Doctors 'being paid not to give out antibiotics'

Destination · 18 Feb 2015 at 11:47

stopper said:
Yeah, that is what they want you to believe.
The truth is, sick people generate money, curing people doesn't.

Fool.
Maybe in the USA where healthcare is an expensive industry and everyone involved gets a profit, GPs here are paid by targets and patient numbers. Them being sick is detrimental to performance, less targets hit, thus well woman clinics, diabetic clinics etc.

Sanchez · 18 Feb 2015 at 12:18

This is what I think should have been linked to originally. I heard the article on Radio 4 this morning.

arknor · 18 Feb 2015 at 12:42

just buy them at the Indian pharmacy website no prescription needed

ethan · 18 Feb 2015 at 12:57

snips86x said:
My mother-in-law suffers from asthma and is subject to chest infections. With 1/2 collapsed lung, recovery without them is very very hard causing fatigue. They refused to give her any last time which was abysmal really!

They can't just blanket this cut back but they don't seem overly clever with getting it right either.

True. The GP they put me with told me to go back if I got any worse. I had to force myself to see him as I was bedridden and he had the nerve to suggest that. I told him I wasn't happy with his decision, and so he asked what I wanted. I said I wanted and I needed antibiotics because I'm asthmatic and I didn't want this chest infection getting worse. Through experience I know when I need medical treatment or not. He looked at me and said ok then but don't use them unless you get worse? I'm now a lot worse, the variety he prescribed didn't work. I'm now throwing up green mucous and I need to go back for some more. Ridiculous policy since it effects patients that genuinely require them.

snips86x · 18 Feb 2015 at 13:01

ethan said:
True. The GP they put me with told me to go back if I got any worse. I had to force myself to see him as I was bedridden and he had the nerve to suggest that. I told him I wasn't happy with his decision, and so he asked what I wanted. I said I wanted and I needed antibiotics because I'm asthmatic and I didn't want this chest infection getting worse. Through experience I know when I need medical treatment or not. He looked at me and said ok then but don't use them unless you get worse? I'm now a lot worse, the variety he prescribed didn't work. I'm now throwing up green mucous and I need to go back for some more. Ridiculous policy since it effects patients that genuinely require them.

I've seen my MiL like this mate and I really feel for you. Hope you get something sorted!

Destination · 18 Feb 2015 at 13:01

How is it ridiculous that the antibiotics he didn't want to give you, and uou demanded then didn't work, when the suggestion in the article is that he shouldn't have gave them to you anyway as they wouldn't work?
Bring a sputum sample, let them culture it, test it for bug strain and a suitable antibiotic, in the same way as they do with UTIs.
That way the antibiotic prescribed will be effective for the bacterial infection you are now exhibiting. Very hard to culture something before it is there in amounts large enough to capture.

checjb · 18 Feb 2015 at 13:03

mattyg said:
Thats what Placebo's should be used for

Placebo? In his case the correct term is bullet.

ethan · 18 Feb 2015 at 13:19

Hikari Kisugi said:
How is it ridiculous that the antibiotics he didn't want to give you, and uou demanded then didn't work, when the suggestion in the article is that he shouldn't have gave them to you anyway as they wouldn't work?
Bring a sputum sample, let them culture it, test it for bug strain and a suitable antibiotic, in the same way as they do with UTIs.
That way the antibiotic prescribed will be effective for the bacterial infection you are now exhibiting. Very hard to culture something before it is there in amounts large enough to capture.

I didn't say that. Read it properly. It's the mass application of that policy I'm critical of that is being used indiscriminately. I agree with the rest of your comments though. But they won't do that. It's too easy for them to ignore it and make it somebody else's problem like the hospital. I know it's guess-work with antibiotics which is why I need to go back. But what is the point if they will not prescribe them satisfactorily in a way that the people who genuinely need them will get them to begin with?

Dis86 · 18 Feb 2015 at 13:23

I'm not handing out antibiotics. Where's my money's?

Minstadave · 18 Feb 2015 at 14:17

ethan said:
I didn't say that. Read it properly. It's the mass application of that policy I'm critical of that is being used indiscriminately. I agree with the rest of your comments though. But they won't do that. It's too easy for them to ignore it and make it somebody else's problem like the hospital. I know it's guess-work with antibiotics which is why I need to go back. But what is the point if they will not prescribe them satisfactorily in a way that the people who genuinely need them will get them to begin with?

You say you genuinely need them, how so? If resistance is becoming more and more a problem and you'd get better anyway is it the right thing to treat you? Because when you die in 20 years time of your multi drug resistant infected knee replacement we may well be regretting current practice.

I don't know who needs antibiotics or not and I prescribe shed loads. Lots of people will tell me they only get better on antibiotics, but that's because they get a course everytime they're unwell and they'd have got better anyway.

Most people will get better without antibiotics even with bacterial infections, so should I be giving them out to people to shorten infections that would get better all the same? There isn't an obvious answer but there is a clear need to restrict antibiotic use and it may well be that a shift in the public's expectations are needed.

ethan · 18 Feb 2015 at 15:34

Minstadave said:
You say you genuinely need them, how so? If resistance is becoming more and more a problem and you'd get better anyway is it the right thing to treat you? Because when you die in 20 years time of your multi drug resistant infected knee replacement we may well be regretting current practice.

I don't know who needs antibiotics or not and I prescribe shed loads. Lots of people will tell me they only get better on antibiotics, but that's because they get a course everytime they're unwell and they'd have got better anyway.

Most people will get better without antibiotics even with bacterial infections, so should I be giving them out to people to shorten infections that would get better all the same? There isn't an obvious answer but there is a clear need to restrict antibiotic use and it may well be that a shift in the public's expectations are needed.

Because I will usually end up with pneumonia if I don't receive proper treatment given the state of my asthma. I've already thrown up mucous and bile this morning. The coughing has caused me to pull three muscles in my back, my ribs hurt and my throat is bleeding due to the incessant coughing as well. Would you refuse antibiotics in this situation or would you just tell me to get better on my own?

Minstadave · 18 Feb 2015 at 15:38

ethan said:
Because I will usually end up with pneumonia if I don't receive proper treatment given the state of my asthma. I've already thrown up mucous and bile this morning. The coughing has caused me to pull three muscles in my back, my ribs hurt and my throat is bleeding due to the incessant coughing as well. Would you refuse antibiotics in this situation or would you just tell me to get better on my own?

No I'd examine you and make up my own mind.

MichaelAwkward · 18 Feb 2015 at 15:41

Sadly this target of reducing antibiotic use will be basically useless in reducing the problem of resistance.

I know several international students (from China, HK, Korea, India, Bangladesh) and in the time I've known them, they've all used antibiotics either brought from their home country or bought from an international shop here without a prescription, without any real knowledge of why they're using them, whenever they've felt ill or had a cold. When I asked one of them about it, they just said it was what they did back home, what their parents did, etc etc.

Preventing antibiotics from becoming useless needs international action. Same as climate change.

Grimley · 18 Feb 2015 at 15:51

mattyg said:
Thats what Laxative's should be used for

fixed.

ethan · 18 Feb 2015 at 15:56

Minstadave said:
No I'd examine you and make up my own mind.

Well the last GP couldn't make up his mind and I ended up at a "walk in" which prescribed without hesitation.
They were not too overly concerned about medical practices or concerns that could arise twenty years down the line when there could be a chance you could die now

dowie · 18 Feb 2015 at 16:45

I guess they respond to incentives just like anyone else.

They should offer the flu jab... they've recently been offered payments for it, as a result I got two letters two SMSs and a phone call to tell me a flu jab was available... Yup they're supposed to be professionals who will not give out antibiotics when not needed, remind people to get flu jabs etc... They'll still be more likely to behave a certain way when someone throws some money at them... like any humans incentives will work on them.

dowie · 18 Feb 2015 at 16:48

MichaelAwkward said:
Sadly this target of reducing antibiotic use will be basically useless in reducing the problem of resistance.

I know several international students (from China, HK, Korea, India, Bangladesh) and in the time I've known them, they've all used antibiotics either brought from their home country or bought from an international shop here without a prescription, without any real knowledge of why they're using them, whenever they've felt ill or had a cold. When I asked one of them about it, they just said it was what they did back home, what their parents did, etc etc.

Preventing antibiotics from becoming useless needs international action. Same as climate change.

I do wonder if any newly developed/future antibiotics should be withheld from countries with lax regulations until they change those regulations and make them prescription only.

Minstadave · 18 Feb 2015 at 17:33

ethan said:
They were not too overly concerned about medical practices or concerns that could arise twenty years down the line when there could be a chance you could die now

Oh you drama queen.

Minstadave · 18 Feb 2015 at 17:34

dowie said:
I do wonder if any newly developed/future antibiotics should be withheld from countries with lax regulations until they change those regulations and make them prescription only.

They'll be withheld whilst the patent cover lasts as cost will limit them largely. Once generics are available it'll be a free for all.

LockyOK · 18 Feb 2015 at 17:37

I have heard some hilarious stories from a GP friend. Back in the days when he was on call, aside from regularly being called out to see children who had a runny nose and wouldn't go to sleep (the parents had work in the morning) and a twenty-year old office worker who complained of having severe pain in his arm (he had been decorating all day).

The current favourite pastime is to bring in pages of tosh garnered off the Internet and to expect the GP to wade through it all and explain why it is rubbish - all in a ten minute session!