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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