Patient demand is a reason why antibiotics are overprescribed.
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If physicians are simply abrogating their professional duties under the demands of patients, why do we have to go pay them to write us a prescription?
It takes years of specialized training to know exactly which unnecessary antibiotic would be the best one for a given patient.
Why is it so hard for doctors to do the right thing? Who CARES if that ill informed patient demands antibiotics and threatens to go down the street to a guy who will prescribe them? Do you REALLY want that kind of patient in your practice? Do you really want to contribute to ignorance?
Yeah, yeah. I’ve heard all the “economic” arguments on this subject. They’re all bullsh*t. I and others have managed to practice good medicine and have refused to participate in this scandal. We’ve done our patients a service by educating them, and preventing them from becoming serial prescription seekers. We’re not going broke.
Anon 2:40–why is it so hard to do the right thing? Because it’s much EASIER not to. It gets frustrating banging your head against the wall, trying to retrain patients who have been brainwashed by lazy ER docs, other PMDs, and unhelpful grandparents that every little cold needs an antibiotic. There are certainly days when I’m tempted to be lazy, throw in the towel, and just write everyone a scrip to make ‘em happy and move them along. It takes work to educate, to let them know what WILL help, if not antibiotics.
I do feel better about myself and my integrity and the quality of my care at the end of the day because I hold my ground. But I will admit, I have had patients leave me over this exact thing. No, I’m not sorry to see most of them go, for the reasons you describe. All the same, when you are in a service profession, you want people to leave your office pleased with that service; it frustrates me to no end that some patients just want a scrip for an antibiotic instead of good medical care, and raise such a stink when they get what they NEED instead of what they WANT.
Just to touch base on previous posts, I was moonlighting last night at a community hospital. Standard 59 y/o with hisotry of CAD with new CP. Simple standard stuff correct. Then I see the nurse hang a bag of Avelox. I nice asked why? ER doc says “I just review his CXR and I think I see an infiltrate.” The practice of medicine that Osler describes is no longer in existance. It’s been beaten out of all us. Anon 2:40 I applaud your practice’s efforts, but your the tip on the mast of a sinking ship, not a beakon of light. (unless other financial factors and regulations are corrected ASAP)
Is it always patients who demand antibiotics or sometimes doctors assume that patients want them?
I really love the logic of the medical profession. If you have the flu, they feel compelled to prescribe an antibiotic whether you ask for it or not,on the theory that if they don’t, you will take your business elsewhere. They seem oblivious to the fact this sort of thing increases the potential for the development of antibiotic-resistant pathogens in both individuals and the populace as a whole. Thus this behavior amounts to malpractice not only on an individual level but on a societal level as well.In fact, they may be putting the health of the entire human race at risk with this behavior.
But if you have chronic pain, many doctors will absolutely, adamantly refuse to give you the one class of drugs practically guaranteed to lessen your pain, and will label you a “drug-seeker” and boot you from their practice if you persist.
In both cases, they are harming the patient, but they feel compelled to indulge drug-seeking when the drug in question is dangerous and oftentimes has no medical value for the problem being treated, yet feel just as compelled to demonize you as a drug seeker when the drug in question is in fact the safest and most effective treatment for pain and is wholly appropriate to prescribe.
Evidence-based medicine? My ass.
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