Surveys of physicians in recent years have found that doctors frequently recommend placebo treatments to mollify patients and describe them in deceptive ways, despite ethical guidelines urging them to steer clear of those practices.

Now questions are being raised about whether it may be OK for physicians deceptively to use placebos in certain situations and what should count as a placebo.

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The physicians, nurses and clerical support staffers in medical offices say the frenetic work pace and high patient volume are making it harder to provide top-notch care.

More than 70% feel rushed when taking care of patients, and 52% say there are too many patients for the number of doctors and other health professionals in the office. Forty-one percent believe their office “has too many patients to be able to handle everything effectively,” said an Agency for Healthcare Research and Quality survey of 23,679 people working in 934 U.S. medical offices that was released in June.

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Two states that require pharmaceutical companies to report how much they spend on marketing their products saw little shift away from brand-name drugs in doctors’ prescribing habits, said a study in the May 28 Archives of Internal Medicine.

The findings come as the Centers for Medicare & Medicaid Services works to address more than 300 responses from physician organizations, drugmakers and others to its proposed rule to implement the Physician Payments Sunshine Act that was included in the 2010 health-system reform law. In May, CMS announced that federal requirements for medical industry firms to collect data on payments to doctors would not begin until 2013. They had been set to start this year.

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Physicians are accustomed to fielding many challenging questions from patients, but there is one query that they may find especially flummoxing, considering the delicate terrain it requires them to traverse.

The question: “Doctor, will you pray with me?”

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One in seven drug packages stored in physicians’ pharmaceutical sample closets is expired, and an estimated $2.2 billion worth of drug samples go to waste each year, a study says.

Researchers took inventories of the drug sample closets at 10 primary care clinics in the Phoenix metropolitan area. Of the 12,581 sample boxes or packages examined, 14% were expired, said the study, published in the May-June issue of the Journal of the American Board of Family Medicine.

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A Food and Drug Administration advisory panel is recommending approval of an over-the-counter, rapid at-home HIV test that would let patients take control of determining their HIV status and could expand the rate of testing.

But some physicians and public health experts say the product, the OraQuick In-Home HIV Test, would allow patients to skip pre- and post-test counseling. It also could hinder efforts to educate patients about practicing safe sex and starting treatment, they said.

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Physicians and hospitals may have another incentive to strictly follow infection-control protocols — preventing infections could lower readmission rates.

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Facebook’s move to allow users to add their organ-donor registration status as a “life event” on their profile pages led to a surge in donor sign-ups and earned the company plaudits from physicians and other professionals in the transplant community.

But experts warn that the social-networking behemoth’s action will not be enough to solve the U.S. organ shortage and could pose ethical problems for patients and families while trivializing the decision to donate.

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Even well-educated, well-to-do patients have trouble asking their physicians questions about treatment options or expressing their medical preferences and values, said a study drawing on focus groups with older adults in the San Francisco Bay Area.

Clear themes emerged from six focus group sessions with 48 patients in Palo Alto, Calif., the study said. Patients said they wanted to have a more active role in making medical decisions with their physicians, but feared upsetting them. The patients, all of whom were 40 or older, said they did not feel as though their physicians listened to or respected what they had to say.

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Eight leading pharmaceutical companies have approved 10 recommendations aimed at improving transparency to address what they call a “credibility gap” that faces industry-funded clinical research.

“Some observers, including some journal editors and academic reviewers, maintain a persistent negative view of industry-sponsored studies,” said an article in May’s Mayo Clinic Proceedings, co-written by 11 drug industry representatives and medical journal editors.

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The 2008 “no-pay” rule adopted by the Centers for Medicare & Medicaid Services to encourage hospitals to stop medical complications has led to consistently funded infection control departments, more collaboration with physicians and other front-line staff, and higher compliance with evidence-based guidelines.

More than 80% of infection-control professionals believe the CMS policy has led to greater focus on the health care-associated infections targeted under the rule, said a study published in the May American Journal of Infection Control. The study reported results of a survey of 317 infection preventionists at a nationally and industrially representative sample of hospitals. The journal is published by the 14,000-member Assn. for Professionals in Infection Control and Epidemiology.

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When actor Dennis Quaid’s 12-day-old twins developed infections in 2007, he and his wife took them to a Los Angeles hospital. But a medical error nearly killed the babies when they received 1,000 times the intended dose of heparin.

Look-alike packaging on the 10,000-unit strength and 10-unit strength vials of heparin and a failure to keep the higher-concentration vials out of patient-care areas contributed to the mistake, patient safety experts said.

Yet the same error had occurred only 14 months earlier at an Indianapolis hospital, when six infants got heparin overdoses and three of them died. The case received widespread news coverage, but it was not enough to spare the Quaid family its ordeal.

Quaid says hospitals should not need to see a serious error in their own facilities before taking preventive action to protect patients. He has joined with patient safety and aviation experts to call for an agency akin to the politically insulated, independent National Transportation Safety Board to investigate cases of medical harm and report deidentified findings to physicians, hospitals and the public.

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