Posted by: Emma Page15 NOV 2013
Some people who visit the doctor with a cough or sore throat might have already tried to treat it themselves with over-the-counter remedies and waited around a week for it to clear, before deciding that it is serious enough to warrant a GP visit. Once they do visit a GP, they might request antibiotics.
However, as I found out at the 15th annual self care conference (12 November 2013, London), a cough lasts on average three weeks and antibiotics are unlikely to be able to treat it effectively.
If patients are told this, I learnt, they sometimes use a tactic referred to as “doctor and nurse shopping,” where, upon learning that their doctor is reluctant to prescribe antibiotics, they try to see a prescriber who will.
This emphasises the importance of all healthcare providers delivering a consistent message to patients about self care and avoiding inappropriate antibiotic prescribing. Patients will stop “shopping” elsewhere if they know that they simply do not need the antibiotics, and therefore no healthcare professional will prescribe them. Additionally, if they are aware of how long common symptoms often last and how to treat them, or that a pharmacist can address any concerns they have, they may not return to the accident and emergency department or their GP next time. Beth McCarron-Nash from the Self Care Forum said that encouraging patients to be equal partners in their own healthcare is the only way to save the NHS.
Attendees at the conference continually asserted that encouraging self care is not intended to limit the services that people can access but, instead, to ensure that patients can have access to the right care at the right time. Pete Smith, from the National Association of Primary Care, explained that delivering the message in the right context is important, so that patients do not feel like they are being turned away or being asked not to return but feel confident in dealing with the condition themselves next time.
Further discussion suggested that the problem is deep-rooted. One doctor said that people have been encouraged to believe that GPs are the experts and patients are “too stupid” to look after themselves. There needs to be a cultural shift so that patients can feel confident to manage their own conditions and seek help only when required.
I believe this can only happen with appropriate education. Rob Darracott, chief executive of Pharmacy Voice, issued a challenge to any members present from Health Education England to put self care on the agenda. One excellent suggestion from another GP was to move the discussion into schools and hold health education lessons teaching children how to take care of themselves and their families. These lessons could be tailored to each age group and to coincide with health issues that occur at different times of the year.