The Impatience of Patients, and How It Costs Us All

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The doctor says, “Let’s wait.” You say, “Fix it now.” Who knows better?

According to doctors, what is often the best medicine for what ails you? Doing nothing. One of many disturbing health care statistics reveals that an estimated $1.1 trillion is spent annually in the U.S. on unnecessary tests, medical visits, and treatments. And the costs of overmedicating make everyone’s health care costs rise.

But when you or your kid is sick, these statistics—and the advice of doctors—are easy to dismiss. Today, the WSJ examines the shifting approach to children’s ear infections. Much of the time, the prudent approach is to do nothing, provided that the child is over the age of 2, doesn’t have a high fever, and is not in a lot of pain. Yet 84% of the children diagnosed with ear infections are given prescriptions for antibiotics.

Why? For one thing, I have to think that many parents, in fact, do nothing but wait it out when their kids have ear infections. They don’t even go to the pediatrician. They simply monitor their kids and give them some time to fight off the infection, like they’re supposed to. So you’ve got to assume that, for the most part, the kids who wind up at the doctors tend to be ones who have got more severe ear infections.

But once a child is at the doctor’s office, the doc must feel pressure to do something, even if he or she is leaning toward the wait-it-out approach. As the WSJ writes:

Some parents say that once a bacterial infection has been diagnosed, they’re not comfortable leaving it untreated. Some also push for the quickest possible recovery so their children can return to school or day care. In a survey of primary-care doctors published in 2007, 65% said parents’ demand for antibiotics was the most important barrier to holding off on prescriptions.

The question becomes: Do you go to a doctor for sage advice? Or merely for a quick fix? Doctors certainly seem willing to appease parents if they’re pushy and impatient. (And I have to think that many parents push not just because they want their kids healthy asap, but also so that they won’t have to take more time off of work to nursing the child back to health.) As one dad interviewed in the WSJ story says, if a doctor didn’t give him a prescription for his kid’s ear infection, he would simply find another doctor who would.

The most sensible approach to handling ear infections (and many other medical issues, for that matter) seems to be this one: When a doctor could go either way, the doc sends the patient home and allows the parent to call up and request a prescription if the symptoms don’t subside in a couple days. Many parents demand that prescription in the first place because they don’t want to be bothered a couple days later with another round of waiting in the pediatrician’s office—nor do they want to be bothered with another co-pay for diagnosing essentially the same illness.