You’ve heard it before – the cost of healthcare is too high, and it keeps on rising! Some physicians tend to place responsibility for high medical costs more on “demanding patients” than themselves. However, new research in JAMA Oncology suggests otherwise, noting that patient “demands” directly account for a negligible change in physician behavior and thus expenditure. Take a look at the original article, or, for a more colorful read, the editorial “The Myth of the Demanding Patient.”
The Infectious Diseases Society of America (IDSA) last week released its list of tests or procedures whose necessity should be questioned, as part of the ABIM Foundation’s Choosing Wisely initiative.
The recommendations are as follows:
1. Don’t treat asymptomatic bacteriuria with antibiotics.
2. Avoid prescribing antibiotics for upper respiratory infections.
3. Don’t use antibiotics for stasis dermatitis of lower extremities.
4. Avoid testing for a Clostridium difficile infection in the absence of diarrhea.
5. Avoid treatment with antibiotics for mitral valve prolapse.
It’s the middle of winter, with no end in sight. A 28 year old male arrives in your primary care clinic with no past medical history and one complaint: a stuffy nose. For the last 3 days, he has had sinus congestion, a mild cough, and associated headache. He denies fever, sick contacts, myalgias, etc. You suspect a viral infection, noting that the patient should improve without antibiotics, but he insists. He must have antibiotics today, so that he can return to work! Do you give in and send him out with a Z-pack?
Consumer Reports has joined with the ABIM and the Choosing Wisely Campaign to help educate patients about when, where, and how to use antibiotics, in an effort to prevent, as they note, unnecessary harm.
Take a look at the patient resources below – if you like them, print them out and display them in your practice. It just might make your next conversation a bit easier…