Prisoner’s Dilemma in the Doctor’s Office
Since the first use of penicillin in 1942 the prevalence of antibiotic-resistant superbugs, bacteria strain which cannot be killed by antibiotics, has grown steadily. Even though the United States has attempted to impede the creation of superbugs by only allowing people with a prescription to obtain antibiotics their efforts have not been completely successful. By instituting such a policy, the government puts the responsibility of deciding whether or not a patient gets antibiotic with the doctor. All too often doctors prescribe antibiotics when a patient does not need them as described in the article “How the doctor-patient relationship has become a prisoner’s dilemma” from the Washington Post. This effect can lead to the patient either being over or under-treated for the problems they actually have. Patients usually want antibiotics because they mistakenly believe antibiotics will cure them even after their doctor has told them they have an illness such as a virus which antibiotics cannot cure.
When a patient comes to a doctor asking for antibiotics the doctor faces a prisoner’s dilemma. Such a dilemma arises as the doctor is expected to provide good health care while cutting cost and ensuring the patient is satisfied. If the doctor prescribes the antibiotics, the patient will be satisfied allowing the doctor to move onto the next patient and also receive a positive rating from the patient. However, by prescribing the antibiotics to a patient who does not need them the doctor has made society worse off as they are aiding in the creation of superbugs. On the other hand, if the doctor does not prescribe the antibiotics, he will help society but will hurt himself as he might lose the patient which equates to lost revenue for himself.
Antibiotics are only one class of drugs the United States requires patients to have a prescription to obtain. The United States also limits other drugs, to prevent patients from abusing the drugs, such as fentanyl or oxycodone. The same prisoner’s dilemma occurs for the doctor when a patient comes to them complaining of extreme pain and asks for painkillers. Either the patient genuinely needs the drugs or they are faking the pain to get them and it is the doctor’s responsibility to decide whether the patient will get the drugs or not. To help alleviate this prisoner’s dilemma we should not allow a patient to rate the quality of the doctor by whether or not they reviewed the medication they wanted.