van der Horst Henriëtte E, Berger Marjolein Y
VU medisch centrum, afd. Huisartsgeneeskunde, Amsterdam, the Netherlands.
Ned Tijdschr Geneeskd. 2012;156(10):A4390.
Doctors often feel pressured by patients to prescribe antibiotics for a common cold or a sore throat, against their better judgment. Yet do patients really put pressure on their doctor or even expect a prescription for an antibiotic or some other medicine? Several interesting studies shed some light on this issue. Doctors in an emergency department, for example, prescribed an antibiotic much more frequently than their patients expected them to. Only in 25% of cases were the doctors correct in their assumptions about patient expectations. In a Norwegian study, the authors found that parents wanted more time and explanation for their coughing children and fewer prescriptions. So instead of assuming that patients want antibiotics for innocent symptoms, we should put more effort into exploring patients' expectations and providing them with relevant information. That way we can step out of the folie a deux.
医生常常违背自己的专业判断，在患者的压力下为普通感冒或喉咙痛开抗生素。然而，患者真的会给医生施压，甚至期望得到抗生素或其他药物的处方吗？几项有趣的研究为这个问题提供了一些线索。例如，急诊科的医生开抗生素的频率比患者预期的要高得多。医生对患者期望的假设只有25%是正确的。在挪威的一项研究中，作者发现，家长希望给咳嗽的孩子更多时间和解释，少开些处方。所以，我们不应假定患者因一些无害症状就想要抗生素，而应更加努力地去探究患者的期望，并为他们提供相关信息。这样我们才能摆脱这种医患双方的心理异常状态。
