Doctors need to learn is how to help more while doing less

Doctors need to learn is how to help more while doing less

One of my doctor friends and I were talking the other day about her cold symptoms – stuffy nose, nasty mucous, facial congestion. No fever. It had only been going on a couple of days but she said to me: “I think I might need some antibiotics.” Now, in our profession, we realize that there is no scientific reason to treat a patient who might be developing sinusitis but has not yet had symptoms for an extended period of time (usually 7-10 days).

Most often these conditions are viral, not bacterial, obviating the need for antibiotics. Reminding her of that fact, she said to me that ” You sound like me talking to a patient.”

We doctors often realize that the best medicine is time. Not everything needs a prescription or even a formal diagnosis. But, when people come to us for help, the expectation is that we tell exactly the organism causing their troubles, write a prescription, or some antibiotics. Our patients do not expect nor want a recommendation to lay in bed and eat chicken soup. Many times, however, that is precisely what we ought to recommend.

I told my friend to get some phó (Vietnamese noodle soup), put some jalapeños in the broth, and she would soon be breathing easy. The spices would clear up the sinuses. The warm soup would make her feel better. Antibiotics would be unnecessary. This scenario repeats itself in emergency rooms, doctor’s offices, and hospitals daily all across the country with colds, aches and pains, you name it. Our patients expect too much of medicine when time and the natural course of things may be the best answer. However, the incentives given to our health care system do not align with whats often best for the patient.

Medicine is designed to do more: more cat scans, more MRIs, more medications, more surgeries. Over-treatment is a major problem in our health care system. What society, and physicians, need to learn is how to help more while doing less.

Cedric Dark is Founder and Executive Editor, Policy Prescriptions.

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  • Charles Timothy Richardson

    Think spine surgeries for simple lower back pain.

    • Suzi Q 38

      Ouch! I am getting one for my cervical spine stenosis. It took 18 months to finally diagnose. I had to rule out M.S. and other related conditions, and I can barely walk. No I don’t want to have it, but I must.

  • kjindal

    I agree that there is certainly a crisis of overtreatment, but does NO responsibility/blame fall on lawyers, mainstream media and even (gasp) patients?

  • azmd

    Great, except that I have no idea how many times over the years I have given your suggested response to patients, friends and family who have asked me to phone in prescriptions for an antibiotic for a URI with one fairly consistent response: an annoyed stare. Frequently I then hear from another physician family member that they have called HIM to get the scrip anyway. In many cases, patients don’t want to be educated, they want us to take care of them the way they want to be taken care of, whether it’s medically appropriate or not.

    I agree with kjindal that it is quite silly of us to blame this epidemic of overtreatment on ourselves alone.

  • southerndoc1

    Your doctor friend is an idiot.

  • Brian Stephens MD

    the only way I can think to fix the problem is to bring back placebo pills and allow doctors the authority to use them without being charged with malpractice.

    patients simply are not satisfied without something in their hands to take with them.

    doing a “back up” script albeit worthless, may be the closest we can come to true science.

  • Diane Fonner

    And the they panic and/or sue b/c antibiotics don’t work for REAL infections……

  • drjoekosterich

    A professor of obstetrics when I was in med school talked of “masterly inactivity”. He was right. The body will in many instances heal itself with just a little support and encouragment

  • KRA

    Pho is my very own personal URI fix as well – clears those sinuses RIGHT up :)

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