The surgical placebo effect; pills are not the only things to fool our minds through the placebo phenomenon According to the NY Times and other sources, a medication needs to prove that it works better than a fake drug when tested by the FDA. There are quite a few medications that have never passed this test, and thereby may never be approved for use. The mind is a powerful thing and often, it has a larger role on how we feel, how we improve and our impression of improvement when a treatment for a condition is recommended. It is the sugar pill idea. Surgical procedures are not subject to the same level of scrutiny and often, a patient may have improved even though they had a procedure done that was essentially worthless. The NY Times discusses the idea of a surgical placebo effect. Check it out here For a drug to be approved by the Food and Drug Administration, it must prove itself better than a placebo, or fake drug. This is because of the "placebo effect," in which patients often improve just because they think they are being treated with something. If we can't compare a new drug with a placebo, we can't be sure that the benefit seen from it is anything more than wishful thinking. But when it comes to medical devices and surgery, the requirements aren't the same. Placebos aren't required. That is probably a mistake. At the turn of this century, arthroscopic surgery for osteoarthritis of the knee was common. Basically, surgeons would clean out the knee usingarthroscopic devices. Another common procedure was lavage, in which a needle would inject saline into the knee to irrigate it. The thought was that these procedures would remove fragments of cartilage and calcium phosphate crystals that were causing inflammation. A number of studies had shown that people who had these procedures improved more than people who did not. Read more