http://www.telegraph.co.uk/health/healt ... colds.html

Well I can understand why the patients ask. They want some relief from the symptoms, but the doctors should stop them. I never ask for anti-biotics for viral infections.

It's a shame doctors can't prescribe a placebo for these illnesses for patients who demand to receive treatment/a prescription.
It would be just as effective. Sadly the media would jump on it and it would be hard to justify charging the patient a prescription charge for sugar pills.

The symptoms of coughs and colds can also be caused by other things that do require antibiotics. Someone I know has just had a lung removed because of an abscess that if diagnosed earlier could possibly have been treated with antibiotics alone.

GPs just seem to want to hand out antibiotics or antidepressants nowadays.

I wonder when they'll move on to letter 'B' in the book of 'How we does that thing folk call medsin'.

'Antibiotics and steroids' - bit of a running joke in my house. For years it was all that was prescribed to either my grandmother or the dog.

If the doctors could issue placebos then that would be good, especially if they can charge the full prescription charge for them. Though the press will probably call it a tax on the middle class.

Currently the only thing wrong with me is the leftover snot from a cold at Easter - fcuking stuff would hold a flying plane together and makes me cough continually

Thankfully, mine won’t. There have been times when I have taken a bad cough to the Doctor because I am concerned it could bring on more problems. They always tell me in those cases that it’s viral and they can’t give me anything. I am aware of that. I have got antibiotics from them, but only when it’s been medically necessary.

Yes but these are prescribed by doctors so people are either pressurising their doctor for something or the doctors missed the lectures on super-resistance?

The problems are manifold:

1. Patient stupidity. I'm not afraid of calling the general public idiots. A good proportion are immensely stupid. The problem with this group is that it doesn't matter how much you try to educate them, they still demand antibiotics. Reason? Because they want their cough/cold/flu to go away and think that antibiotics will help. Worse, they've been given antibiotics previously - either for something that required it, or something that didn't require it - and since the symptoms cleared up within 3-4 days (the length of a typical "cold"), they now have it in their minds that antibiotics are the only things that will work.

2. Parental concern. These are parents who want their kids to be healthy. This in itself isn't a bad idea (if not taken to extremes). The problem is apparent when a child has a simple cough/cold/flu and they think the child needs antibiotics. No amount of reassurance or education will filter into the parents' brains. By hook and crook, they will obtain them. I've seen posts on the internet, particularly on news websites where parents think they know when their child needs antiobiotics. This then leads to the next issue.

3. Delayed prescriptions. Because the general public want antibiotics for their viral illnesses, and/or the doctor has failed to impress upon them the uselessness of antibiotics (or worse, just to get the patient out of their room), doctors give "delayed prescriptions". Essentially, you prescribe the antibiotic but you tell the patient to wait 3-4 days for the symptoms to settle, and if they fail, then to "cash in" the prescription and take the antibiotics. This measure is also used in cases where the cause is uncertain.

4. Is it bacterial or viral? Things like ear infections and tonsillitis can have both viral and bacterial causes. The problem is that it's not always clear which it is and sometimes does not become apparent until the illness has markedly progressed. Patients usually present fairly early on and it's at this point where there is still some ambiguity as to the causative pathogen. If it's bacterial and you don't give an antibiotic, the consequences can be severe. In ear infections, there's a risk of permanent loss of hearing.

5. Medico-legal. If you don't know whether something is viral or bacterial in origin, then it's difficult to know whether to prescribe. But let's take the above example of ear infections. As stated, there's a risk of permanent loss of hearing. So how would you feel, as a parent, when your child loses their hearing because the doctor thought the ear infection was viral (more likely) rather than bacterial (less likely)? Probably bad enough to want punishment/revenge, mainly in the form of suing the doctor. Hence why medicine has become defensive. It's better to prescribe an antibiotic than take the risk of not doing so and something going wrong.

6. Risk (or susceptibility). In those who are at greater risk of developing bacterial infections or complications, it's far better to prescribe an antibiotic to cover for that risk. Example: young lad who is asthmatic is more likely to develop a chest infection than someone who isnt''t asthmatic. Hence, if they have symptoms of a cough, you cover for a bacterial infection. This reduces the likelihood of developing a a chest infection and requiring hospital admission.

The worse thing about antibiotics is that often people don't complete the course of antibiotics and then usually flush the stuff down the loo. This increases resistance too.

Probably when the Govt. stops going after targets. If you run a practice, you only get 50% of your pay. The other 50% you have to "earn" by meeting targets.

In the olden days, if you had a 80-year-old lady who had a slightly raised blood pressure, you'd document it but wouldn't act on it. Now, it counts against you. If less that 90%* of people with raised blood pressure are not on medication, you haven't met the target and now you don't get that extra pay. Spread this across things like depression, asthma etc and you can see why things like this happen.

General practices are businesses. To take home some money, you have to maximise your income, which in turn maximises your profit and hence your take home pay. If as a GP, your practice is supposed to get £250k, and because you didn't meet any of the targets, you're gonna get miffed at the £125k. Especially since out of that, you have to pay rent, bills, staff, insurance, products, equipment etc. Then you take home whatever's left.

I got asthma about 2 years ago, after starting my new job. I had never suffered from any symptoms, until I was over 40 and had a new job. I had to take a cortisone spray twice a day and had an emergency spray.

I had to use the emergency spray every time somebody lit a cigarette near me (up to 100M when walking in the street and the person was up wind).

Since changing jobs, the asthma has gone. I stopped taking the cortisone about a week after changing jobs, I was still wheezing a bit, so took it once a day. Then after 2 months, I stopped taking it altogether. My next test at the doctors showed full lung function and I hadn't used any medication for months!

In my case, I never believed I had asthma and was convinced that it was related to my place of work.

I still have some problems if people are smoking heavily in the area or I go into a room where a lot of smoke has built up over time - I played pool with my girlfriend and brother a few weeks back and the staff had left the door to the smoking room open. After 2 games, I had to leave the building.

Yes, targets are an issue throughout the NHS and other bodies such as the Police.

They have a huge detrimental effect on performance, placing greater emphasis on what is seen to be done rather that what is actually done. That just results in the NHS wasting money and skewing the whole ideology of care, likewise in the Police and their ability to do their job.

I can't imagine anyone is actually happy with the target system in the NHS or Police be they patients, GPs or the Police themselves.

Oh maybe criminals and Pharamceutical companies, they probably don't mind...

You left out the truly idiotic people who when given antibiotics for a genuine reason, will hold a few doses back for “the future”. When a cold comes along, they will chug them down, feeling that they are doing the right thing.

Edd here has been taking antibiotics for most of the year. And now that he stopped them , symptoms are back within weeks.
Antibio are bad for you. they can damage stomach lining, give you anaemia, build resistance ... People should realise that we have a finite amout of antibio, and when they are useless we won't have anything to treat people with