General Discussion

Aristus

(71,708 posts)

220. Yes. I didn't acknowledge that.

Mon Dec 9, 2013, 10:56 PM

Dec 2013

If I acknowledge everything an antibiotic-obsessed patient (or participant in this thread, for that matter) parses out of one of my replies, we'll be here all night.

If I diagnose a patient with viral pneumonia, I treat the symptoms. I also get a chest x-ray to confirm or rule out pneumonia.

And I plan close follow-up with the patients to monitor for worsening symptoms or for secondary infection. If those present, I treat appropriately. (It's worth pointing out that follow-up often requires a return visit to the clinic, which some in this thread have characterized as a greedy grab for more money. You can't win with some people.)

The point we advocates for sensible antimicrobial prescribing are trying to make in this thread is that we treat appropriately, using evidence-based medicine, and standard of care. If antibiotics are indicated by history of present illness, review of systems, physical exam, and lab testing, we prescribe them.

But the detractors have turned this into: "My provider hates me and is a bad provider because he doesn't give me whatever I want, whenever I want it."

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The doctor's office just told me that they were not allowed to call in [View all] Maraya1969 Dec 2013 OP

Are you a doctor? cleanhippie Dec 2013 #1

He is not going to do any tests either. He is going to look into my throat Maraya1969 Dec 2013 #3

And he is likely to tell you that you have a viral infection. cleanhippie Dec 2013 #7

I've only had this about 55 times in my life. Yea I don't know the Maraya1969 Dec 2013 #9

So you are a doctor, or just have special powers of diagnosis not requiring medical training? cleanhippie Dec 2013 #11

So I just got back and I have an infection - not a virus as you Maraya1969 Dec 2013 #47

2 hrs Niceguy1 Dec 2013 #86

Okay: a virus IS an infection, just not a bacterial infection. Aristus Dec 2013 #126

What test did the doctor perform to determine that it was a bacterial infection? FarCenter Dec 2013 #132

So you took my advice and got a proper medical diagnosis? cleanhippie Dec 2013 #151

Problem solved, then. You went to the doctor, who prescribed for you. MineralMan Dec 2013 #153

yes, it's a monopolistic franchise grasswire Dec 2013 #160

lol cleanhippie Dec 2013 #197

Maybe it's that pipi_k Dec 2013 #15

MY lung doctor knows that it can be deadly not to prescribe an antibiotic Maraya1969 Dec 2013 #53

If he's doing it pipi_k Dec 2013 #188

I totally understand marsis Dec 2013 #22

I know. It is really pissing me off. Like a diabetic learns his body Maraya1969 Dec 2013 #48

...after examining you in person. brooklynite Dec 2013 #60

I totally get it, too. And I am a doctor (veterinarian). I am very prone to complications of kestrel91316 Dec 2013 #76

laryngitis and bronchitis can also be (and most often are) viral Ms. Toad Dec 2013 #124

They do start out as viral, but then develop secondary bacterial kestrel91316 Dec 2013 #251

You can have lung and sinus infections that are viral. it doesn't matter how many times you've had Aristus Dec 2013 #24

You won't get dark green phlegm with a viral infection. (nt) jeff47 Dec 2013 #40

Happens all the time. Aristus Dec 2013 #49

Yes you do. Ms. Toad Dec 2013 #128

If a person has a cough for weeks on end, pnwmom Dec 2013 #217

The key part of that being - "a doctor should rule out" Ms. Toad Dec 2013 #228

I swear by zinc also, but for once, it didn't work recently. pnwmom Dec 2013 #238

That would be why it didn't work . . . Ms. Toad Dec 2013 #243

Yes, you can. Toward the... 3catwoman3 Dec 2013 #138

Really? What would you prescribe a person who is having asthmatic Maraya1969 Dec 2013 #51

First, a nebulizer treatment, then symptomatic treatment. Aristus Dec 2013 #67

I also said green thick mucus and no fever. Is that not evidense of Maraya1969 Dec 2013 #96

Yeah, I always like to exam my patients.Obviously, I can't do that in this case. Aristus Dec 2013 #108

Did you not hear? I posted that I am now back from the doctor's and Maraya1969 Dec 2013 #112

Boo! Aristus Dec 2013 #118

Can't stand it when you are wrong? Maraya1969 Dec 2013 #123

Yes. I can't stand it when I'm wrong. Aristus Dec 2013 #141

On night duty in the ED for a few nights elias7 Dec 2013 #165

Right there with you. Aristus Dec 2013 #172

Thank you for weighing in on this Ruby the Liberal Dec 2013 #203

I hate to be a downer but come watch us brand this spring Drahthaardogs Dec 2013 #205

I'm aware of the role that feeding massive amounts of antibiotics to livestock Aristus Dec 2013 #207

Okay Doc Drahthaardogs Dec 2013 #241

Wow! Really? Are you sure you want to make an argument that's that stupid? Aristus Dec 2013 #249

So you are telling me, that the gut flora will become resistant Drahthaardogs Dec 2013 #259

I can see this is going nowhere. You obviously didn't read what I wrote. Aristus Dec 2013 #260

Of course they don't work on viruses. My point is, Drahthaardogs Dec 2013 #261

Are you talking about feeding antibiotics to livestock? pnwmom Dec 2013 #223

How will you feel the first time one of your patients -- pnwmom Dec 2013 #221

Wow. Now you have me killing people, huh? Aristus Dec 2013 #224

Some hospital and doctor mistakes do kill people. pnwmom Dec 2013 #226

He needed intubation, not antibiotics. Barack_America Dec 2013 #234

The doctors who testified said he should have been put on I.V. antibiotics. pnwmom Dec 2013 #236

Antibiotics don't treat respiratory failure. Barack_America Dec 2013 #244

He wasn't in respiratory failure when he entered the hospital. pnwmom Dec 2013 #256

Um, no. Pneumonia is diagnosed by chest X-ray, not sputum culture. Barack_America Dec 2013 #233

Often doctors will wait to prescribe any antibiotic pnwmom Dec 2013 #237

And what evidence are you looking for? Cultures that take days pnwmom Dec 2013 #218

You're not acknowledging that viral pneumonia can be complicated pnwmom Dec 2013 #213

Yes. I didn't acknowledge that. Aristus Dec 2013 #220

If you really wanted to advocate for all of us, pnwmom Dec 2013 #222

There are plenty of people advocating for that already. Aristus Dec 2013 #225

"Please don't waste my time with this." pnwmom Dec 2013 #227

Wasting bandwidth, then. Aristus Dec 2013 #232

There are good doctors, and there are M.Deities. pnwmom Dec 2013 #240

Nobody denies that there are some bad practitioners out there. Aristus Dec 2013 #245

If your "lung Doctor" will call it in, why not call him/her? karynnj Dec 2013 #33

My PULMONOLOGIST is away and he will not prescribe unless he is in Maraya1969 Dec 2013 #56

I am trying to understand the complaint BlueStreak Dec 2013 #81

MY PULMONOLOGIST HAS BEEN PRESCRIBING FOR ME FOR YEARS! Maraya1969 Dec 2013 #85

If he has been doing this for years and you keep requiring antibiotics BlueStreak Dec 2013 #91

the pulmonologist might feel more comfortable doing it treestar Dec 2013 #182

Okay, so you normally see another doctor for this sort of thing Yo_Mama Dec 2013 #180

I agree with you Samantha Dec 2013 #58

Because bacterial infections result from a specific exposure to a specific bacteria. Ms. Toad Dec 2013 #133

Do you really not understand that infections Ms. Toad Dec 2013 #121

you've had something that required antibiotics 55 times? CreekDog Dec 2013 #209

Call the lung guy. GeorgeGist Dec 2013 #235

How can you say that? Asthmatics often get viral infections pnwmom Dec 2013 #212

actually if she has green mucus she most likely has a bacterial infection azurnoir Dec 2013 #230

So you too, are a doctor? cleanhippie Dec 2013 #252

I think you should look down thread :) azurnoir Dec 2013 #257

if you are so unstable that the walk from the car to Niceguy1 Dec 2013 #130

One thing about over-prescribing Orrex Dec 2013 #6

Another huge problem pipi_k Dec 2013 #18

That's a great observation Orrex Dec 2013 #25

Same here, and... pipi_k Dec 2013 #190

Just to play the devils advocate marsis Dec 2013 #92

Personal body awarness means bupkus in terms of distinguishing bacterial infections Ms. Toad Dec 2013 #136

bupkus well that is a stretch, marsis Dec 2013 #155

Unfortunately, with respect to the distinction between viral and bacterial respiratory infections Ms. Toad Dec 2013 #174

So glad you have a handle marsis Dec 2013 #255

I suspect doing the test once or twice Ms. Toad Dec 2013 #258

Maybe. pipi_k Dec 2013 #191

Feeding antibiotics to cattle is what is causing epidemic of antibiotic-resistant bacteria. Jesus Malverde Dec 2013 #36

Lying is not the right thing. Mariana Dec 2013 #117

Are you an asthmatic? How many times have you yourself had pneumonia? pnwmom Dec 2013 #211

Jesus fucking Christ. Who knew that advising one to get proper medical attention would be so bad! cleanhippie Dec 2013 #253

You aren't allowed to prescribe your own drugs sharp_stick Dec 2013 #2

That is not true. Th1onein Dec 2013 #164

Why don't you also order 500 Vicodin, since you're self-prescribing anyway? Orrex Dec 2013 #4

Oh Gawd. Maraya1969 Dec 2013 #5

I hear you NV Whino Dec 2013 #10

You forgot the part where you PAY THEM before you even get into Maraya1969 Dec 2013 #59

Viral infections vanish on their own - Ms. Toad Dec 2013 #137

Well, a cold is a viral infection, not bacterial nadinbrzezinski Dec 2013 #163

Slap yourself all you want. You still can't self-prescribe. Orrex Dec 2013 #14

any life-threating condition sweetapogee Dec 2013 #34

It is not self prescribing. It is speaking with the doctor over the phone Maraya1969 Dec 2013 #61

Well, get a new doctor, since you obviously know more than this one. Orrex Dec 2013 #75

IT'S NOT FUCKING CONVENIENCE!! DO YOU KNOW WHEN A PERSON Maraya1969 Dec 2013 #82

THEN GO TO THE FUCKING HOSPITAL BEFORE YOU PASS OUT!! Orrex Dec 2013 #99

I feel your pain, I have ashtma nadinbrzezinski Dec 2013 #166

I had pneumonia in theearly 1980's. right lung only. pangaia Dec 2013 #8

I know you're not serious, Ranchemp. Dec 2013 #19

party pooper. dionysus Dec 2013 #28

Sorry about that, Ranchemp. Dec 2013 #29

i once had a coworker innocently offer "i can mail you some of mine, right?" dionysus Dec 2013 #31

Yep. Ranchemp. Dec 2013 #41

the poor lady didn't even know they were controlled... i had to explain the concept. dionysus Dec 2013 #42

post flagged by the DEA.. Jesus Malverde Dec 2013 #37

Post flagged by the NSA Ranchemp. Dec 2013 #50

I'm guessing surveillance at DU is mostly done by the FBI. Jesus Malverde Dec 2013 #63

I would say, with some experience, Ranchemp. Dec 2013 #71

Is that the marshalls service?... Jesus Malverde Dec 2013 #83

Correct, Ranchemp. Dec 2013 #93

So does the media... every amber alert and I am trolling nadinbrzezinski Dec 2013 #170

Good luck catching me for those BlockBuster Video late fees, copper! Orrex Dec 2013 #107

Ahhh, but you just don't know, but you've just been moved Ranchemp. Dec 2013 #113

Doh! That puts me above those mattress tag scofflaws! Orrex Dec 2013 #114

It's hard time for you I tell ya, Ranchemp. Dec 2013 #116

The name is Agent Mike Hunt. He's all over DU!! madinmaryland Dec 2013 #189

Yeah it was a joke OwnedByCats Dec 2013 #178

If the DEA wants them they are welcome to them pangaia Dec 2013 #206

lol, it makes as much sense. loli phabay Dec 2013 #62

Reminds me of the Vet on Saturday wercal Dec 2013 #12

Same thing for my vet... pipi_k Dec 2013 #21

CoQ10 would probably help her a lot. Maraya1969 Dec 2013 #66

Upon checking pipi_k Dec 2013 #246

I had an adopted dog Rusty, an old Beagle dog who had a lot of problems Maraya1969 Dec 2013 #262

dogs and cats get a lot of the same antibiotics that people do magical thyme Dec 2013 #30

Well then you'll need a vet to prescribe it sharp_stick Dec 2013 #44

that is the point of my post. it is why vets will not prescribe without actually seeing your pet. nt magical thyme Dec 2013 #248

And it hasn't occured to any of you that it might have a bit to do with Maraya1969 Dec 2013 #64

From the CDC website: wercal Dec 2013 #79

Speaking of risk BlueStreak Dec 2013 #88

Its a huge risk wercal Dec 2013 #95

The doc would lose 100% of those cases BlueStreak Dec 2013 #104

Money. Good point. Aristus Dec 2013 #147

Yes. And I do realize the similarity between me and a kitchen. Maraya1969 Dec 2013 #148

Was the allergory too complex for you? Sorry. Aristus Dec 2013 #150

Please remember, Change has come Dec 2013 #219

As it has been pointed out to you, it has to do with reducing the abuse of anitbiotics nadinbrzezinski Dec 2013 #168

How is that extreme?? We are required to maintain a valid doctor-client-patient relationship, kestrel91316 Dec 2013 #89

I really don't think its extreme wercal Dec 2013 #101

If they aren't comfortable with that, you will just have to go in. HappyMe Dec 2013 #13

He is allowed to call in a prescription. He just doesn't want to mainer Dec 2013 #16

Lying about the reason was wrong. Mariana Dec 2013 #149

Agree. I think the lying sucks mainer Dec 2013 #154

I don't think her doctor would mind elias7 Dec 2013 #167

That may be true. Mariana Dec 2013 #186

Preppers and doomsters buy antibiotics from aquarium supply stores. FarCenter Dec 2013 #17

Whaaaat?! HappyMe Dec 2013 #20

Just google "how to buy antibiotics without a prescription" FarCenter Dec 2013 #23

I wouldn't be comfortable with dosing myself HappyMe Dec 2013 #32

They are the exact same antibiotics for which a doctor RebelOne Dec 2013 #90

How the hell do you know how many to take? HappyMe Dec 2013 #97

milligrams are milligrams grasswire Dec 2013 #111

True. 840high Dec 2013 #27

I buy my antibiotics from pet supply websites RebelOne Dec 2013 #84

Not just preppers and doomsters...people who don't have insurance do the same. ScreamingMeemie Dec 2013 #229

antibiotics are different than other drugs alc Dec 2013 #26

Antibiotics screw up the digestive tract FarCenter Dec 2013 #39

I know - I also take probiotics. Maraya1969 Dec 2013 #68

We *so* need to talk!!! IdaBriggs Dec 2013 #98

I'm not an expert in the field -- just a casual observer of the science scene FarCenter Dec 2013 #120

One thing that was recommended forever by my pediatrician nadinbrzezinski Dec 2013 #171

if you come in they can get a swab for culturing magical thyme Dec 2013 #35

yes and if they did that years ago, while waiting for the damn culture Maraya1969 Dec 2013 #72

no. when they see you they can give you a broad spectrum antibiotic. magical thyme Dec 2013 #250

My husband has to take antibiotics every time he goes to the dentist HockeyMom Dec 2013 #38

Thank you. All these "doctors" are pissing me off. For some people Maraya1969 Dec 2013 #74

that's why you should see your doctor Niceguy1 Dec 2013 #106

Why a doctor needs to make sure it is due to a BACTERIA and not a VIRUS nadinbrzezinski Dec 2013 #193

Your husband has as specific predisposition to bacterial infections Ms. Toad Dec 2013 #139

I agree and that was my point HockeyMom Dec 2013 #177

. Ms. Toad Dec 2013 #199

Those OTCs containing pseudoephedrine... 3catwoman3 Dec 2013 #173

Last time I bought that decongestant in NY (3 months ago) OwnedByCats Dec 2013 #183

It's about drug resistance, and also, frazzled Dec 2013 #43

That is exactly what my daughters pediatrician said 30 years ago HockeyMom Dec 2013 #57

It is actually the bacteria that builds up the immunity - Ms. Toad Dec 2013 #140

Yes! Your daughter's pediatrician knew his stuff, and so do you. Avalux Dec 2013 #143

It's all about money with my doctor too. My old doctor B Calm Dec 2013 #45

It doesn't have anything to do with money. HappyMe Dec 2013 #46

Whatever. . If I don't feel right I make an appointment. He B Calm Dec 2013 #54

They can just call into the laboratory that draws the blood. Maraya1969 Dec 2013 #77

Well, you have to go to the doctor's office HappyMe Dec 2013 #80

I don't know one doctor that draws blood anymore. They all make you Maraya1969 Dec 2013 #87

You don't know ALL doctors. HappyMe Dec 2013 #94

Same with my doc. I think this is more common than ever. BlueStreak Dec 2013 #100

My husband did have 2 vials taken. HappyMe Dec 2013 #105

It's bullshit. Baitball Blogger Dec 2013 #52

Thank you. Maraya1969 Dec 2013 #78

That's my bet too. backscatter712 Dec 2013 #102

What a crappy doctor wanting to SEE their patients and not randomly prescribe medicine tammywammy Dec 2013 #55

The nerve of him/her! HappyMe Dec 2013 #70

boo hoo! grasswire Dec 2013 #115

Okay, just let everyone diagnose themselves HappyMe Dec 2013 #119

why not? grasswire Dec 2013 #125

LOL! HappyMe Dec 2013 #127

why don't you trust fellow citizens to think for themselves? grasswire Dec 2013 #131

As I said before, HappyMe Dec 2013 #134

no one is seeking to limit your health choices grasswire Dec 2013 #159

Ah, yes. The "Experts? I don't need no stinkin' experts" Libertarian mantra. Orrex Dec 2013 #135

preposterous? grasswire Dec 2013 #158

Yes, preposterous. Orrex Dec 2013 #162

If people make choices pipi_k Dec 2013 #187

your prediction is not supported by evidence. grasswire Dec 2013 #204

I think people pipi_k Dec 2013 #192

So, can we call it a day? brooklynite Dec 2013 #65

In Florida the only medicine I think it NOT allowed called in 1awake Dec 2013 #69

I am a libertarian regarding the rx exclusive franchise MDs/government have created. grasswire Dec 2013 #73

And when antibiotic resistant bacteria start exploding in proliferation worse than now... Humanist_Activist Dec 2013 #103

as someone else said above grasswire Dec 2013 #109

28 European countries require no rx for antibiotics grasswire Dec 2013 #122

Europeans DO have a problem! Here are some links!... yawnmaster Dec 2013 #196

Here are the 28 countries listed... yawnmaster Dec 2013 #200

.. abelenkpe Dec 2013 #110

I'm sorry but you can't do this with antibiotics. Avalux Dec 2013 #146

28 European countries allow antibiotics with no Rx. grasswire Dec 2013 #156

Please read this European report on the subject. The vast majority obtain prescription... yawnmaster Dec 2013 #201

Quit using Europe as justification for unregulated antibiotic use. Avalux Dec 2013 #247

In Europe they STILL write scripts for things like Antibiotics, but I am proof positive you nadinbrzezinski Dec 2013 #169

you didn't read what I wrote grasswire Dec 2013 #176

I fear the WHO is also in the fear mongering business too nadinbrzezinski Dec 2013 #185

Europeans are quite concerned about overuse of antibiotics Yo_Mama Dec 2013 #181

Not sure if it is a federal law, but most doctors in the country want to see you before prescribing lostincalifornia Dec 2013 #129

I know you're upset, but there's a good reason for not giving it to you on your word. Avalux Dec 2013 #142

Message auto-removed Name removed Dec 2013 #144

A virus is a pathogen. Avalux Dec 2013 #145

I think drug stores are behind this, so they are not held liable SoCalDem Dec 2013 #152

FL law or not - doctors should not prescribe antibiotics without seeing patients. yellowcanine Dec 2013 #157

You got that right. Aristus Dec 2013 #161

Society is harmed greatly by improper use of antibiotics. With antibiotics, in particular,... yawnmaster Dec 2013 #175

the dangerous overuse of antibiotics.... grasswire Dec 2013 #179

absolutely wrong. A resistant form appearing in a human directly affects humans... yawnmaster Dec 2013 #184

The problem is like 90% agriculture, if not more. Warren DeMontague Dec 2013 #194

Not seeing that in the literature... yawnmaster Dec 2013 #198

Im not saying prescribing to humans shouldn't be judicious, still Warren DeMontague Dec 2013 #202

Don't get me wrong, I agree that prophylactic ag use is definitely a problem... yawnmaster Dec 2013 #239

Just my opinion energumen Dec 2013 #195

Post removed Post removed Dec 2013 #208

Er... LadyHawkAZ Dec 2013 #210

I just served on a jury for this one Aerows Dec 2013 #214

I was the one who alerted. LadyHawkAZ Dec 2013 #215

Results: Aerows Dec 2013 #216

Antibiotics won't treat your asthma exacerbation, steroids and albuterol will. Barack_America Dec 2013 #231

Have you been to see them in the last 6 months? kdmorris Dec 2013 #242

Why we need to relax the idiotic pharmacy laws in the US JCMach1 Dec 2013 #254