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Dr. Herb Wettreich, MD is an otolaryngology (ear, nose & throat) specialist in Mooresville, NC and has been practicing for 28 years. He graduated from Umdnj--New Jersey Medical School in 1984 and specializes in ear, nose, and throat.Read his story
This content was provided by Dr. Wettreich "I started this practice in 1990, and it has grown to 3 physicians, a nurse practitioner, and two audiologists. I have firm roots in the community, with both my children attending the public schools. I am blessed, thoroughly enjoy, and am passionate about my occupation. One of the most gratifying aspects of being a physician is being able to help people. Patients' perspectives of how we do our job can now be shared via social media. For the most part, this is a very good thing. Medical care, like anything else you pay for, is a service. However, providing this service properly sometimes violates the dictum that "the customer is always right". The following example (in Ears, Nose & Throat) will highlight this challenge: Not prescribing antibiotics for viral upper respiratory infections: A patient came to see me in mid winter, with symptoms of nasal congestion, postnasal drainage and cough. Several weeks prior to our visit, she had been seen at urgent care with similar symptoms that had been occurring for about a week. She was prescribed and antibiotic and a steroid and got significantly better. However shortly after completing her treatment, the symptoms returned. She contacted the urgent care, asking for more antibiotics. She was told that her symptoms were viral and therefore no further antibiotic treatment was necessary. Her present symptoms had been going on about a week and she therefore wanted more antibiotics. Pertinent findings of her physical exam revealed some inflammatory changes in her nose with normal sounding lungs. My impression was that she contracted a viral upper respiratory infection (URI) and that antibiotics were not warranted. I explained to her the differences between a viral versus a bacterial infection* (see below) and that treating a viral infection with antibiotics is not only ineffective but will select out resistant bacteria. We discussed the fact that many viral URIs may last up to three weeks and are best treated with over the counter medications. She made me aware that she did not agree with my diagnosis so I repeated my medical reasoning. This was to no avail and I could tell by her facial expression that she was dissatisfied. After she left, I thought to myself how much easier it would have been not spending 30 minutes with her and simply writing her an antibiotic prescription. But this on so many levels was the wrong thing to do. The next thing I thought about was getting "skewered" by her on social media (HealthGrades etc.). Physicians have little defense in removing inappropriate reviews unless you can prove libel. What did follow was a call to our customer satisfaction representative stating that she was treated inappropriately and should not pay for her office visit. She noted that 3 days after her visit she developed severe wheezing, saw another doctor and was prescribed inhalers and an antibiotic. *There are several excellent articles chronicling to misuse of antibiotics during viral URIs. Search the following titles: "Antibiotics for URI/Sinusitis-A simple decision gone bad", "Antibiotic Use in Acute Upper Respiratory Infections", or "Diagnostic Criteria for Rhinosinusitis". They summarize recommendations from the CDC, American Academy of Otolaryngology and American Academy of Family Physicians. They can be paraphrased as follows: Viral infections do not respond to antibiotics, they are self-limiting and should start getting better within 7-10 days. Antibiotic treatment should not be considered before this time and only if there is cheek / facial pain and discolored nasal discharge. The presence of wheezing and bronchitis during an upper respiratory infection is also likely viral and once again antibiotic treatment is not suggested. I have gone into great detail about a topic that is near and dear. Please remember, your health is my priority."
This content was provided by Dr. Wettreich "Our office strives to provide state of the art medicine within a caring environment. Listening to, and addressing patients' a family concerns is a priority. Previous internet research is welcome!"