Jarrod Shapiro's excellent Practice Perfect 464 on antibiotic overuse struck a cord with me.

I have been fighting against the misuse of pre-op antibiotics for years.

About 5 years ago I entered the pre-op holding area and the nurse ASKED me if I would like to give pre-op antibiotics.  Seeing that the patient was young and healthy and the procedure was short I told her NO... ..

A few days later I was called to the Administrators office.  She asked me "Why did you not give antibiotics?"

I promptly told her "Because the nurse ASKED me.  She did not Obligate me to give them.  So therefore I can say NO.....  Is that a problem" I asked.

She said YES...  You must give pre-op antibiotics according the Medicare SCIP program.

Well.....Then tell your nurse NOT TO ASK ME if I want anti-biotics...  But rather give them to my patient and later I may or may not sign the order !!!!!!!!

Needless to say.   I have succumed to the pressure and just give it now.

But I can really relate to what you  are saying..

Soon we will not have autonomy over our own patients.

Dr Jorge Nasr DPM FACFAS
Residency Program Director
Kendall Regional Medical Center
Miami, Florida

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