CASE studies
These studies are summarised versions of actual cases from MDDUS files and are published in Summons to highlight common pitfalls and encourage proactive risk management and best practice. Details have been changed to maintain confidentiality
PROFESSIONALISM: PRESSURE TO PRESCRIBE
BACKGROUND: Dr G is a salaried GP and also works as a doctor at a local private school. He visits the school once a week and is often asked to attend sporting events on a Saturday morning to provide first aid. He has developed good relationships with both pupils and parents, who often ask him questions relating to their own health. One Saturday morning a parent tells Dr G about her difficulties with anxiety and insomnia. She had been treated for this in the past when she lived abroad and found a particular treatment very helpful. She is worried her condition will again deteriorate and asks Dr G to prescribe a small number of the benzodiazepine that she used several years ago as a short-term measure to alleviate her symptoms. She explains she has found it difficult to see her own GP as she has been too busy with work and her children. She assures Dr G she will call her own GP to make an appointment on Monday. Dr G is sympathetic to her concerns and, even though she is not his patient, agrees to help. He writes a prescription on his practice (NHS) pad for a short course of treatment and tells the parent this will be the only time he can do so. She is very grateful for his help. Four days later Dr G’s practice is contacted by a local pharmacist who informs them that the drug prescribed by Dr G is not available on the NHS. When the details are checked, it becomes apparent the person who this prescription was for is not in fact a registered patient at the practice. The partners arrange a meeting with Dr G to discuss the matter.
ANALYSIS/OUTCOME: Dr G contacts MDDUS for advice on how to proceed. He regrets his actions and admits he felt pressured into writing the prescription because he felt sorry for the parent. He was unaware that he should not have used the practice’s FP10 prescriptions for this and should have issued a private prescription instead. Having reflected on the incident, he accepts that in future he should not prescribe a medication that he is not familiar with or has not used before, and certainly not without a thorough assessment of the patient. The MDDUS adviser recommends familiarising himself with
General Medical Council guidance on prescribing, which states: “You should prescribe medicines only if you have adequate knowledge of the patient’s health and you are satisfied that they serve the patient’s needs.” Dr G is advised to meet with the partners to discuss the matter, to consider undertaking a significant event analysis to identify learning points and to reflect on this case at his next appraisal.
KEY POINTS •
•
Don’t feel pressured into writing prescriptions for someone without adequate knowledge of their health.
Consider whether a prescription request should be directed to the individual’s own GP.
• Take extra care with requests for medicines such as benzodiazepines which can be more commonly associated with misuse.
20
SUMMONS
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24