Saturday morning surgery, first patient - apparently a pleasant enough dad
with his 12 year old daughter. The daughter, a known asthmatic on MDI
beclomethasone and salbutamol, has gone a bit wheezy; parents have,
reasonably enough, increased steroids, and come for advice. Examination of
the girl reveals no specific focus of infection, temp is normal, ENT - NAD,
and chest has a few wheezes, but nothing spectacular. I explain all this to
dad, agree the next step up the BTS guidelines, about to say cheerio, when.....
*BAM* - "So you're not going to give her antibiotics then?"
Careful explanation of why I felt this was entirely inappropriate resulted
in a verbal haranguing along the lines of "I KNOW that if she doesn't have
antibiotics, she'll end up in hospital within the next few hours. You did
this last time and look what happened; if she'd seen any other doctor, she'd
have been given antibiotics without any problem. If my daughter gets any
worse, I'll take this a lot further, believe me."
Attempts at any kind of logical explanation of best practice, my 15 years
experience in general Practice, etc, merely served to inflame the situation,
and to avoid a potentially nasty confrontation, I gave in and gave him a
scrip for antibiotics.
I lost the battle with him, and I'm sure I've also lost the war - I can't
see me getting anywhere with any attempts at patient education. So what do I
do? Give in each time, suggest they find another doctor, remove them from
the list, or simply stand my ground and tough it out next time?
Offers please,
C-P
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Dr Adrian Canale-Parola
"If you want a doctor I'll examine
Every inch of you....."
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