"We have this in our culture where we want instant cures"

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?

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.

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)

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.