Overprescription and subsequent overuse of antibiotics is an increasing concern, contributing to higher drug costs and the increasing prevalence of antibiotic-resistant bacteria. But in many cases, doctors' over-prescribing of medication may not be due to misdiagnoses, but to insistent requests and subtle hints from their patients.
Scott and his colleagues analyzed data from a 1996-1999 observational study of nearly 300 outpatient visits to 18 family practices in the US. All of the visits were related to acute respiratory tract infections such as the common cold, bronchitis or middle-ear infection. The findings show that "the encounter between the physician and the patient with respiratory infection is an intricate dance in which both partners play important roles," Scott said. "Any interventions to reduce antibiotic prescribing must pay as much attention to the patient as to the physician."
The manner in which the patient communicates his or her illness to the physician strongly influences whether or not the physician prescribes an antibiotic. These unnecessary prescriptions were often given as a result of subtle pressuring of physicians by their patients. Physicians appear to be trying to maximize patient satisfaction by giving antibiotic-seeking patients what they want.