While the growing problem of antibiotic resistance threatens lives and economies worldwide, prescription rates are higher in U.S. regions that are more physician-dense, particularly in areas where retail and other walk-in clinics drive competition among ambulatory providers for patients, according to a post in the Conversation.
The "doc in a box" effect is less troublesome in poorer areas, in which primary care access is expanded to include patients who otherwise wouldn't access the healthcare system at all, according to authors Eli Klein, assistant professor at Johns Hopkins University, and Ramanan Laxminarayan, senior research scholar and lecturer at Princeton Environmental Institute at Princeton University in Australia. In wealthier areas, however, retail clinics create more competition for traditional offices.
"So people now have a choice: they can just walk in to a clinic or try to make an appointment at their doctor," they wrote. "Thus in areas with a lot of physicians, the introduction of a clinic and the resulting competition for patients pushed prescribing rates by physicians up even further."
In these climates, physicians may tend to prescribe unnecessary antibiotics out of a desire to maintain good relationships with patients and retain their ongoing business, the authors suggested, echoing similar provider sentiments reported by FierceHealthcare.
To counter these pressures, more stringent oversight of clinics' compliance with prescribing guidelines is necessary, the post advised, as well as greater coordination and collaboration among different types of healthcare providers.
To learn more:
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