I think it has to do with doctors being paid so much in the U.S. Many of them are millionaires. Money and ethics seem to be inversely related. Look at our current business climate. I've got mine, so now what if I do take down the whole world financial system?
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Most liked posts in thread: Survey: Half of US doctors use placebo treatments
The truth is that for many non-life threatening conditions placebos often work as well or better than actual meds and are usually a lot cheaper.
Also, many conditions that people see doctors for have no cures. There's nothing you can take but pain relief and sleep aids for a cold. It won't go away any faster. Same thing for a flu.
Selling people hope works, whether it comes in a bottle, a church, or an abstract human construction like "nationality" or "personality".
As for giving someone an antibiotic just to make them feel better: I'd argue that's not a placebo. Placebos don't do anything. Giving someone penicillin for something like a broken leg is just shitty practice. Buckley's is a placebo. The only thing it does is make people gag.
First of all- INFORMING a patient they are getting a placebo eliminates the placebo effect. They must BELIEVE the treatment efficacious to get the benefit.
Second of all, giving painkillers, mood elevators or sedatives can NEVER be considered a placebo treatment because these medications ALWAYS have systemic effects that affect state of mind and sensation of pain.
Painkillers may not be an effective treatment for the underlying cause of a condition... but it DOES relieve pain related to that condition, ergo- it can not be a placebo. Such treatments are called "Palliatives", not placebos.
Also- recent experiments suggest that the "pain" suffered by hypocondriacs is REAL pain, in that the pain related nerve centers in their brain ARE firing...
Therefore, a doctor who suspects the patient's condition is imagined can offer placebo, and pain relief as the ONLY potentially effective treatment.
Further... the human body is a pretty amazing thing... Most of us will SELF heal from most maladies we can get.
GPs are trained to understand that 90% of Patient's complaints will resolve ON THEIR OWN within 2 weeks.
When confronted with ambiguous symptoms... or complaints that seem non-acute... Doctors routinely prescribe some palliative treatment, and tell the Patient to come back in two weeks.
Because 90% of complaints self-resolve- this approach is actually ALWAYS going to emerge in every medical office in the world... because any other, more aggressive approach is not only NOT going to be more effective... it is going to add considerable cost.
This approach to healthcare saves billions of dollars.
That being said... the real crime only occurs when the patient HAS a genuinely treatable condition and the Doctor resorts to placebo rather than discern the actual condition.
The real horror of Managed care is the idea that Doctor's salaries become tied to REFUSING care.
It is a short walk from a doctor prudently seeing if a patient's own immune system will handle whatever they have, and a dangerous reticence to test or order treatments that are clearly indicated.