Tuesday, September 25, 2007

Was the Trip to the Doctor's Office Necessary?


QUESTION: When I called my family doctor on the phone and requested that he
call a prescription into the pharmacy for an antibiotic, he asked me to come
to his office first to be examined. While I was there he took a culture, and
told me that it would be several days before he had an answer. Then he
prescribed an antibiotic anyway! Doesn't this mean that the trip to the
office and the culture was all really not necessary, and just another way of
making me spend my money? I suppose you won't answer this question in your
column, or just stick up for the doctor anyway.
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ANSWER: You're wrong about my not using your question. As for "sticking up"
for your doctor, I'll explain what I think happened and let you decide that. I
must suppose you described certain symptoms to your doctor when he spoke with
you on the phone, symptoms which may be caused by any one of a wide variety of
infecting bacteria or viruses. Since different bacteria require different
antibiotics, and viruses do not respond to antibiotic treatment at all, and
since your description of your symptoms may have left him in doubt as to the
cause of your illness, he decided that an examination was necessary for a
diagnoses that could come closer to hitting the mark. The history of your
illness that you provided him at the office, and the findings of his
examination probably cleared up a few things, but the exact nature of the
bacteria must still have been in doubt. If he then prescribed a medication,
without a culture, and your situation did not improve, the treatment might
have interfered with the growth of the bacteria at a later date. So he chose
two courses of action. A culture now to identify the bacteria (even if the
results would take several days) and a prescription for an antibiotic now,
based upon his findings during the examination, his knowledge of the possible
bacterial infections that might be going around in your community, and his
past experiences in the use of the medication he prescribed. Now all the bets
were covered. If the medication was effective, you would be well in the
shortest possible time, and if not, he would then know with some certainty
the identity of the bacteria that was the cause of infection, and so be able
to change to an antibiotic that would be more effective in your case. In my
opinion, he was right on the mark. Now what do you think?

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