JulieLeung.com: a life told in tidepools

Finished up Elisabeth’s chalky white Augmentin this morning but still have a few more days of Abigail’s pink Cephalexin to go. I dropped the bottle of antibiotic into the trash and sat down briefly at my desk in the kitchen for a few minutes to peek at blogs, as I do sometimes during meals when the kids are still enjoying their food for a while…

There, on my friend Enoch’s blog I discovered Appropriate antibiotic prescribing, a response to
No antibiotics for ear infections, written by another doctor, Jacob, who wrote a comment on Enoch’s too More on otitis

Reading about these physicians who try to avoid prescribing antibiotics both encouraged me and helped me feel frustrated. I had not heard that only 20% of ear infections require antibiotics; I enjoyed seeing the study Jacob linked. I like how both Jacob and Enoch manage their patients, as they describe, even though their caution has a cost, as Tania and Enoch each blogged last week, talking about their daughters illness. I’m glad that drugs are not necessary much of the time, and that some doctors out there are being careful and interacting more with their patients, following up, rather than just sending them home with prescriptions, to be done with them.

But I got frustrated about my own situation, wondering why it is that my girls had to have antibiotics recently. In both cases I would have been happy to wait. Elisabeth’s ear infection was only discovered during a routine well child check-up with Dr. “N”. She had been acting fussy for a while, but maybe it would have resolved itself, had I waited longer. And I was willing to wait for Abigail’s salivary gland swelling that happened last Saturday. I even subjected her to bloodwork, hoping to get Dr. “G” to write us a reprieve from antibiotics. As I’ve blogged before, I am not a mom who comes in asking for drugs for her daughters.

Maybe it is a difference in personality between me and my doctors. Maybe I need to learn to fight more or become more aggressive. I do try to ask questions, and inquire what my options are. I really don’t want to resist, and I’m sensitive to the attitude of disapproval I feel I receive when I go against the doctor’s preference. I want to trust my doctor and do what he or she recommends. That’s the kind of person I am, I suppose, and the kind of relationship I want to have. Not one where I’m constantly questioning or arguing. I don’t think that would be a good fit for either me or my physician.

Perhaps too it comes down to protocol. Maybe the clinic has a protocol for all the physicians to follow. Maybe Dr. “N”, and Dr. “G”, neither of whom have a lot of experience or tenure at the clinic, were bound by the book to give me a prescription. Perhaps they are unaware of these new studies or ways to manage pediatric infections? Enoch mentions that prescription rates are published among providers – I wonder if that is also done here and I’d be curious if I could see that information for the doctors I know at our island clinic!

Or maybe it comes down to the pocketbook. What costs more? It costs both the doctors and our family more if we keep coming back, as Enoch and Jacob described, rather than going home with drugs. We have a high deductible so we end up paying for quite a few sick visits out of our own pockets. At $100 or more an office visit, I really don’t want to bring my kids to the doctor. January’s bills are gonna hit us hard! It is cheaper to go buy a bottle of antibiotic, rather than spend more time and money continuing to go to the clinic. I’d rather though been given the choice to pay the price than simply assigned a medication.

Ah well, as I said, after my blog reading today, I’m feeling both happy and unhappy at the moment about my dilemma with my daughters and their drugs. We’ve got three more days to finish the pink stuff for Abigail’s face, which began to look fine after 48 hours or so. And I have a follow up appointment for Elisabeth’s ears on Monday morning…maybe I’ll think about asking Dr. N. more about his prescription policy….