Kiwi I think that we have found something that we agree on as far antibiotics being used wrongly, however I think that starts in the Doctors office. Now my disclaimer: I am not a doctor, nor do I claim to know more than a doctor, with that being said.....I am not sure what it is like in NZ, but in the US if a patient wants an antibiotic and the Doctor disagrees, then the patient just goes to the next Doctor until they get what they want. So what happens is business gets in the way of good medical decisions. They don't want to loose their patients, because that hits them in the pocket book in private practice.
One of my biggest hang-ups doing these RM gigs is when an antibiotic is given for the "because I can" with no other medically nec. explanation available. I often try to explain this to my Mongolian Doctors, if you give a medication be sure to document your findings in your chart that would suggest the need for the medication. This is especially true for antibiotics.
My concerns come from two angles, first and foremost the patient care. I don't want a patient to receive a medication (i.e. antibiotics) for something that will resolve itself with OTC's in a few days, or that needs to take its course. Well a distant second is that supplies are a continous problem here where I am at, and that presents its own problems.
I also have a short coming when it comes to what anibiotic to give for what, that is why before I do I consult a PDR or hell even the internet. That way I have some basis for my decision. Now I will say this I have been lucky enough to have done this job with some pretty good guidlines, that says if you see this give this and expect that (call it cookie cutter medicine if you will).
However, I still try to look up information so that I can educate myself maybe on a particular case. Maybe the next time I encounter such a case I can pull that out of the memory bank, the next time I encounter a similar case.
MongoMedic