Uncertainty
While it is very easy to scribble a prescription, it takes courage to avoid unnecessary prescriptions. Inability to make a fairly accurate clinical diagnosis is one of the most common causes of antibiotic abuse. Inability to convince the patient about the nature and simplicity of the illness and about the non-requirement of antibacterials is another reason. Some doctors may think that it is better to give "something powerful" for every patient so as to achieve "dramatic" results. The fact remains that most patients do not demand any particular prescription from their doctor and many are indeed happy if they are explained about their problem and prescribed as less drugs as possible. Fear of law-suits for 'negligence' (act of omission') and hence 'defensive' practice may also be another reason.
Patients
Rarely do patients insist on a prescription for antibiotics so as to "get better as fast as possible" or to "avoid any hassles", particularly in cases of children and the elderly. In such situations, it is the duty of the doctor to resist any such pressures. But some doctors may yield to these pressures, often to appease the patients and to 'save' their practice.
Other physicians
Some doctors may have a fear that if they do not prescribe, their colleagues may prescribe these 'powerful' drugs and get all the credit for 'curing' the patient. To avoid this 'loss of practice' they tend to prescribe these 'powerful' remedies. This is another face of 'defensive' practice.
Pharmaceuticals
With hundreds of pharmaceutical companies and thousands of medical representatives, it is natural to come under some pressure for prescribing these drugs, which earn handsome profits for the drug industry. With competition heating up, the companies seem to mislead the doctors about the indications, suppress the facts on adverse effects and hide the facts on cost of therapy.
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