Last night we were pulled in by the police. Nothing like a flashing blue light in the rear view mirror to make you feel guilty. They asked for my driving licence and I could hear them call my name in on the radio. No problem. There had been a robbery. They got away, apparently, in a car like mine.
Today an email from the practice asked that I contact the Directorate of Legal Services urgently. I wasn’t aware of any problems but you don’t phone the health board solicitor with a light heart. It was OK. They simply wondered if I could give a rapid opinion on a case.
This week the newspapers are full of stories about abuse of prescription drugs, not to mention an article in the BMJ. In our practice, we seem to have an ongoing battle about prescription painkillers. We try to persuade people that they don’t need the strong analgesia commenced unthinkingly at the hospital. We aim to prevent patients getting started, advise them about taking too high a dose and try to wean them off when possible. We don’t issue repeat prescriptions and patients must speak to a doctor if they request strong analgesia. Patients are unhappy, it creates huge work for receptionists, and makes our life very difficult. But, what if just one patient was to complain that, on one hand we didn’t give them appropriate analgesia for their pain or, on the other, that we were responsible for them becoming habituated. No win. Just one example from everyday practice. It’s a tightrope. No wonder GPs are anxious.
Domhnall MacAuley is primary care editor, BMJ