Several years ago, when my son was in middle school, he developed a nasty sinus infection. He didn’t have a fever, and I suspected it was a viral infection that would run its course unaided. I told him this, but he was unimpressed.
Partly to make him feel better, and partly because I wanted my diagnosis confirmed, I made an appointment for him to see our pediatrician.
I had a good relationship with our pediatrician. We shared the same philosophy of watchful waiting and not rushing to order unnecessary tests and prescribe unnecessary drugs.
Unfortunately, it was his day off. My son was seen by the new pediatrician. She listened as he described his symptoms—headache, stuffy nose, bloody yellow snot, the usual—and then wrote him a prescription for a Z-Pak (Zithromycin/azythromycin). Our appointment lasted for, oh, about 5 minutes.
I was surprised she ordered an antibiotic, but my son was delighted. Even at that age, he knew other friends who had been prescribed the popular Z-Pak (do middle schoolers really talk on the playground about the medications they are prescribed?) Convinced he would soon be on the mend, he gave me that look: “See, what do you know?”
Well, I wasn’t going to argue with the pediatrician. Maybe she recognized subtle signs of a bacterial infection that I missed.
A few years later, I was reading the blog of a family practice doctor whose stories I enjoy. He posted about his “doctor’s trick” of prescribing Z-Paks to patients who don’t really need an antibiotic, just because it “makes the patient feel like the doctor is doing something for the patient who paid the co-pay and waited 2 hours in the office.”
The problem with Zithromax…is that it spends very little time in the blood stream, going directly inside the cells of the body and spending a very long time there, often away from the infection itself. This is OK for certain types of infections, but…it’s a fairly weak drug for middle-ear infections or sinusitis…These, of course, are the main things for which the drug is prescribed. [My emphasis]
So, in all likelihood, that pediatrician prescribed the Z-Pak knowing that my son didn’t have a bacterial infection, and that the drug would do little for him even if he did.
This new information really irritated me. Not only did I feel “managed” by the pediatrician, but she reinforced for my son the belief that all infections must be treated with antibiotics, and all visits to the doctor’s office must result in a prescription.
We should depend on doctors to educate us and do what is in our best interests, even if that means not giving us what we think we need.
I, for one, do not like being “tricked.”