About half the US physicians polled in a recent survey regularly prescribe placebos and most believe the practice is ethical, according to a report in the British Medical Journal.

The placebo effect refers to perceived clinical improvement caused by an inert substance such as a sugar pill or salt water, or one that has no impact on the condition for which it is prescribed. Since the 1960s, many clinicians and ethicists have frowned on placebo therapy because it involves deception and thus disregards principles of informed consent and patient autonomy.  Others disagree, noting that placebos can be the most effective treatment for certain conditions, and they can be administered without deception.

In the BMJ study, scientists surveyed 600 internists and 600 rheumatologists they had randomly selected from the American Medical Association master files. 46-58% (depending upon how the question was worded) reported using placebos regularly. The most common placebos were over-the-counter analgesics (41%) and vitamins (38%). Thirteen percent used antibiotics and sedatives as placebos.

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For 8 years, the Bush administration has systematically dismantled America’s reputation. People see us as arrogant and out of touch, as the country that brought you Guantanamo and Abu Ghraib.

Colin Powell had this in mind when he endorsed the Big O last week. An Obama election, he said, “will not only electrify our country…it’ll electrify the world.”

The global impact of next week’s election will be huge no matter who wins, because “cooperation is essential to address 21st-century challenges,” according to NY Times columnist Nicholas Kristof. “You can’t fire cruise missiles at the global financial crisis.”

Indeed. So what do people in other countries think about the two candidates running for president of the United States of America?

It could not be clearer. Respondents in all 22 countries polled by the BBC World Service indicated they prefer Obama. Among those who expressed a preference, the average margin was four to one: 49% want the Big O, 12% favor Top Gun. The rest are undecided.

The biggest Obama backers were Kenya (87%), Italy (76%), France (69%), Australia (67%), Canada (66%), and Germany (65%).

People in 17 of the 22 countries think Obama can improve America’s international relations, whereas those in 19 of 22 countries believe things will remain unchanged during a McCain administration.

With respect to Obama’s African-American heritage, a majority in 15 countries indicated that his ascent to the presidency would fundamentally change their perception of America. 

For lots of people, next Tuesday can’t come soon enough.

The Institute for Healthcare Improvement’s long awaited National Network Day is today. The event will feature dozens of collaborative learning opportunities and will offer participants a chance to celebrate progress towards some laudable goals.

IHI describes the event as an interactive series of web-based virtual learning sessions that will highlight some of the best and most innovative quality improvement and patient safety work in extant. National leaders will share successful strategies to reduce patient falls, hospital infections, complications due to anticoagulant therapy and readmissions. There will also be sessions aimed at refining the business case for quality.

National Network Day runs from 11:30AM to 5:30PM EST. Pre-registration is not required. Interested parties can access the event through WebEx (found here).

The event is one of many initiatives spawned by the IHI’s 5 Million Lives Campaign, whose aim is to support the improvement of medical care in the US and in particular to reduce morbidity and mortality in US hospitals.

As part of the Campaign, the IHI challenged hospitals to prevent 5 million incidents of medical harm over a 2-year period. The IHI estimates there are 15 million such incidents each year.
 
The 5 Million Lives Campaign is an expansion of an earlier initiative, the 100,000 lives campaign. In that effort, the IHI and partner organizations worked with 3,100 facilities and saved, according to IHI, “an estimated 122,000 lives in 18 months.” 

It should be a great event. Good luck to the speakers!