Science, Art, Litt, Science based Art & Science Communication

An informed patient is the most cooperative one!

People of science are complaining that misuse of antibiotics is causing drug resistance.

And I want to ask them the question who is responsible for this mess?

Okay, medicines are very costly. Especially for the poor and the people in the third world countries. The patient thinks, ''Why should I use a full dose when half a dose is making me feel better? I can save some money by using only half of the dose the doctor prescribed." S/he doesn't know that the dose s/he chooses can make the bacteria antibiotic resistant.

This has been reported in various studies too:

Making people pay for medicines out of their own pockets encourages the spread of drug-resistant microbes in developing countries, research suggests (1).
Steep medical bills may force patients to shorten expensive antibiotic treatments or switch to poor-quality drugs often found in private pharmacies.

Big bills push patients to shorten expensive drug treatments. This can lead to microbes becoming resistant. The more that patients pay, the more resistance rises.

Shortening drug treatment or using antimicrobial drugs unnecessarily, for instance to fight a viral infection, can lead to microbes becoming resistant to the medicines that are meant to destroy them, turning common bacteria such as E. coli into killers.

According to WHO reports that observed the prevalence of drug resistance for nine pathogens across 47 countries, including 23 in Africa, various social and environmental factors might play a role in increasing resistance. These included poverty levels, sanitation facilities, the number of hospital beds and patients’ out-of-pocket medical expenses.

The results suggest high prices may fail to discourage patients from taking unnecessary antibiotics. Instead, many people look for cheaper or easier ways to buy them. They often find these in private facilities that may over-prescribe medicines and where they may also be of poorer quality.

Only when people can afford to buy a full course of antibiotics, and not reduce their doses to keep costs low, will resistance be kept in check.

Farmers use antibiotics to save their cattle from deadly diseases. Some also use them in small quantities as growth hormones to increase the weight of animals and production of eggs! These antibiotics are getting into the food chains of human beings through, milk, egg and meat consumption. And these low doses in human populations are making the bacteria resistant to antibiotics. Do the farmers know the consequences of their actions? No!

Instead of complaining why can't we 'educate' them to make them cooperate with us in the fight with the micro-organisms?

I would like to mention two incidences of my experiences with two doctors to make my point clear.

My mother suffers from various health conditions. Diabetes is one of them.

Recently I took her to one doctor, an endocrinologist. There was a big queue of about 100 patients outside her room. After a long wait in the Q, when we finally got our chance to meet the doctor, she just saw the case sheet, asked what medicines we were using and wrote on the sheet, 'stop, stop, stop' beside the medicines we were using and wrote the names of similar medicines manufactured by another company and 'ordered', "Stop using these and start using the ones I prescribed now. After one week, get the blood of your mother tested and come with the results to me. Also bring the cover of the injection bottle I want to see whether you really used it or not . Next (patient please) " and dismissed us with the wave of her hand. I was shocked. I tried to talk to her, but she said, she had more patients to deal with and we could talk later. And I paid a huge sum for all this!

I came home, threw her prescription into a draw and never looked it again! Why would I? The doctor didn't allow me to ask questions, didn't tell me why she was changing the brand all of a sudden, didn't give us enough time to understand things. She just 'ordered' us to do things.

I know the drug companies are giving 'incentives' to the doctors to prescribe their medicines. I think that is why doctors change the medicines to the ones that benefit them - not necessarily the patient - when ever we visit a new one. I also felt the doctor was trying to experiment with my mother, trying to see how the new medicine she prescribed works with older patients. That was why she asked me to bring the wrapper of the medicine to be sure. Would I allow my mother to be made a Guinea pig? Never!

Then we went to another doctor. This time the doctor had less number of patients. He was very patient, took a lot of time to listen to us, allowed questions, explained things in detail to us. I was impressed. Although this doctor too changed the brand of insulin my mother used, I cooperated with him more willingly.

That is the difference between a well informed patient and an ignorant patient. An 'educated patient' will cooperate with you and help you solve the problem. An ignorant person causes more problems.

What people generally look for is a counsellor, a doctor who is able to make wise recommendations based on understanding a patient and his/her priorities.

Now the choice is yours, people of science. Do you want ignorance or education to rule the world around you? Do you want solutions to your problems or more problems? If you want solutions, educate people and communicate effectively!

Watch a wonderful video on doctor - patient relationship