Be empowered: Partner with your doctor to make smart choices together

*The content is brought to you in partnership with Discovery Health

By Dr Roshini Moodley-Naidoo*

Commonly in South Africa, mention of being resistant to medicine or becoming ‘drug resistant’ sounds like something rare out of a medical journal. The reality is very different, and very worrying. It is becoming easy for or any of us, healthy or unwell, to become resistant to one of the most commonly prescribed treatments for general infections such as  influenza, urinary tract infections, sinusitis – antibiotics. Globally, there has been an alarming increase in antibiotic resistance and in the occurrence of ‘superbugs’ that don’t respond to antibiotic treatment. In simple terms becoming resistant to antibiotics could require more expensive treatment and even mean that one day there may be none of these medicines left to effectively treat life-threatening conditions.

Resistance to antibiotics has reached such alarming rates that the World Health Organization declared this a global health crisis, made worse by unnecessary or incorrect use of antibiotics. Our government, together with public and private healthcare sectors, works to promote the appropriate and safe use of antibiotics. These efforts are collectively referred to as “antibiotic stewardship” and include policy setting, knowledge sharing in the medical community, research, and public education. Each of us holds a responsibility to contribute to these national efforts. Whenever an antibiotic is prescribed in South Africa, a choice is made before the medicine is scripted. We must help by making certain that the choice is always the right one, the choice that will protect these essential medicines for our children and their children.

Antibiotic resistance; however, is only one example of how unnecessary treatment or non-adherence to prescribed treatment can affect the cost of care and people’s health over the long term. Discovery Health believes people need to be empowered with relevant information when making choices about their health and their healthcare to eliminate unnecessary or unsafe practices, a and to promote the care that will be most effective.

How can this be achieved? Discovery Health believes it starts with conversations between patient and doctor for smarter health and healthcare choices. Essentially, it is about choosing care that you know is based on evidence with an excellent track record, not a simple duplication of tests or procedures, always free from any harm, and really necessary. It is not always easy for people who are unwell to initiate or engage in such conversations with their doctors. Without these conversations though it is difficult for doctors and caregivers to know and appreciate what the true needs of patients are and what they value most. Doctors expect us to engage openly and helpfully. The best outcomes of care come from genuine partnerships between doctors, patients and their families.

Applying these principles to your conversations, can ensure mutual understanding of the necessary and alternative courses of treatment, the cost, and health outcomes. Let’s apply these principles to antibiotics use as an example.

What does evidence say about the use of antibiotics?

Studies show that up to 50% of antibiotics that are prescribed is not really necessary. Before asking your doctor to prescribe an antibiotic, have a discussion about it first.

Is antibiotics the best course of treatment?

Antibiotics work only for infections from bacteria, not viruses. Common infections are mostly caused by viruses, the treatment for which is largely supportive such as rest, good hydration and nutrition. Ask your doctor what alternative treatments are, and what would happen if an antibiotic is not prescribed. Trust your doctor’[s advice if the decision is made to not prescribe an antibiotic.

Some infections take some time to feel better. There are treatments that can relieve symptoms. Ask your doctor about these. When time has passed and you still don’t feel better, that might indicate you now require an antibiotic.

Do you need tests?

If you’re not getting better, discuss any tests your doctor may want to do. Use available information from your health records at doctors or your medical scheme to get recent results. This avoids duplication of tests and unnecessary costs.

Is the treatment free from harm and really necessary?

Using antibiotics when it is not needed, can harm your health. It can lead to unpleasant side effects, and harmful bacteria can replace good bacteria. You can even feel worse, especially when you use it to treat a virus.

Just asking these questions, specifically when it comes to whether or not you need an antibiotic can help ensure you use antibiotics for the right reasons. Remember, when you do use antibiotics, always follow your doctor’s prescription.

Why are these conversations important? Creating closer partnerships between doctors and patients for improved health outcomes is an essential part of a patient-centred healthcare system. This is the healthcare system Discovery Health envisions for a sustainable future. This healthcare system focuses on the best care and health outcomes for the patient, and has effective tools for coordination of care and flow of information between patients and health professionals.

Discovery Health has developed Discovery HealthID to enable the digital flow of information between health professionals for more coordinated care. With many other initiatives, that include elements of measuring care, Discovery Health is at the forefront of platforms that enable information sharing between patient and doctor, and doctor and doctor. A patient-centred health system, we believe, not only offers greater value to patients through improved health outcomes, it can result in significantly lower wastage, for example, in over servicing and duplication of services, which will all help lower healthcare costs. We see this lowered costs over the long term freed up for richer medical scheme benefits and increased remuneration for health professionals.

Knowing more about your health and healthcare, and partnering with your doctor in the choices you make can positively contribute to addressing global health concerns as well as to changing our healthcare system. Start the smart conversations now.

• Dr Roshini Moodley-Naidoo is head of Strategic Risk Management at Discovery Health.