http://www.kevinmd.com/blog/2006/11/quid-pro-quo-why-doctors-give-out-so.html Tue, 14 Feb 2012 22:28:00 +0000 hourly 1 http://www.kevinmd.com/blog/2006/11/quid-pro-quo-why-doctors-give-out-so.html#comment-68480 Anonymous Sun, 05 Nov 2006 00:51:00 +0000 http://clients.emmense.com/kevinmd/2006/11/quid-pro-quo-why-doctors-give-out-so-many-antibiotics.html#comment-68480 1. Sniffle is not an early sign of meningitis<br/>2. Oral antibiotics is not the best treatment for early meningitis<br/>3. Agreed that it is difficult to build a private practice if you prescribe antibiotics appropriately. However, if everyone did that, none of the patients would have the unrealistic expectations they do. We do this to each other. "Well, my husband's doctor gave him a zpak for the same thing!" That just makes it harder for me. Stop doing this! If you are concerned the patient has pneumonia and not bronchitis, check an xray. There are tested algorithms for sore throat and acute sinusitis you can find in Annals. <br/>b 1. Sniffle is not an early sign of meningitis
2. Oral antibiotics is not the best treatment for early meningitis
3. Agreed that it is difficult to build a private practice if you prescribe antibiotics appropriately. However, if everyone did that, none of the patients would have the unrealistic expectations they do. We do this to each other. “Well, my husband’s doctor gave him a zpak for the same thing!” That just makes it harder for me. Stop doing this! If you are concerned the patient has pneumonia and not bronchitis, check an xray. There are tested algorithms for sore throat and acute sinusitis you can find in Annals.
b

]]> http://www.kevinmd.com/blog/2006/11/quid-pro-quo-why-doctors-give-out-so.html#comment-68393 Anonymous Thu, 02 Nov 2006 22:24:00 +0000 http://clients.emmense.com/kevinmd/2006/11/quid-pro-quo-why-doctors-give-out-so-many-antibiotics.html#comment-68393 Everyone knows this truth. Fear, expediency, and maybe, just maybe its the right call. Does it really matter why anymore? No one is truely listening. Before this becomes an academic issue of "appropriate Ab use", we must first address the business issue. Until the business of medicine is fixed and reimbursement is tied to the practice of good medicine, only then can we try to limit it's proper use. Everyone knows this truth. Fear, expediency, and maybe, just maybe its the right call. Does it really matter why anymore? No one is truely listening. Before this becomes an academic issue of “appropriate Ab use”, we must first address the business issue. Until the business of medicine is fixed and reimbursement is tied to the practice of good medicine, only then can we try to limit it’s proper use.

]]> http://www.kevinmd.com/blog/2006/11/quid-pro-quo-why-doctors-give-out-so.html#comment-68381 Anonymous Thu, 02 Nov 2006 16:44:00 +0000 http://clients.emmense.com/kevinmd/2006/11/quid-pro-quo-why-doctors-give-out-so-many-antibiotics.html#comment-68381 Other reasons in the ER: 1. If I don't give it, they'll just come back, sign in, and clog up the ER even more. This keeps them out of the ER for a month. 2. What if that sniffle really is a precursor to early meningitis? WHen they come back in a week with meningitis or pneumonia, all they'll do is look at my chart from last week, and say that I missed a meningitis. The lawyers won't care that he had no meningitis or pneumonia last week. At least this way I can show I treated him in some way, and that he developed his meningitis (or pneumonia) despite my "Best" treatment. Other reasons in the ER: 1. If I don’t give it, they’ll just come back, sign in, and clog up the ER even more. This keeps them out of the ER for a month. 2. What if that sniffle really is a precursor to early meningitis? WHen they come back in a week with meningitis or pneumonia, all they’ll do is look at my chart from last week, and say that I missed a meningitis. The lawyers won’t care that he had no meningitis or pneumonia last week. At least this way I can show I treated him in some way, and that he developed his meningitis (or pneumonia) despite my “Best” treatment.

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