Sometimes doing no harm means doing nothing

A couple of years ago, I took care of a 12-month-old boy with a cough. He had been seen by three other doctors over the last two days. Initially, he was seen by his pediatrician, who told his mother that it was “just a virus” and that his symptoms would go away on their own. Unsatisfied with this answer, she left the pediatrician’s office and drove immediately to an urgent care facility, where they told her that her son had pneumonia, and he started on an antibiotic. The next day, he was coughing more. So his mother took him to a different urgent care facility, where a second antibiotic was started. On the third day, she brought the child to the pediatric emergency room where I worked. She was very concerned that his cough was worsening, despite the two antibiotics he was on. She was worried that he had now developed diarrhea, in addition to his primary symptoms. And more than anything, she was irate that his pediatrician had done “nothing.” Everything about his history and physical exam screamed: “bronchiolitis” (a common viral respiratory infection in young children that does, in fact, go away on its own). Worsening over the first three to four days is precisely what I would expect from this illness. And more than likely, his diarrhea was a result of the antibiotics he was on. Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how.
Source: Kevin, M.D. - Medical Weblog - Category: Journals (General) Authors: Tags: Physician Pediatrics Source Type: blogs