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Less Is More
September 2014

Next Time I’ll Ask

Author Affiliations
  • 1Executive Director, Maine Quality Counts, Manchester
JAMA Intern Med. 2014;174(9):1431-1432. doi:10.1001/jamainternmed.2014.3049

I knew I should have asked. My 82-year-old, “I’m fine” mother had struggled with a worsening upper respiratory tract infection and cough for 5 days. My sister and I finally convinced her to leave her home an hour north of us to spend a few days under our watchful eyes. As her cough and fever continued to worsen, my mother reluctantly agreed to go to the local hospital emergency department.

My mother and I listened attentively to the physician’s diagnosis of pneumonia, and we were reassured to learn she was a good candidate for oral antibiotic therapy and outpatient care. Feeling grateful and trusting, my mind prickled only slightly when the emergency department physician recommended a newer, broad-spectrum antibiotic, without a discussion of cost, my mother’s ability to pay, or the possibility of a less-expensive, equally effective treatment.

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