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The Curbsiders Internal Medicine Podcast | MedEd | FOAMed | Internist | Hospitalist | Primary Care | Family Medicine

Supercharge your learning as these board-certified Internists interview the experts to bring you clinical pearls, practice changing knowledge, and a healthy dose of humor. 

Feb 5, 2018

Boost treatment efficacy and amplify the “doctor as a placebo” phenomenon with tips from placebo expert (and ex-cartoonist), Mark W. Green, MD, Director of Headache/Pain Medicine and Professor of Neurology, Anesthesiology, and Rehabilitation Medicine at the Icahn School of Medicine at Mount Sinai. Topics include: What’s that pesky sugar pill actually doing to us? Why do we get a boost from taking medicines that have no active compounds within them? How does placebo work? How can it be leveraged? What does it mean for study design/blinding? And what’s with its pesky dark twin--the nocebo effect? “Enjoy this, our only placebo-controlled episode”  (Thanks, Stuart!).

Written and produced by: Molly Heublein, MD and Nora Taranto MS3; Edited by: Matthew Watto, MD

Full show notes available at

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Time Stamps

  • 00:00 Disclaimer
  • 00:37 Intro banter
  • 01:30 Picks of the week
  • 08:02 Getting to know our guest
  • 14:00 Clinical case of pain
  • 15:08 Placebo hierarchy
  • 17:19 Non-inferiority studies
  • 18:20 Clinical trials, placebo, eligibility creep and regression to the mean
  • 22:04 Nocebo response
  • 27:05 Physiologic response to placebo
  • 29:13 Placebo amplification
  • 30:18 Caffeine experient
  • Dr Green reports no relevant financial disclosures
  • 32:47 How to counsel patients interested in alternative or ineffective therapy
  • 34:22 Surgery and placebo; sham surgery
  • 37:15 Open-label placebo and genetic response to placebo
  • 42:04 Blinding in placebo controlled trials may be ineffective
  • 43:53 Script for counseling patients on alternative therapy
  • 45:51 Take home points
  • 47:56 The Curbsiders recap and lessons learned
  • 52:52 Outro 

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