Prescribing: Doctors are patients too

Dr Katie Smith is an ST2 in public health and in August 2015  finished a year as a Clinical Leadership Fellow with the GMC. She writes here on the question of self-prescribing and treating family, friends and colleagues. The GMC has published a helpful resource on prescribing to support doctors 

For me, my decision not to prescribe for friends and family is quite straightforward. I would hate to write them a quick prescription, with the intent of helping them out, only to later find my assessment was wrong. The risk of false reassurance, particularly at home where I don’t have access to basic equipment and tests, is not one I am willing to take. I would sooner accept that my friends and family don’t get much ‘use’ out of me being a doctor than cope with the thought that I had failed to spot something crucial or done something to harm them.

There is also the question of prescribing for myself. I know that many doctors see self-prescribing as a benefit to the NHS – they don’t have to take time away from their role to attend an appointment which could be given to another patient – and I can understand this thinking. But I also have concerns about what it means in terms of equity. Notwithstanding the issues of self-regulation, and the potential blurring of boundaries when we begin to prescribe for ourselves and our families when we cannot be objective, I also think it introduces a situation whereby those with the ability to prescribe don’t experience health-care in the same way as any other patient.

While you could argue that it saves the NHS time, realistically it also saves our time. It is much more convenient to self-prescribe than to try and make an appointment, wait for the appointment, travel to and attend that appointment and then go to the pharmacy. To choose instead to self-prescribe somehow suggests that we don’t need to bother with that rigmarole because we are doctors. If I am seeking medical care or treatment then in that context I am a patient too, irrespective of my medical training. If I expect other patients to go through that process then I feel I should also be willing to do it myself.

Read the GMC’s guidance on doctors prescribing to themselves or those close to them. We have also published a helpful resource on prescribing to support doctors 
Katie Smith

Dr Katie Smith is an ST2 in public health and and in August 2015  finished a year as a Clinical Leadership Fellow with the GMC

5 responses to “Prescribing: Doctors are patients too

  1. As an experienced GP with Type 1 Diabetes my situation is more complex.
    I have significant numbers of people depending on me for their day to day care, and time I spend trying to obtain care from inefficient parts of the NHS has a negative effect on a lot of people.
    I am also very aware that the proper thrust of diabetes care, and of other LTCs, is for patients to look after themselves to the best of their ability.
    I do think that there should be clear criteria by which doctors decide not to provide care to friends, family, or self- no drugs of dependence for example, and of course not to stray outside the limits of competence.
    The GMC seems to assume that all medical care in the UK is of a good standard- despite being provided with evidence to the contrary on a regular basis.
    The current simplistic prohibitive approach of the GMC is actually damaging to patients- it discourages doctors providing treatment to friends or family from communicating details to the patients regular medical attendant; this should be one of the criteria that is expected, not discouraged.

  2. seems a bit strange that we are moving towards patient-oriented care: EXCEPT when the patient is also a doctor!

  3. Would you trust a car mechanic to repair his/her own car? Would you expect an electrician/plumber/carpenter to be prohibited from fixing a problem in their own home that you would trust them to fix in yours? Should chefs not eat their own food – in case it isn’t edible?!

    Should we as doctors be expected to seek medical help if we have a simple cold – in case we get it wrong? We’re expected to seek help from colleagues if we’re unsure about something when treating someone else; presumably the same should apply to ourselves – it is common sense to ask if you’re unsure! Tony Kelpie above makes some sensible points.

  4. I think there should be flexibility in prescribing medication for family or friends. Frist of all , you will not prescribe medication for anybody if you are not sure about the diagnosis. I do not see any problem to treat family member or friends. My ma suffer from hypertension and know how to treat hypertension. I have enough experience and confidence to treat this condition. I will not prescribe any thing for her which I am not confident about . For example sedative or anxiolytics . Being a doctor in the family , she has some advantages which she can avail. She should not go through the hassle .
    In addition there are some conditions which can be easily diagnosed and treated by any doctor. The bottom line is if you have no experience or confidence you do not treat anybody . You need to revisit your qualifications . Making everything under policies and guidelines we are losing our common sense.

  5. A somewhat flawed argument. I do not disagree that experiencing healthcare from a patients perspective can be enlightening and help shape the way we care for others. Nor do I think we should be trying to manage anything potentially life threatening when access to imaging and investigations is not readily accessible. However, to think that treating a common ailment for ourselves or family is wrong seems misguided, or at least naive. I think your experience plays a big part , especially when it comes to recognising limitations.

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