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.”

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About Julia Manning

Julia Manning is a social pioneer, writer, campaigner and commentator. Formerly a clinical optometrist specialising in diabetes and visual impairment, she is the founder and Director of 2020health, an independent, social enterprise Think Tank whose aim is to Make Health Personal and Social. 2020health has through research, events and campaigning influenced opinion and action in fields as diverse as bioethics, alcohol, emerging technologies, fraud, education, consumer technology and vaccination. In 2014, 2020health were founding partners of the Health Tech and You Awards with Axa PPP and the Design Museum. Since 2016, 2020health has increasingly focused on digital health and public health in the community. Julia is a Fellow of the RSA and now also a part-time PhD student at the UCL Interaction Centre, studying the use of digital technology for stress management in the workplace. 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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