Patient expectations over the prescribing of antibiotics can pose a real challenge to GPs. Dr Marika Davies, senior medicolegal adviser at Medical Protection, outlines how your communication skills can rise to the fore
GPs already spend a considerable amount of time explaining to patients why antibiotics will not help. The ongoing campaign by Public Health England (PHE) is a welcome initiative, one which I greatly hope helps to add a dose of reality to public perception of antibiotics.
For the time being, this perception continues to pose a challenge to GPs. Between December 2017 and January 2018, Medical Protection ran a snapshot survey of our GP members to gauge their views – with a third of respondents saying they frequently experience anger or frustration from patients when advised that antibiotics are not needed.
Clearly the PHE campaign was never going to be an overnight fix, and there is still much to do.
All GPs should feel confident to refuse to prescribe: patients cannot insist on a particular treatment
Anger and frustration
Difficult consultations with patients who want antibiotics, even when they aren’t required, are still happening. Dealing with these demands is an additional cause of stress to GPs who are already under a great deal of pressure.
Good communication and management of patient expectations can help in dealing with these situations, although we are all too aware that some patients will not accept this and will become angry or frustrated when they do not get the treatment they want.
Although we know the pressure is on GPs in these situations, all GPs should feel confident to refuse to prescribe: patients cannot insist on a particular treatment, and
the GMC says that you should only prescribe when you are satisfied that the treatment meets the patient’s needs.
Prescribing when it is not considered appropriate is not in the best interests of the patient and could put a GP at risk of criticism. GPs should try to explain the reasons for their decision politely and calmly, and make notes of the conversation in the patient’s record. If the patient remains dissatisfied and angry, offer them the practice’s complaints procedure: if a complaint is lodged,
Medical Protection can assist.
Useful links