Practice Management Alert

If your practice is overprescribing antibiotics, it’s not alone.

If any physician at your practice has ever felt like some patients’ demands for antibiotics is insatiable, they’re not alone.

According to a recently published study, “The inconvincible patient: how clinicians perceive demand for antibiotics in the outpatient setting,” funded by the HHS Agency for Healthcare Research and Quality (AHRQ) and published in Family Practice, while there are multiple factors at play in the overprescription of antibiotics, patient demand is a major player.

Interestingly, many physicians feel compelled to please their patients and struggle with a patient-provider relationship that is grounded more in the realm of customer service or business than medical advice. In fact, more than half of the responding physicians believed that the patients felt that a visit to the office or clinic was transactional, and that a prescription for antibiotics was “more valuable to patients than an exam, advice, or reassurance,” the study says.

Similarly, physicians reported fearing the negative feedback associated with not giving patients what they want, and were afraid of repercussions, including hits to their practice’s finances, reputation (particularly with the advent of online reviews), and the emotional drain of arguing with patients. Physicians also reported fearing that a refusal to prescribe unwarranted antibiotics could incur longstanding damage to the patient-provider relationship.

Physicians also reported that previous experiences discussing clinically appropriate antibiotic prescription and usage shaped how they approached such discussions with other patients. Physicians who had not been able to convince prior patients that antibiotics were inappropriate might not want to put in the emotional effort and time to try the conversation again with a different patient.

The authors of the study ultimately concluded that communication is key. To realign antibiotic prescription rates with that which is clinically appropriate, providers need better communication tools for managing patient expectations surrounding antibiotics, as well as in-practice and industry support and coordination to ensure that clinicians are presenting a united front and consistent messaging surrounding antibiotic prescription and use.

Read the entire study at  https://academic.oup.com/fampra/advance-article/doi/10.1093/fampra/cmz066/5613669?guestAccessKey=f0b4f204-5a19-4510-9cc0-754b88a2cf8d.