Antibiotics: A Laissez-Faire Approach to their Prescription

dh2007 wrote:

I just think doctors use Amoxicillin for everything and I find it lazy

I wouldn't comment on the bulk of your story withouth knowing the full details. However, I think the statement above above is interesting. While it is, of course, factually wrong, it's a belief held by a lot of people.
Back home in Tallaght, everyone knows what amoxicillin is. People who can't spell it, or say it, know what it is. You would struggle to find somebody wos not been on it. Where I live in the UK, most of my non medical friends don't know what it is.
In Tallaght, friends and family tell me it's because rubbish lazy docs prescibe amoxicillin because they "don't know about other antibiotics" or "they have shares in the company". Whereas, by and large, you don't hear these stories in the UK. Of course, UK docs might be better than their Irish counterparts, or may be more reckless with their prescribing of the more exotic antibiotics. But I have a different theory. I think it's all about payment for medical services. People feel ripped off when they go to their GP or hospital if they don't get an antibiotic for an infection. It's almost an in insult when I tell parents that I won't be giving them an antibiotic for their kid, as it's most likely a viral infection. Everyone is pleased when you give them an antibiotic though. It's like you're taking them seriously.
So when I go to my GP in Glasgow with the lurgy, he usually says "you have a virus it will go away in 4-5 days,see ya". He won't give me an antibiotic. He's the doc, and it's his choice. I know that none of the following will secure me an antibiotic:

1) But it's gone to my chest, doctor

2) But I get an antibiotic at this time every year, doctor

3) It's too bad to be just a virus, doctor.

BUT, I go to my doc in Dublin if I'm home, and I ALWAYS get an antibiotic. So does everyone who visits him. That's because we pay him 50 euro. He's a really good doctor, but you can't take the 50 euro and then not give the antibiotic. He knows that most antibiotics he gives out for sore throats and sore ears are as useless as prescribing starbursts. But have you ever heard anyone who has come back from an Irish GP surgery that's been denied an antibiotic? The moral outrage is palpable in the air for weeks. Last person I knew that it happened too never went back to that GP (even though it was patently obvious that they had a viral infection).
So, in the circumstances where GPs feel they have to give an antibiotic to every member of the public, amoxicillin (or poxy-cillin as it'a called in the trade coz it's so crap) is the drug of choice. It supposedly has a broad spectrum of activity, but lots of stuff is already resistant to it, so the GP's don't feel too bad about breeding resistant strains.
There are a lot of faults with the NHS, but medical autonomy has been preserved, which is, I believe, one of the great failings of any fee for service primary care setup.

Sorry dh I probably came across a bit harsh there...I didn't intend to be. It's just that she may have had a good rationale for prescribing what she did without it being a case of her being ignorant/ fobbing you off or whatever! I don't know enough about the topic to comment in that respect.

When I talk about a doctor-patient relationship I believe that's exactly what it should be, a relationship, a partnership with mutual respect and trust, particularly when it comes to GPs where you could be talking about a lifelong/ family wide relationship with them... but that's a whole other thread!