Why do physicians think parents expect antibiotics? What parents report vs what physicians believe

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Original Research

Why do physicians think parents expect antibiotics? What parents report vs what physicians believe

J Fam Pract. 2003 February;52(2):140-148

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References

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Conclusions

Two parental communication behaviors in particular resulted in physicians feeling pressured to prescribe antibiotics: the use of candidate diagnoses and resistance to viral diagnoses were more strongly associated with physicians’ perceptions of parents’ expectations than with parents’ reports of their expectations. This finding indicates an incongruity between physicians’ perceptions of parents’ expectations and parents’ reports of their expectations. Future research needs to determine when physicians are accurate in perceiving antibiotic pressure, and when they should perceive other parental concerns for which reassurance would be the most desirable responsive action. Although antibiotics clearly are relevant in these pediatric encounters, physicians may be overly sensitive and thus too quick to understand certain communication behaviors as in search of antibiotics. Not only do such perceptions lead to inappropriate prescribing, but they also potentially contribute to dissatisfaction because parents who are in search of reassurance are not necessarily appeased by medication.^3,13,16,25

Further, parents who were in search of reassurance but who receive neither medication nor reassurance may be still less satisfied. This study has provided an initial step toward linking communication behaviors with survey reports of parents’ expectations and physicians’ perceptions. Future research is needed to translate these findings into communication-based interventions to decrease inappropriate prescribing. Physicians who recognize parental communication behaviors as communicating pressure for antibiotic treatment may be able to directly communicate with parents about their expectations and thus more directly assess and address parents’ expectations or desires. Future interventions should consider alternative communication practices physicians can use as resources for addressing perceived parental pressure.¹⁶

Acknowledgments

Thanks to Jeff Robinson for helpful comments on an earlier version of this manuscript.

Corresponding author
Tanya Stivers, PhD, Department of Pediatrics, University of California, Los Angeles, 12-358 Marion Davies Children's Center, 10833 LeConte Avenue, Los Angeles, CA 90095-1752. tstivers@ucla.edu