Excuse me but I don't care if oral steroids given as an emergency
treatment (first
24 hours) can marginally reduce a self-limiting illness.
There is already enough pressure on my time from those with acute and
chronic
conditions that might kill them and/or prevent them from continuing to
function
for significant periods without blocking up appointments by encouraging
those
with a nuisance condition to rush in for steroids.
By not giving antibiotics for sore throats, my patients learn to self
manage and
leave space in the surgery for others with more significant problems. Not
giving
steroids for sore throats is likely to have the same effect in practice
but might
not convince those on academic salaries.
The further research (and funds) always called for at the end of papers
might
start to include the impact of introduction of evidence based medicine on
real
world practice and resource.
IN BMJ terms, my own practice of reading Des Spence's column before the
editorials has, yet again, been justified by the evidence!
Competing interests:
None declared
Competing interests:
No competing interests
28 August 2009
Andrew J Ashworth
GP
Davidson's Mains Medical Centre, 5 Quality St, Edinburgh, EH4 5BP
Rapid Response:
So What?
Excuse me but I don't care if oral steroids given as an emergency
treatment (first
24 hours) can marginally reduce a self-limiting illness.
There is already enough pressure on my time from those with acute and
chronic
conditions that might kill them and/or prevent them from continuing to
function
for significant periods without blocking up appointments by encouraging
those
with a nuisance condition to rush in for steroids.
By not giving antibiotics for sore throats, my patients learn to self
manage and
leave space in the surgery for others with more significant problems. Not
giving
steroids for sore throats is likely to have the same effect in practice
but might
not convince those on academic salaries.
The further research (and funds) always called for at the end of papers
might
start to include the impact of introduction of evidence based medicine on
real
world practice and resource.
IN BMJ terms, my own practice of reading Des Spence's column before the
editorials has, yet again, been justified by the evidence!
Competing interests:
None declared
Competing interests: No competing interests