By Michael Smith, MD
WebMD Chief Medical Editor
When WebMD published the results of a survey on antibiotic prescribing, it hit a nerve with doctors. Overall, 77% of patients said they have never asked for antibiotics. Many doctors say that’s not what they hear.
I’m not surprised many docs don’t buy it. I have certainly felt pressure to prescribe an antibiotic when I was confident it wasn’t needed. Some patients even argue or just head over to the urgent care center to get them.
Let’s Be Honest and Listen
As a patient, you have the responsibility to be honest with your doctor and help him come to an accurate diagnosis. Doctors have the responsibility to listen and use their years of experience and expertise to diagnose and treat patients appropriately.
If you have a stuffy nose, sore throat, cough – even if you’re blowing green gunk out of your nose – you probably have a cold. An antibiotic will do absolutely nothing. You also risk side effects (and some can be serious). There’s also significant concern that over-prescribing of antibiotics may make bacteria more resistant to the antibiotics we have.
And that last time you got better a couple of days after starting the antibiotic? That would have happened even if you didn’t take an antibiotic, because that’s how colds progress.
Unneeded Antibiotics Are Bad Medicine
Doctors must take responsibility, too, and help patients understand why an antibiotic is not in their best interest — not just because the doctor said so.
The survey shows health care providers prescribe antibiotics when they’re not totally sure they’re necessary about 20% of the time. But doctors are under increasing pressure to make patients happy. Many doctors’ pay is even linked to patient satisfaction. So sometimes we give in. That’s not good medicine for the doctor or the patient.
Honestly, it’s easier for us to give you an antibiotic. And we fully understand why you might expect that. You’ve paid the co-pay, taken off of work, and made the trip to the doctor’s office. You expect something out of that effort and cost. I get that.
Instead of an antibiotic, though, I would hope that you would expect your doc’s full attention, and for her to do what’s healthiest for you. Your doctor’s rational explanations and alternatives, like holding off on antibiotics to see if you get better on your own, are based on solid science and knowledge – not just stubbornness.
And I would hope that doctors would understand where patients are coming from. Understand they feel horrible and want help. They’ve made sacrifices to get to you. Appreciate that and advise and talk to them. Don’t just tell them what to do. Some studies have shown that dissatisfaction with care was due to poor communication – not due to whether patients got an antibiotic.
In the end, we all have responsibility to improve the patient-doctor relationship, and that may start with a cold.