Fam Pract Manag. 2018 May-June;25(3):34.


Working in an immediate care center, I sometimes feel bombarded by patients who want me to prescribe an antibiotic for their viral cold. Lately, I have added a new twist to my usual spiel explaining why I cannot prescribe one. If I am absolutely certain they do not need an antibiotic, I first reassure them that their own body is going to be able to take care of this illness and that they will be fine by next week. I even offer medication to relieve their symptoms. For patients who are still determined to receive an antibiotic, I then explain that, by avoiding an unnecessary antibiotic, they do not have to worry about getting antibiotic-associated diarrhea or developing antibiotic-resistant organisms that can hurt them later. If they continue to protest, I emphasize that, based on my medical knowledge, I truly believe they don't need an antibiotic, and I say, “If I give a patient medicine to treat a condition I don't think he or she has, that is kind of like malpractice, isn't it? Neither of us wants me to do that.” They usually give me a funny look and stop asking.


Patients increasingly are turning to the Internet to find doctors and rate their medical care, and practices cannot ignore this information — especially when the feedback is negative. I have turned off the ability for patients or other visitors to post on my clinic's Facebook page, so I don't have to monitor reviews there. Google reviews are more important, so I respond to negative reviews with comments such as, “We work hard and appreciate your feedback, which has helped us grow.”

To help neutralize negative feedback, I encourage more patients to post reviews. I do this by periodically posting a notice in the waiting room window with a QR code patients


Practice Pearls presents readers' advice on practice operations and patient care, along with tips drawn from the literature. Send us your best pearl (250 words of less), and you'll earn $50 if we publish it. We also welcome questions for our Q&A section. Send pearls, questions, and comments to, or add your comments below.


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