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GPs who prescribe fewer antibiotics receive worse patient satisfaction scores

GP practices get poorer patient satisfaction scores the fewer antibiotics they prescribe, according to a study out today in the British Journal of General Practice.

Researchers from Kings College London found antibiotic prescribing volume was a major determinant of practices’ ‘GP satisfaction’ scores in the General Practice Patient Survey.

The number of antibiotics a practice prescribed also determined patients’ satisfaction with the practice as a whole, although to a lesser extent than for the GP-specific rating.

It comes as NICE has recommended GPs have their individual antibiotic prescribing monitored and reviewed at least once a year, with its lead on the issue even calling for GPs who persistently prescribe antibiotics inappropriately to be referred to the GMC and face sanctions.

However, at the same time, the Government is increasign patient scrutiny of GP practices, with the introduction of its ‘Friends and Family Test’, which asks patients to consider whether they would recommend the practice.

This latest study found that practices who prescribed fewer antibiotics in line with Government recommendations are likely to fare worse. 

The team estimated that practices prescribing 25% fewer antibiotics than the national mean could expect between 0.5% and 1.0% lower patient satisfaction scores.

Dr Mark Ashworth, who led the team from the Primary Care and Public Health Sciences department at Kings College, said: ’As practices have relatively similar satisfaction scores, this reduction in satisfaction has a bigger impact on the overall rankings, corresponding to a drop of 3-6 centile points in national satisfaction ranking.’

Dr Tim Ballard, vice chair of the RCGP, said it was ‘concerning that patients associated a prescription for antibiotics with a satisfactory visit to their GP, particularly as we know that in many cases antibiotics are not appropriate forms of treatment and could actually do more harm than good, so it may be better not to prescribe’.

Dr Ballard added it was ’frustrating that GP practices that are working hard to reduce inappropriate antibiotics prescribing in order to prevent diseases becoming resistant to them face falling patient satisfaction ratings’ and that it was ’a case of being damned if we do and damned if we don’t’.

He said: ’Public perception needs to change – our patients need to understand that when diseases become resistant to antibiotics, it means that antibiotics will cease to work and as it stands, we don’t have an alternative.’

Br J Gen Pr 2015; available online 7 December

Readers' comments (14)

  • Perhaps it's time to withdraw all these patient satisfaction questionnaires? This is the problem with keep forcing us to do things with no evidence base just to satisfy some fashionable political dogma. Primum non nocere.

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  • Next time someone wnats to study this sort of thing:
    1. Give me the money
    2. Bottle of Red
    3. Pen and Paper.
    And I'll come up with the conclusions. OK no stats.
    100 Colds, 100 prescriptions, 100% satisfaction, 100% bad medicine.

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  • maybe the government should get off their fat butts and educate the public then rather than turning GPs in to the bad guy.

    Government is 'cool' parent giving them whatever they want yet they expect GPs to be 'angry' parent saying no to everything.

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  • GP patient Survey, Friends Family Test, Healthwatch visits, CQC visits & patient survey for revalidation. What other profession within the NHS or elsewhere is subject to such repeated ludicrous levels of scrutiny?

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  • Again no excrement Dr. Holmes

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  • Now there's a surprise. I'm sure we could all have guessed that. Much the same could be said for ANY inappropriate request, eg fit note, investigation etc. It just proves what a lot of nonsense these totally unscientific satisfaction surveys are.

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  • At least it is evidence for what we all knew. Now - when can we expect the powers that be to use that evidence to improve the NHS? Don't hold your breath!

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  • Vinci Ho

    This is the classical argument why patients are not equating customers.
    Unfortunately no politician wants to accept the truth.

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  • Yet another example of how we get judged by everyone. We have uneducated and jobless alcoholics who know exactly what a GP should and should not do. What does the government do about that? They encourage them to report us to the GMC where we will get ruined for trying to do our jobs properly. RLE my friends.

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  • There's no where to turn in the wretched UK

    You're watched for your prescribing habits and penalised if you prescribe to much ( esp antibiotics) and then on the other hand you get complaints or low ratings if you don't prescribe..

    Its amazing having left the uk how in other countries one realises that the familiar "heartsink" is a purely UK phenomenon. I used to have tonnes of these vermin whereas now one simply removes them from ones list and tells them to find another mug to moan to. Until doctors are given the ability to actually use their clinical skills in determining whether or not a patient requires treatment, this sort of garbage will continue.

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