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 entrepreneur, writer, campaigner and commentator. She is based in London and is the founder and Chief Executive of 2020health, an independent, social enterprise Think Tank whose aim is to Make Health Personal. Through networking, technology, research, relationships and campaigning 2020health has influenced opinion and action in fields as diverse as bioethics, alcohol, emerging technologies, fraud, education, consumer technology and vaccination. Julia studied visual science at City University and became a member of the College of Optometrists in 1991. Her career has included being a visiting lecturer at City University, a visiting clinician at the Royal Free Hospital, working with south London Primary Care Trusts and as a Director of the UK Institute of Optometry. She specialised in diabetes (University of Warwick Certificate in Diabetic Care) and founded Julia Manning Eyecare in 2004, a home and prison visiting practice for people with mental and physical disabilities using the latest digital technology, which she sold to Healthcall (now part of Specsavers) in 2009. Experiences of working in the NHS, contributing to policy development, raising two children in the inner-city and standing in the General Election in Bristol in 2005 led to Julia forming 2020health at the end of 2006. Julia is a regular guest on TV and radio shows such as BBC News, ITV’s Daybreak/ GMB, Channel 5 News, BBC 1′s The Big Questions, BBC Radio, LBC and has taken part in debates and contributed to BBC’s Newsnight, Panorama, You and Yours and ITV’s The Week. She is mum to a rugby-mad son, a daughter passionate about Shakespeare, and wife of a comprehensive school assistant head-teacher. She loves gardening, ballet, Zimbabwe, her Westies Skye and Angus, is an honorary research associate at UCL and a Fellow of the RSA.
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