Are physicians overprescribing antibiotics to get higher ratings from patients?

Patients said they were most satisfied with their physician's visit when they received an antibiotic for a respiratory tract infection, whether they needed the drug or not, a study published in JAMA Internal Medicine found.

The researchers looked at more than 8,000 appointments for these infections through a national telemedicine provider. 

Patients' ratings of their appointments contributed to their physician's overall patient satisfaction scores. Concern about satisfaction scores could be leading physicians to prescribe antibiotics, study author Kathryn Martinez, PhD, told NPR.

"It is very problematic because it creates an incentive for physicians to do things that are not medically necessary in order to drive up their satisfaction ratings," Dr. Martinez said.

Most telemedicine patients in the study (66 percent) received antibiotics for respiratory tract infections, a rate Dr. Martinez said is far too high since conditions like the common cold rarely need antibiotics.

Physician visit reviews were significantly higher if patients got a prescription, particularly those for an antibiotic. In a rating out of five stars, 72 percent of patients gave five-star ratings after visits with no prescriptions; 86 percent gave five stars when they received a prescription for something other than an antibiotic; and 90 percent gave five stars when they got a prescription for an antibiotic.

The research team said it may help to exclude reviews from respiratory tract infections appointments from physicians' overall satisfaction ratings.

 "The incentive is too great" to prescribe antibiotics during these visits, Dr. Martinez said.

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