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
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