Dr. Jeffrey A. Linder, a professor of medicine at Northwestern, revealed in a New York Times op-ed recently that doctors are hardly infallible- and that there’s certain hours of the day where statistically those errors rise.
In a 2014 study, Linder and fellow researchers discovered that doctors prescribed less unnecessary antibiotic prescriptions for respiratory infections in the morning, but that went up over the day. In a startling rise, a doctor caring for the exact same patient had a 26% higher chance of writing a antibiotic prescription at 4 pm instead of 8am.
Why? Linder believes that as doctors get more tired, they default to the easier option of just giving antibiotics when patients ask rather than taking the time to explain why it’s not necessary. That’s frightening as unless action is taken to stop practices that have allowed antibiotic resistant to spread, and new antibiotics developed, we could return to the days when routine operations, simple wounds or straightforward infections could post real threats to life, according to England’s chief medical officer Sally Davis.
But of course it’s not just doctors over-prescribing antibiotics that have led us to this gloomy road. Lance Price, an antibiotic researcher at George Washington University in Washington DC, adds: “Superbugs are gaining strength because we continue to squander these precious medicines through overuse in human medicine and as cheap production tools in animal agriculture.”
Travel is also another factor, adds Davis.
“One Swedish study followed a group of young backpackers who went off on holiday to different parts of the world. None had resistant bacteria in their guts when they left. When they returned a quarter of them had picked up resistant bugs. That shows the pervasive nature of the problem we face,” she said.
But back to the timing of your medical appointments- so let’s say your ailments aren’t flu or viral related, but for other illnesses or injuries. Does timing matter?
Yes- another study published in JAMA Network Open found that doctors ordered fewer breast and colon cancer screenings for patients later in the day, compared to earlier in the morning. Ordering rates at 8am were highest, but by the end of the afternoon that dropped by 10-15%! Linder believes that that’s down to doctors running late, and something called decision fatigue- “the progressive erosion of self-control as we make more and more choices”.
So what can you do when you get stuck with a 4pm checkup? Linder’s advice: prepare. Read up more about your condition and the screenings and meds that you might get.
Or bring your doctor a cup of coffee?