from the a-quick-way-of-clearing-the-waiting-room? dept.
http://www.eurekalert.org/pub_releases/2014-10/bawh-iyw100214.php
Research Letter (Preview): http://archinte.jamanetwork.com/article.aspx?articleid=1910546
Researchers have discovered that doctors are more likely to prescribe an antibiotic for respiratory infections later on in the day.
"Clinic is very demanding and doctors get worn down over the course of their clinic sessions," explained Jeffrey A. Linder, MD, MPH, a physician and researcher in the Division of General Medicine and Primary Care at BWH and lead author of this study. "In our study we accounted for patients, the diagnosis and even the individual doctor, but still found that doctors were more likely to prescribe antibiotics later in their clinic session."
The researchers merged billing and electronic health record (EHR) data for patient visits to 23 different primary care practices over the course of 17 months. They then identified visit diagnoses using billing codes and, using EHRs, identified visit times, antibiotic prescriptions and chronic illnesses. They analyzed over 21-thousand ARI visits by adults, which occurred during two four-hour sessions, 8a.m. to noon and 1p.m. to 5p.m. The researchers found that antibiotic prescribing increased throughout the morning and afternoon clinic sessions.
"This corresponds to about 5 percent more patients receiving antibiotics at the end of a clinic session compared to the beginning, "explained Linder.
(Score: 2) by VLM on Tuesday October 07 2014, @09:25PM
My personal experience with bacteria pneumonia is you show up feeling like crap and sit thru a couple hours of tests (x-rays, etc) and then they send you home with antibiotics somewhat after lunch.
So I would be surprised if the % wasn't dramatically higher at the end of the day.
(Score: 0) by Anonymous Coward on Wednesday October 08 2014, @06:40AM
In other news, people who are sick and feel terrible don't make it to the doctor's office until later and have to wait to be seen as a walk in. Their prescriptions are written during the appointment, which is later in the day.
Someone page Rick Romero!
(Score: 4, Insightful) by Dunbal on Tuesday October 07 2014, @09:27PM
Considering that US doctors prescribe antibiotics for Ebola (a virus) and then send the patient home, I'm not surprised at all. Yes I'm a doctor.
Honestly I'm sick and tired of this crusade against prescribing antibiotics. It makes sense. However it flies into the face of reason when most veterinarians are dumping metric tonnes of antibiotics into the ecosystem by prescribing prophylactic treatment for livestock that's not even sick. Then you come to me and say that my patient is the major cause of antibiotic resistance because she took her pills for 3 days instead of 7? I don't buy it.
(Score: 0) by Anonymous Coward on Tuesday October 07 2014, @09:47PM
It isn't either/or - both of those practices are wrong.
(Score: 4, Insightful) by Dunbal on Tuesday October 07 2014, @09:54PM
You're missing my point or I'm not making it clear enough. Someone was motivated enough to do a study and believes that 5% more likelyhood of prescribing antibiotics in the afternoon vs the morning is scandalous. In the meantime there are very very few studies on the effects of throwing antibiotics like vancomycin (among our last line of defense against resistant organisms) at chickens, cows and pigs. Every single doctor I know - including myself - is well aware of the fact that antibiotics are over-prescribed for patients. Well aware. You're worried about the mouse and I'm more worried about the elephant.
(Score: 0) by Anonymous Coward on Wednesday October 08 2014, @12:06AM
So multi-drug resistant tuburculosis is due to use of antibiotics on farms? Hospital-acquired MERSA is because farmers bring it to the hospital?
As the AC said, this is not an either or situation. Studies are being done on both situations. It is important to know what can affect a health care worker's judgement.
You don't need to get sensitive about it.
(Score: 2) by Dunbal on Wednesday October 08 2014, @12:57AM
You need to learn about plasmids. And then you need to learn about how enterococci (which are not only specific to human digestive tracts) are pretty good at becoming resistant to antibiotics. Normally they don't cause disease themselves but hey GUESS WHAT they can share their plasmids with other bacteria and give them the gift of drug resistance.
I am sensitive about it because studies are NOT being done in the veterinary situation. Yet physicians are called on a 5% variation - 5% which easily can fit in the error of any study.
(Score: 0) by Anonymous Coward on Wednesday October 08 2014, @02:17AM
Most of us patients are well aware as well.
(Score: 2) by meisterister on Wednesday October 08 2014, @11:16PM
I think that good money could be made manufacturing very dressed-up and reasonably costly (to intensify the placebo effect) brand of sugar pills. It would also be useful to release it under different names for different diseases to avoid suspicion. The same company could even offer a "generic" version to pharmacies so that patients could feel like they were being proactive and "saving money".
Is this plan dishonest? Yes.
Will it help fend off antibiotic resistant disease while at the same time making patients feel better anyway? Absolutely!
(May or may not have been) Posted from my K6-2, Athlon XP, or Pentium I/II/III.
(Score: 2) by urza9814 on Thursday October 09 2014, @01:18PM
...until someone who's prescribed those pills Googles the name, finds out what they are, and sues their doctor for lying to them...
(Score: 2) by RamiK on Tuesday October 07 2014, @09:54PM
In other news, study finds patients with respiratory infections, chronic conditions or those suffering from mild symptoms to schedule their doctor visit after working hours.
compiling...
(Score: 0) by Anonymous Coward on Tuesday October 07 2014, @10:06PM
How about when they prescribe more adderal?
(Score: 0) by Anonymous Coward on Wednesday October 08 2014, @02:24AM
"I called him the other day and said, Doc, I just swallowed a bottle of sleeping pills.
He told me to have a few drinks and get some rest."