Why Your Doctor Won't Prescibe Antibiotics

Why are some doctors so stingy with antibiotics? House Call Doctor reveals the dangers of antibiotic overuse. Plus - the reason why it's so hard to get a prescription for antibiotics over the phone

By Sanaz Majd MD |

Scientific American presents House Call Doctor by Quick & Dirty Tips. Scientific American and Quick & Dirty Tips are both Macmillan companies.

Have you ever wondered why doctors seem so stingy with antibiotic prescriptions?
I mean, here you are suffering from a nasty cold and you simply cannot be sick right now (what with your crazy, busy life). What’s the harm in taking a few anti-bacterial zappers? They couldn’t hurt, right?  Why can’t these stuffy doctors just give in a little?

A new patient recently came to see me in clinic. He decided to switch primary care doctors after his previous doctor (who practices in my group) wouldn’t write a prescription for a second round of antibiotics without seeing him in clinic.

Initially, the patient self-diagnosed with a sinus infection, called his doctor, was given one round of antibiotics that didn’t seem to work.  So he tried to call in for another round but was denied.  He was distraught and angry.

“I can’t come in for every little thing just because he wants to collect my copay and make money off every visit,” he exclaimed.  “So I told him I’m finding a new doctor!"
It's a valid question: Why are some doctors hesitant about prescribing antibiotics, especially without a visit?

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If you've read or listened to my earlier episode Why Is My Doctor Always Late?, you know that there are a lot of misconceptions and problems in the field of primary care. So I can certainly understand his frustration. Let’s reveal the truth behind why doctors don’t like to prescribe antibiotics. (Hint: It's not because they want to charge you an extra copay).

What Are Antibiotics?
Before we discuss why doctors don’t like to prescribe unnecessary antibiotics, we must learn what antibiotics are in the first place.
Antibiotics, along with vaccines, are truly some of the most miraculous discoveries of our time. We can now cure many infectious diseases that previously caused severe complications and deaths. When necessary, antibiotics can be life-saving.

But which infectious diseases exactly do antibiotics target? Antibiotics only help to destroy bacteria specifically. This includes illnesses like bacterial pneumonias, strep throat, bacterial ear infections, pertussis (or whooping cough), some STDs (like chlamydia, gonorrhea, and syphilis), tuberculosis - really nasty bugs.

Viruses, on the other hand, tend to be much more common than any bacteria that I just mentioned (at least here in the U.S.). Viruses affect almost all of us at one point or another. The common cold and flu viruses run rampant particularly during the winter.

Unfortunately, in spite of what you may have heard, antibiotics don’t do a thing for viruses.