Half of German doctors prescribe placebos, according to a new study for the German Medical Association.
The report says placebos, from vitamin pills to homeopathic remedies or even sham surgery, can prove highly effective in various treatments.
In Bavaria, it found, 88% of GPs have sent patients home with prescriptions for placebo drugs.
The German Medical Association (BÄK), which commissioned the report, Placebos in Medicine, admitted that it doesn't fully understand how placebos work, but welcomed the report's findings.
"Placebos have a stronger impact and are more complex than we realised. They are hugely important in medicine today," says Christoph Fuchs, the managing director of the BÄK.
The report recommends that students and doctors should be taught about placebos and their usage.
"Placebos can maximise the effect of medication," says Robert Jütte, author of the study and a BÄK board member.
"They can reduce undesirable side-effects and are a more efficient usage of our healthcare budget."
Recent research, he said, showed that placebos had helped 59% of patients who had been suffering from an upset stomach. Used to treat depression, placebos have the same effect as antidepressants in about a third of cases.
The efficacy of a placebo depends on many factors, according to the report, including the size and colour of a pill.
The more expensive the placebo, the higher the success rate, the study found, and intravenous injections are shown to be more effective than oral medication.
It's also a question of trust. Placebos produce better results if a patient feels their doctor understands their concerns, and believes they are being taken seriously, the study says.
Ethically, however, placebos are still a grey area. Few doctors knew whether they could legally administer placebos.
The study advises doctors to only prescribe placebos if the patient has a minor illness and if it seems likely that a placebo treatment will be successful.
Patients should not be denied the use of standard medication if there is a possibility of their condition getting worse, says the report.
To create a clear framework for the use of placebos, the BÄK is now calling for internationally recognised guidelines.
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