Liam Farrell: That's as may be, but I still want an antibiotic

Overzealous? Not me. So I knew just what to do when Mrs X told me: 'I've an awful sore throat and I need an antibiotic.'

I'd actually rather cut off my own hand than refuse Mrs X her weekly prescription for antibiotics - it'd save trouble in the long run and probably be less painful. But this time, maybe it'll be different, I thought, maybe we'll work everything out by reason, diplomacy, dialogue and mutual co-operation.

According to the Academy of Medical Royal Colleges (AoMRC), there is growing evidence that pressure for doctors to do something at each consultation has led to patients sometimes receiving treatments that are of little or no value.

Which is hardly news; in ancient Mesopotamia, when he wasn't massacring the neighbours, King Hammurabi was establishing the Code of Hammurabi, one of the earliest surviving codes of law.

Included in this was a law threatening overzealous surgeons with the loss of a hand or an eye. Nowadays, we could just take away their big shiny cars.

'Before I prescribe antibiotics, which of course I shall do with a heart and a half,' I said to Mrs X, 'the good people at AoMRC have advised that you ask me three questions.'

I handed her the list, which she squinted at suspiciously.

'Do I really need this test, procedure, or treatment?' she read.

'No,' I said, 'any more antibiotics and one day a big green monster will jump out of your chest and run screaming down the road.'

Her glare was in the terawatt range, just for me. It made me feel special. 'Are there simpler options?' she continued.

'There certainly are,' I said. 'Heretical though it sounds, medical science would advise rest and plenty of fluids.' This was followed by a long silence, a threatening kind of silence, with shades of a mob, a rope and a hanging.

Finally, she asked: 'What happens if I do nothing?'

'You'll get better on your own,' I said. 'Your immune system, which has evolved over millions of years, will respond to this undoubtedly crippling viral infection with gusto and enthusiasm.'

'That's as may be. I still want an antibiotic,' she said, implacably.

And as the ghost of Hammurabi came whispering to my mind, I thought, well, I don't really need my left hand.

  • Dr Farrell is a GP from County Armagh.
  • Follow him on Twitter @drlfarrell

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins

Register

Already registered?

Sign in

Follow Us:

Just published

GPs told to display coronavirus posters and identify patient isolation space

GPs told to display coronavirus posters and identify patient isolation space

GPs have been advised to display patient information posters outside their surgeries...

1,000 GP partners lost in 12 months as thousands more near retirement

1,000 GP partners lost in 12 months as thousands more near retirement

General practice lost almost 1,000 GP partners in the year to December 2019 - and...

GPs not responsible for 'holiday cancellation letters' amid coronavirus outbreak, RCGP warns

GPs not responsible for 'holiday cancellation letters' amid coronavirus outbreak, RCGP warns

Insurers and travel companies have been asking patients to obtain letters from their...

Fully-qualified GP workforce down 277 over the past year

Fully-qualified GP workforce down 277 over the past year

The GP workforce lost 277 fully-qualified, full-time equivalent (FTE) doctors in...

Talking General Practice - the new podcast from GPonline

Talking General Practice - the new podcast from GPonline

GPonline is launching a new podcast called Talking General Practice - listen to our...

GPs should not prescribe antibiotics for impetigo, says NICE

GPs should not prescribe antibiotics for impetigo, says NICE

GPs should prescribe hydrogen peroxide 1% cream rather than topical antibiotics for...