medical staff and medical residents were not significantly different (Table 2)

Table 2 Responses by Medical Staff Versus Medical Residents

Resident Staff / Medical Staff / p
Never prescribed a placebo / 63.6 / 72.00 / 0.73
I tell the patient "it is a medication" / 35.20 / 60.00 / 0.38
Placebos never effective / 20.00 / 13.6 / 0.152
More effective in female patients / 43.5 / 33.30 / 0.3
Main indication is as “Diagnostic Tool” / 84.00 / 72.7 / 0.26
Mode of action is psychological / 84.00 / 68.2 / 0.59
Research is required before its common use / 47.9 / 42.9 / 0.51

The responses by the 3 medical specialties of the doctors surveyed (Family and Community Medicine, Medicine and Psychiatry) were similar except that fewer psychiatrist (53.8%) than physicians (87.5%) or family physicians (83.5 %) believed that the mode of action of placebos was psychological (p=0.05)

The responses of doctors who practiced for more or less than 5 years were not significantly different except that fewer longer practicing doctors believed that women are more likely to respond to placebos (29.2 % and 42.8% respectively ( p=0.029)( Table 3)

Table 3 Responses according to Duration as a Doctor

< 5 years as a doctor / > 5 years as a doctor / p
Never prescribed a placebo / 73.0 / 50.00 / 0.17
1I tell the patient "it is a medication" / 19.00 / 27.80 / 0.18
Placebos never effective / 21.50 / 5.6 / 0.53
More effective in female patients / 42.80 / 29.2 / 0.029
The main indication is as “Diagnostic Tool” / 47.3 / 66.7 / 0.64
Mode of action is psychological / 88.10 / 52.8 / 0.065
Research is required before its common use / 30.5 / 38.9 / 0.33

Disturbingly, however, of the doctors who prescribed a placebo, 55.5 % told the patients that it is an actual medication and 22.2% told them “nothing” and only 2% told the patients that it is actually placebos. The nurses were more truthful and fewer of them claimed that the placebo is a medication.