So, you might ask, why does your health care provider write a prescription for antibiotics every time you take your child in to see him (or her)? If your provider knows that your child has only a virus, and that antibiotics do nothing to cure a viral infection, and that overuse of antibiotics may be harmful — why would your friendly provider, whom you trust with your child’s health, even consider writing such a prescription?
The answer to this question lies in a number of integrated factors. It’s important to fully understand these concepts so that you are well armed with current medical knowledge. This will help you make an informed decision, should your provider be a bit too hasty in writing a prescription of antibiotics for you child’s illness.
Before I explain these “factors”, I should say that there is no “good or bad” involved. This is not a condemnation of providers who write an abundance of prescriptions. This problem has its roots from many decades ago — when antibiotics were first discovered — and it involves the “expectations” of both the parents and the provider. I personally disagree with the overuse of antibiotics. These articles are designed to make you an informed parent so that you can decide what’s best for your child.
So…your child has been sick for three days with fever and “cold” symptoms. By day three you, as a parent, begin to panic. (It’s interesting to note that “day three” seems to be when Mom’s patience runs out and the panic button is internally activated). Let’s say that it’s day time and you decide to go to a clinic (because we’ve all heard about the four hour wait in the emergency department). So now you have a two hour wait, a $50 office visit…and your child still has a fever.
By the time you finally get to see the provider, you’re hungry, your child has been crying nonstop, you’re anxious, and your nerves are rattled because you didn’t get any sleep last night. Under these circumstances, do you really think that a provider will examine your child, turn to you and say: “Your child has a simple virus and in a couple of days he’ll be fine. He doesn’t need anything”? Nope. The provider will more often turn to you and say something like: “Your little Johnnie is sick and also has an ear infection. Here’s a prescription for some Amoxicillin and he’ll be much better in a couple of days.”
So let’s dissect the above situation and see why little Johnnie got antibiotics…when he didn’t need them.
First, your provider knows that you’ve paid for an office visit from your hard earned money (and most parents can barely afford food for the table, much less medical expenses). Second, he knows that you’ve already waited several hours on an uncomfortable chair, your child is crying, you’re upset, and you desperately want some medicine to make your child better. Third, he is busy and other patients are waiting to be seen and he has little time to explain all of the facts we learned in Part One of this series. Finally, he knows that most parents are there to get the magic pill to make their child instantly well; and that magic pill is an antibiotic.
Most folks in the CNMI —whether their origin is the Philippines, Korea, Russia, China, CNMI, or Micronesia —
generally are brought up believing in antibiotics as a cure for all illness, whether bacterial or viral. This appears endemic to nearly all cultures.
Bringing together all of the above, we see that the parent expects antibiotics; we see that the quickest way for the provider to wrap up the exam and move on to the next patient is to meet the parent’s expectation, and simply write a prescription for antibiotics. Interestingly, I have even heard some providers tell parents that the antibiotics will make the child better in “a couple of days.” And, indeed, the child IS better in a couple of days.
When this happens, it hardens the deception of antibiotics curing a “cold”, and the parents will likely return to that “nice and knowledgeable provider” who made their child better with antibiotics. The facts, however, are a bit different. Most parents will bring their ill child to the clinic around day three. Most children are ill with a “cold” for about five days. So, it’s a safe bet to tell the parent that their child will be better in two days…but it’s NOT from the antibiotic: it’s the normal course of a typical cold.
To me, this borders on unethical practice. The end result: the parents will insist on antibiotics because “it made little Johnnie better the last time he was sick”; and little Johnnie will continue to receive antibiotics for which he does not need.
I worked with a doctor in a busy emergency department in Alaska. Nearly every child he saw had an ear infection. Why? Because only he could look in the child’s ear. That was the Doctor’s justification to write a prescription for antibiotics. He often didn’t even need to finish the exam. After the parents received the prescription, they were satisfied and the Doctor could move on to the next patient. Of course, most of those children never had an ear infection (after I rechecked some of those “infected ears,” it became obvious that the Doctor did this to save time, since most of those “infected ears” appeared quite normal). Fortunately, this is not the norm, but these practices do exist and parents should be aware.
So what can you as a parent do?
1. Don’t request antibiotics. Studies show that providers will often give in to a parent’s request, even though antibiotics are not needed. Why? Too often we providers end up with a very insistent and demanding parent. It’s easier to write the prescription, rather than get frustrated and waste time arguing with the parent. Wise parents should begin by informing their provider that they wish to avoid antibiotics, unless it’s absolutely needed.
2. Ask questions. If the health care provider does write for antibiotics, make sure that he justifies its use by explaining why this is a bacterial infection, not viral. I encourage parents to ask these questions. It’s your right.
3. Be informed. Educate yourself by going online and finding out the latest facts regarding antibiotic use. A good place to start is the Centers for Disease Control Web site. Do a focused search on the appropriate use of antibiotics, and do review the CDC’s educational “Get Smart” program.
Remember that most providers will give good care to your child. Just be aware of the ones who are too quick to write a prescription for antibiotics. Your right and duty as a parent is to make sure that those antibiotics are in your child’s best interest, and not written merely to make YOU satisfied.
Thanks for taking the time to read this information and I hope that it has been helpful.
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