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Non-antibiotic treatment recommendations: delivery formats and implications for parent resistance

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  • Stivers, Tanya

Abstract

This study draws on a database of 570 community-based acute pediatric encounters in the USA and uses conversation analysis as a methodology to identify two formats physicians use to recommend non-antibiotic treatment in acute pediatric care (using a subset of 309 cases): recommendations for particular treatment (e.g., "I'm gonna give her some cough medicine.") and recommendations against particular treatment (e.g., "She doesn't need any antibiotics."). The findings are that the presentation of a specific affirmative recommendation for treatment is less likely to engender parent resistance to a non-antibiotic treatment recommendation than a recommendation against particular treatment even if the physician later offers a recommendation for particular treatment. It is suggested that physicians who provide a specific positive treatment recommendation followed by a negative recommendation are most likely to attain parent alignment and acceptance when recommending a non-antibiotic treatment for a viral upper respiratory illness.

Suggested Citation

  • Stivers, Tanya, 2005. "Non-antibiotic treatment recommendations: delivery formats and implications for parent resistance," Social Science & Medicine, Elsevier, vol. 60(5), pages 949-964, March.
    • Handle: RePEc:eee:socmed:v:60:y:2005:i:5:p:949-964
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    References listed on IDEAS

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    1. Feikin, D.R. & Schuchat, A. & Kolczak, M. & Barrett, N.L. & Harrison, L.H. & Lefkowitz, L. & McGeer, A. & Farley, M.M. & Vugia, D.J. & Lexau, C. & Stefonek, K.R. & Patterson, J.E. & Jorgensen, J.H., 2000. "Mortality from invasive pneumococcal pneumonia in the era of antibiotic resistance, 1995-1997," American Journal of Public Health, American Public Health Association, vol. 90(2), pages 223-229.
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    Citations

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    Cited by:

    1. Stivers, Tanya & Timmermans, Stefan, 2021. "Arriving at no: Patient pressure to prescribe antibiotics and physicians’ responses," Social Science & Medicine, Elsevier, vol. 290(C).
    2. Angell, Beth & Bolden, Galina B., 2015. "Justifying medication decisions in mental health care: Psychiatrists' accounts for treatment recommendations," Social Science & Medicine, Elsevier, vol. 138(C), pages 44-56.
    3. Wang, Nan Christine & Liu, Yuetong, 2021. "Going shopping or consulting in medical visits: Caregivers’ roles in pediatric antibiotic prescribing in China," Social Science & Medicine, Elsevier, vol. 290(C).
    4. Koenig, Christopher J., 2011. "Patient resistance as agency in treatment decisions," Social Science & Medicine, Elsevier, vol. 72(7), pages 1105-1114, April.
    5. Hudak, Pamela L. & Clark, Shannon J. & Raymond, Geoffrey, 2011. "How surgeons design treatment recommendations in orthopaedic surgery," Social Science & Medicine, Elsevier, vol. 73(7), pages 1028-1036.
    6. Toerien, Merran, 2021. "When do patients exercise their right to refuse treatment? A conversation analytic study of decision-making trajectories in UK neurology outpatient consultations," Social Science & Medicine, Elsevier, vol. 290(C).
    7. Tate, Alexandra, 2020. "Invoking death: How oncologists discuss a deadly outcome," Social Science & Medicine, Elsevier, vol. 246(C).
    8. Chappell, Paul & Toerien, Merran & Jackson, Clare & Reuber, Markus, 2018. "Following the patient's orders? Recommending vs. offering choice in neurology outpatient consultations," Social Science & Medicine, Elsevier, vol. 205(C), pages 8-16.
    9. Bergen, Clara & McCabe, Rose, 2021. "Negative stance towards treatment in psychosocial assessments: The role of personalised recommendations in promoting acceptance," Social Science & Medicine, Elsevier, vol. 290(C).
    10. Rynkiewich, Katharina & Gole, Sarin & Won, Sarah & Schwartz, David N., 2023. "Cultures of antibiotic prescribing in medical intensive care," Social Science & Medicine, Elsevier, vol. 324(C).
    11. White, Anne Elizabeth Clark, 2020. "When and how do surgeons initiate noticings of additional concerns?," Social Science & Medicine, Elsevier, vol. 244(C).

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