all the above is true, but there is also the fact that physicians are trained to diagnose and treat, to do something. The hardest thing in the world is to choose to do nothing. We will couch it to the family as active surveillance or active monitoring, but we are not writing an order for a treatment and that creates a cognitive dissonance that competes with the theoretical knowledge that this is right, and what if I am wrong and the patient gets sicker and dies and someone else says to the family, if he had only been given an antibiotic in time he might have lived. all of this is bouncing in the head at the same time, antibiotic resistance and superbugs are somewhat theoretical and in the future, my sick patient before me is here, now and very real. It is mentally exhausting and emotionally exhausting and physical fatigue at the end of the day, yep I just may not fight as hard.
Martin Hudzinski