With nobody immune in this time of economic uncertainty, people are demanding medication rather than go off sick, writes ANN MARIE HOURIHANE
EVER WONDERED why we are swallowing so many antibiotics? Me neither. But the implication of European Antibiotics Awareness Day, which took place last Friday, was pretty clear: we, the general public, demand antibiotics out of pure ignorance. We are such a collection of silly billies, we just don’t realise that antibiotics are not a cure for everything short of radiation poisoning.
This in many ways admirable initiative to reduce the unnecessary prescribing of antibiotics started in the European Centre for Disease Control – or ECDC to us heavy metal fans. Its modest advertising budget in Ireland amounted to €73,000, excluding VAT. This sum was provided by the HSE public education programme.
A paragraph from the statement outlining European policy and research history on antibiotic misuse reads: “Studies have shown that prescriber (mainly GP) education alone does not produce a sustained reduction in inappropriate antibiotic use: patient and public education is needed as well.”
Which can be roughly translated as: “Back off, you plonkers. You have your poor doctors terrorised with your mad demands for antibiotics. And, because in many cases the doctor-patient relationship is now more commercial than anything else, those poor medics are forced to hand out antibiotics like smarties in order to keep you savages on side, and paying up.”
So much for doctors’ orders.
Of course the public is unrestrained and illogical – hello, that’s our job – but those little vulnerabilities may not be the only reason that we’re necking the Augmentin. Take the employment market, for example.
“People are under pressure to get back to work, especially now,” said a general practitioner contacted by The Irish Times. “They don’t want to take time off work at all. Last winter they were coming in and saying ‘I can’t take time off. I have to get better’.”
This doctor said that all that stuff about doctors feeling under pressure from their patients was absolutely true. “I personally feel under pressure with people asking for antibiotics, particularly for children. When kids are sick the creches won’t take them. The parents have to take time off work to look after them. And now they are afraid to do that.”
The doctor was faced with working mothers pleading for antibiotics which were in all likelihood unnecessary, because the working mother, and possibly her husband, had already taken too much time off work to look after kids who were sick. “Of course,” said the doctor, “creches are where kids pick up everything”.
Antibiotics it is then, for the children of working parents. It could be said that nowadays working parents are the economic equivalent of the worried well. They’re just waiting for the other shoe to drop, for disaster to strike. They can’t afford to tempt fate even the tiniest bit.
The healthier wait-and-see option is also out of bounds because it often necessitates two visits to your doctor. “It’s easier to send medical card holders away and tell them to come back in a week,” the doctor said. “If somebody pays you it does change the relationship.”
The doctor worked for years as a general practitioner in the United Kingdom. There, all GP visits were free. When a GP told someone that you weren’t going to give them antibiotics, and would like to see them after an interval of a couple of days “they accepted it more readily”.
Maybe our consumption of antibiotics will fall when all GP visits are free. Maybe it will fall when the economy bottoms out completely, or recovers – whichever is more likely. Then people in general and working parents in particular might worry less – although parents aren’t the best at ceasing to worry.
Public education schemes are a very good thing; if anything we are pretty short of them in this country. Those car crash advertisements are about the closest we come to having a consistent public information campaign. Those and the ads that explain how someone almost killed their relatives by failing to cook meat correctly.
So let’s have public education schemes about the misuse of antibiotics, because we, the general public, are just about prepared to admit that we’re not completely sensible about the long-term results of misusing them. But someone should admit that doctors are not all that sensible either. That they are succumbing to emotional blackmail to prescribe against their professional opinion, which is hardly scientific of them.
And then there’s antibiotic use in hospitals – the education campaign on that issue
must be a secret one.
Most of all, someone should start tabulating the unforeseen medical results of having a health system where large numbers of people have to pay to get the most basic care. Let’s do that now, before the Minister of Health leads us to the nirvana where GP visits in Ireland are free.
There was once a case for saying that Solpadeine – an excellent hangover cure – was what kept the Irish economy functioning. Solpadeine, which contains codeine, has now vanished behind the chemist counter, and you have to be interrogated by a pharmacist before being granted access to it. It would be interesting to look at the role the antibiotic now performs in keeping what is left of our economy together.