With the rapid spread and implementation of electronic health record (EHR) the government and its health organizations are getting more and more involved in monitoring doctors adherence to practice guidelines and their deviation from it in some circumstances penalizing those who are not compliant.
With the emergence of resistant bacteria that are baffling scientists, it is quite prudent to increase the pressure on doctors to slow down the crazy old practice that an antibiotic is cure for all infections!!! Did you know that US consumption of antibiotics is about 50% of the world consumption!!
Hence, doctors nowadays are having tinnitus from something called “Antibiotic Stewardship”. Every conference we attend we hear repeatedly this outcry for sensible, intelligent, and accurate antibiotic use, and get threatened in bold terms if we do not comply with financial sanctions and payments cuts!!! Most of us by now are on board with this rally and have implemented stricter rules and we are posting in our clinics (Urgent Care 1 Group) posters that will help doctors explaining to the Z-PAK addicted customers when it is proper to give an antibiotic.
Most of the problem however is not the doctors bad habit but rather deep public conviction in this deep seated false perception. We are facing mixed responses when we decline prescribing antibiotics, on one hand the intelligent patients usually appreciate and thank us for explaining why the antibiotic is not necessary and on the other hand we sometimes are faced with the not so smart patients who are convinced that the antibiotic is the cure no matter what the cause is.
One day I was working in our Garden City Office, a woman and her teenage son walked in, he has cold symptoms for 2-3 days, after taking history and doing physical exam it was quite clear that the son has a cold, I tried to explain to the mother why this is a cold, she interrupted me with some rudeness and asked: “Are you going to give him a Z-PAK?” I replied no, she stormed out of the room telling her son: “Let’s go to another clinic”. We care tremendously about our patients but part of this care is to give an accurate diagnosis and to prescribe the right medicine while adhering to the national practice guidelines. Our dear patients need to understand that the old Z-PAK JUST ASK days are over and they should be happy because this means better medicine practice now and less resistant bacteria in the future.