SAMANTHA CUNNINGHAM | Senior Editor
It is no secret that one of the biggest concerns in medicine right now is the overuse and over-prescription of medical care and medications. Patients are treated as customers, and in a world where “the customer is always right,” physicians must ensure patient satisfaction. Many of us have been guilty of visiting the doctor with expectations of how the visit will go. We may expect our providers to give us a prescription, refer us to a specialist, or help plan a procedure, for example. Rightfully, we feel that we know our bodies better than any physician could. However, it is ultimately up to our medical providers, who have spent years in training, to decide what options are available to us. They serve as gatekeepers to our medical care.
In the Fall 2016 issue, I write about my personal experience with endometriosis, a common disease of the female reproductive system. Endometriosis is detected solely based on the patient’s symptoms, at which point a laparoscopic biopsy is conducted for confirmation. This means that a physician must be relatively certain of the diagnosis prior to testing, so that the patient does not undergo an unnecessary surgical procedure. Physicians often try noninvasive treatment methods, such as birth control pills, prior to conducting the laparoscopy. At my first appointment with my new OB-GYN, I suggested the diagnosis of endometriosis and also requested a laparoscopy. After subsequent visits over several months, he finally agreed. This anecdote illustrates the ongoing power struggle taking place in doctors’ offices.
In March 2016, The New York Times published an article examining the phenomenon of antibiotic resistance and the exacerbation of poor patient-physician relationships. While doctors are partly to blame for prescribing too many antibiotics, patients are too, often pressuring their providers. The article discusses how many physicians concede to their patients will to avoid lengthy arguments. Given the choice between quickly writing a prescription and spending the next ten minutes hearing about how the patient is sure they need amoxicillin, the physician may understandably grant the patient’s request, despite the indications for the antibiotic.
Physicians should strive towards employing a shared-decision making model where no one party overpowers the other, and the patient receives appropriate care. While a patient may know his body, a physician is an expert in anatomy and physiology. Put together, a physician and his patient can determine the best course of action for a given patient, but only if the physician stands his ground and calls upon his training.
Fox CR, Linder JA, Doctor JN. “How to Stop Overprescribing Antibiotics.” New York Times. 27 Mar. 2016.