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Prescribing under Pressure - Parent-Physician Conversations and Antibiotics (Paperback)
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Prescribing under Pressure - Parent-Physician Conversations and Antibiotics (Paperback)
Series: Oxford Studies in Sociolinguistics
Expected to ship within 10 - 15 working days
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Antibiotics will soon no longer be able to cure common illnesses
such as strep throat, sinusitis and middle ear infections as they
have done for the last 60 years. Antibiotic-resistant bacteria are
increasing at a much faster rate than new antibiotics to treat them
are being developed. The prescription of antibiotics for viral
illnesses is a key cause of increasing bacterial resistance.
Despite this fact, many children continue to receive antibiotics
unnecessarily for the treatment of viral upper respiratory tract
infections. Why do American physicians continue to prescribe
inappropriately given the high social stakes of this action? The
answer appears to lie in the fundamentally social nature of medical
practice: physicians do not prescribe as the result of a clinical
algorithm but prescribe in the context of a conversation with a
parent and a child. Thus, physicians have a classic social dilemma
which pits individual parents and children against a greater social
good.
This book examines parent-physician conversations in detail,
showing how parents put pressure on doctors in largely covert ways,
for instance in specific communication practices for explaining why
they have brought their child to the doctor or answering a
history-taking question. This book also shows how physicians yield
to this seemingly subtle pressure evidencing that apparently small
differences in wording have important consequences for diagnosis
and treatment recommendations. Following parents use of these
interactional practices, physicians are more likely to make
concessions, alter their diagnosis or alter their treatment
recommendation. This book also shows how small changes in the way
physicians present their findings and recommendations can decrease
parent pressure for antibiotics. This book carefully documents the
important and observable link between micro social interaction and
macro public health domains.
General
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