Monday, January 03, 2000

The big bad bug

Have you heard? When the big bad antibiotic-resistant bug to end all bugs descends on the human race, it will be our fault. That's right -- it's pushy moms who are rendering antibiotics ineffective by ordering doctors to prescribe them against their wills, willy nilly. An article in October's Southern Medical Journal warns: "Pediatricians may believe that parents will be dissatisfied and seek treatment elsewhere if children with colds are not given antibiotics. Pediatricians may thus prescribe antibiotics against conventional medical wisdom simply to appease the parents. Such a tendency to prescribe antibiotics unnecessarily is particularly disturbing in light of the increasing emergence of antibiotic-resistant bacteria."

Now, I don't know what planet these folks are on, but here on planet Earth -- the planet of three-hour waits in the sick-child waiting room and HMOs that figure it's cheaper if you die -- you're lucky if the doctor speaks to you at all, much less quivers to do your bidding. I've had pediatricians who preferred to wait until the child had been oozing snot for several months before they'd prescribe, and pediatricians who couldn't find anything wrong but insisted on prescribing antibiotics anyway, just in case, but neither decision seemed to have an awful lot to do with me, the parent, that inconvenient extra adult in the room. I'm as proactive as the next mom, and I sure do share my opinion, but I usually just get that look: the one that says, "There's an unpleasant buzzing in this room, and as soon as it stops I can proceed with my work." And so the idea that these doctors are merely slaves to parents' whims is . . . well, laughable comes to mind.

So whose fault is it anyway? I'm always happy to blame HMOs, who have probably calculated that drugs cost less than a doctor's diagnostic time. But then there's this insight from the newsletter of the Alliance for the Prudent Use of Antibiotics: "Although we would like to believe otherwise, it is often less time-consuming for a physician to write a prescription than it is to engage in a lengthy discussion with parents about the natural history of an infection, diarrhea, or sore throat."
Now that I can believe.

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