Is “listening” the key to reducing antibiotic prescribing?

Wednesday will see the publication of a report on GPs over-prescribing antibiotics for patients – nothing new there – but this has a twist: GPs over-prescribing antibiotics even when the patients are not particularly asking for them. This comes at a time when once again medics have been warned again that too many prescriptions for antibiotics are being given, and together with the public have been warned that there is a looming catastrophe of antimicrobial resistance to antibiotics which could turn previously treatable infections into life threatening emergencies.

This has been a warning given high profile by Professor Dame Sally Davies, England’s most senior medical adviser whose warnings led to recent articles in the Independent, Guardian, Telegraph etc.

So why does this new report find that doctors are still over prescribing? I don’t know if it will reveal this, but it got us thinking.

There will always be the odd case of a frustrated GP just wanting to get a patient out of the consulting room door and giving a patient a prescription as an exit strategy. Some doctors say that patients almost refuse to leave without a prescription. However is the real issue one of doctors – whether through ignorance, fatigue or deliberately – just not listening to the patient? Or, to put it another way, the patient feels as though they are not being listened to, or taken seriously? Considering how much of medicine depends on understanding the patient’s history, it is bizarre that someone would chose to be a GP if they didn’t like conversing with people. But then we’ve probably all come across a teacher who doesn’t like children.

Another consideration is the short appointment time – can you feel listened to if your appointment only lasts 7 minutes? Will you ever really feel that the doctor had the chance to consider everything that brought you to her door within 420 seconds? And how about eye contact? No one feels listened to if they aren’t looked at. How many doctors have copied Dr Sam Everington’s brilliant example and rearranged their desk so they can sit side-by-side with their patient so when they are not looking at each other, they are both sharing the screen view together?

GP practices have for many years have had posters up advising patients that antibiotics don’t work with coughs and colds, but the study featured by NHS choices on actual GP behavior showed that despite this, antibiotics are still being given to more than 90% of patients with chesty coughs, 80% with ear infections, and 60% with sore throats. Maybe it’s time for patients to be more assertive and tell their GP that they need to be listened to, they need some reassurance but don’t want pills unless it’s critical. In fact the British Heart Foundation has some good advice for patients who don’t think their GP is listening to them.We’ll all be in a stronger position when we have control of our medical records, but in the meantime we all need to get more involved in our health and healthcare decisions.

Final words go to the wise owl, Sir Muir Gray: “People love antibiotics and hate MRSA, but the two are intimately related like yin and yang.”

About Julia Manning

Julia is a social pioneer, writer and campaigner. She studied visual science at City University and became a member of the College of Optometrists in 1991, later specialising in visual impairment and diabetes. During her career in optometry, she lectured at City University, was a visiting clinician at the Royal Free Hospital and worked with Primary Care Trusts. She ran a domiciliary practice across south London and was a Director of the UK Institute of Optometry. Julia formed 20/20Health in 2006. Becoming an expert in digital health solutions, she led on the NHS–USA Veterans’ Health Digital Health Exchange Programme and was co-founder of the Health Tech and You Awards with Axa PPP and the Design Museum. Her research interests are now in harnessing digital to improve personal health, and she is a PhD candidate in Human Computer Interaction (HCI) at UCL. She is also dedicated to creating a sustainable Whole School Wellbeing Community model for schools that builds relationships, discovers assets and develops life skills. She is a member of the Royal Society of Medicine’s Digital Health Council. Julia has shared 2020health's research widely in the media (BBC News, ITV, Channel 5 News, BBC 1′s The Big Questions & Victoria Derbyshire, BBC Radio 4 Today, PM and Woman's Hour, LBC) and has taken part in debates and contributed to BBC’s Newsnight, Panorama, You and Yours and ITV’s The Week.
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