Patient demanding antibiotics for a virus
- Kind
- Practical scenario
Prompt
You are a family physician. A patient comes in with a cough, a sore throat and a runny nose that started three days ago. Your examination suggests a viral infection, which antibiotics will not treat. The patient insists on a prescription for antibiotics, explaining that she has an important work trip next week and that antibiotics have always worked for her in the past. She tells you that if you refuse, she will go to the walk-in clinic down the street and post a negative review of your practice online. How would you handle this situation?
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After you practice: what this question tests and how to approach it
What this question tests
- Communication
- Professionalism and integrity
- Health systems and advocacy
How to approach this question
This MMI station tests whether you can say no to a patient's request while keeping her trust, and without letting a threat decide your care. Name the stakes: her real worry about an important work trip, your duty not to give treatment you've judged won't help, and the public health cost when treatment is handed out to keep people happy. Start by exploring why she wants it and what she's afraid of, then explain your reasoning in plain language. Offer what you can do, such as a plan for the trip and a clear point at which she should come back. Respond to the threat of a bad review calmly, and accept that she may leave unhappy. When the station widens to who should fix a shared problem, consider the roles of patients, physicians and the system.
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