Antibiotics – sick patients expect them, rate doctors lower who don’t prescribe

Antibiotics – sick patients expect them, rate doctors lower who don’t prescribe

Patients are less satisfied with doctors who prescribe fewer antibiotics, even though the medication may not be appropriate treatment and could do more harm than good.

In these days of managed care, physician satisfaction scores grow increasingly important. However, when it comes to antibiotics, physicians may be in a no-win situation. One in five sick patients who go to their doctor expect to be given antibiotics, even though their condition may be a cold or flu for which antibiotics are ineffective.

The family practice journal GP says that as winter progresses, doctors are bracing for an increase in patients with requesting antibiotics for inappropriate conditions. Doctors need to be careful about satisfying patient desires, as the National Institute for Health and Care Excellence (NICE) issued guidance in August 2015 that urged providers to take a hard line when patients want unnecessary antibiotics.

Professor Mark Baker, NICE Centre for Clinical Practice director, went so far as to say that it is “vital” that physicians use antibiotics “more sensibly,” and “should face sanctions if they hand out antibiotics inappropriately.”

The concern is antibiotic resistance. “The more we use antibiotics, the less effective they become,” said GP Dr. Tessa Lewis. Lewis helped helped write the new guidelines.

Public Health England (PHE) Chief Executive Duncan Selbie said that the antimicrobial resistance is growing and “represents a major threat to public health.”  He said that the population relies heavily on antibiotics, and the “pressure on healthcare professionals to prescribe is great,” even when the antibiotics are not needed.

A 2012 GP Patient Survey looked at 7,800 practices, and found that patients were less satisfied with practices who prescribed fewer antibiotics. Practices who prescribed 25 percent fewer antibiotics than national averages could expect to have an estimated 0.5 to 1.0 percent lower patient satisfaction scores, indicating that patient satisfaction is not always consistent with good quality care.

Dr. Tim Ballard, vice chairman of the Royal College of General Practitioners, said these poor satisfaction results were “concerning.” He says patients want to feel they are getting something from their physician appointment, and family doctors feel pressured to respond.

“It’s concerning that patients associate a prescription for antibiotics with a satisfactory visit to their GP,” said Ballard, “particularly as we know that in many cases antibiotics are not appropriate forms of treatment and could actually do more harm than good.”

Public perception needs to change, according to Ballard. “Our patients need to understand that when diseases become resistant to antibiotics, it means that antibiotics will cease to work and as it stands, we don’t have an alternative.”

Photo by Global Panorama, Creative Commons License