Think back to the last time you decided to go to the doctor for an acute illness. You probably debated whether your symptoms were severe enough, would the doctor actually do anything, and would it be better to wait it out? As you considered your decision making process, what was the value you were seeking in the doctor visit?
Going to the doctor for some requires money and for everyone requires time. Nobody wants to waste either of these, therefore we want to receive something from the doctor visit. We tend to be hardwired to think that the outcome should come in the form of something tangible. If we receive a prescription or treatment from a visit, then it was successful, but if our illness didn’t require any intervention and we walk out empty-handed, then we feel duped and let down.
According to a 2016 Journal of American Medical Association (JAMA) article evaluating data from 2011-2012 in the United States, approximately 30% of all antibiotic out-patient prescriptions were “inappropriate.” It also reported that approximately half of antibiotic prescriptions given for acute respiratory conditions were unnecessary, equaling about 34 million courses of antibiotics. Is this the result of providers prescribing medication without educating themselves about current guidelines and practices? In an ideal world prescribers would adhere strictly to current evidence-based guidelines, but human influence plays a part. The reasoning frequently is that patients believe – or providers think patients believe – that antibiotics are necessary in their specific circumstances, even if current evidence points to the illness being viral. Providers are unable to fully educate patients about these matters because of lack of time, and patients tend to want the prescription because they have never been educated and don’t want to waste their time and money. The result of the antibiotic overuse is widespread bacterial resistance, misunderstanding of pathology by patients, and greater numbers of severe side effects such as C-Difficile diarrhea.
The Real Value
The discussion about medication and treatment overuse is not enough to change practice. Patients and providers need to have a desire for the best outcome, and work towards that goal. The real value in seeing a doctor is the understanding and better management of one’s own health. This is the long-term benefit that we forget about when we walk out empty handed. A quality doctor visit should entail a thorough investigation of the patient history, a proper exam, and then the right treatment regimen should be discussed. A conclusion from a 2018 JAMA Internal Medicine article regarding medical overuse was “Engaging patients in conversations aimed at shared decision making appear[s] to be useful in reducing overuse.” Shared decision making can only occur with proper education of the patient.
Education is great, but…
It’s great to talk about the value of education that is received from a doctor visit, but we still tend to leave disappointed because we spent time and money to understand that we don’t need anything special. The disappointment will be removed though if we didn’t spend the time and money, but still received the same answer. If we could see a doctor at lower cost from the comfort of our home, still have a thorough history, exam, and education regarding the pathology, and receive prescriptions as necessary, then we wouldn’t feel duped. The reality is we would have the assurance of a clinician’s expert opinion, and the knowledge to power us to healing.
Care on Location is about giving you the value of expert medical advice and treatment, without the expenditures of time and money we associate with seeing a doctor. Seeing patients over video decreases the cost to the you the consumer. It has also been shown to be as effective for the illnesses that Care on Location cares for as an in person visit (See our articles about rashes, concussions, sore throat, and more). Find real value in seeing a doctor by videoing with a provider that enables you to understand and improve your health.