GP Stage 3 Simulated Consultation - Healthcare Professional 6
JYou are an SHO on a geriatric ward. Michelle, one of the HCAs who you know well and have a good professional relationship with has asked to see you briefly during your break.
You are Michelle, one of the HCAs on a geriatric ward. You have arranged to meet one of the doctors who you know well during a break. You would like the doctor to prescribe a course of antibiotics for your 13 year old son (Jonathan) who has had a ‘sore throat’ for over one week. You are concerned that you have brought something home, and because it has persisted are keen to commence antibiotics. Unfortunately, you have not had time to visit your GP, and as a single parent who is working the next 7 days in a row; you will not have time for at least the next week. Your mother looks after your Jonathan when you are at work, however you feel bad asking her to take Jonathan to the GP as well.
You don’t mind ‘paying for a private prescription’ and would just like your son’s sore throat to improve. If advised that the majority of ‘sore throats’ are viral and don’t need antibiotics, you explain to the doctor that you read online that if they have tonsilar exudate (white spots on the tonsils), high temperature (>38.5) and no cough, the cause is likely bacterial and requires prompt antibiotics. All of these criteria apply to your son’s sore throat.
A colleague of yours recently asked one of the other doctors for a similar favour, and they provided a prescription without any questions. If denied a prescription, you are disappointed that the doctor who you believed was a friend is not able to assist you when most required.
The vast majority of candidates will understand that it is not acceptable to write a prescription on this occasion. The distinction being between those attempting to object on medical grounds, and those objecting due to GMC guidelines which state as follows:
‘Wherever possible you must avoid prescribing for yourself or anyone with whom you have a close personal relationship. We expect our registrants to follow our guidance, if you decide to act contrary to the guidance you should be prepared to justify your decision to do so.’
GMC: Good practice in prescribing and managing medicines and devices (2013)
Excellent candidates will advise Michelle to arrange for her son to see the GP, as well as exploring the social circumstances which have meant that Jonathan has not been able to see the GP already. Addressing these may involve, exploring ways in which Michelle may be able to access additional support, as well as being able to obtain time off work to meet her son’s and own personal health and welfare needs. Additionally, an exploration of the apparent inappropriate actions of one of the other doctors, as well as a plan to investigate this further is also appropriate.