Bet it was over pregabalin
Are we really going to put someone on allopurinol for life after one episode, that may never recur, with all the expense, possible side effects and polypharmacy involved? Seems overkill to me and hardly a holistic approach. What is the supposed downside to delaying? Possible 1st MTPJ OA? Is that something that come up often on GP lists? If there were a risk of other pathology then we would likely be discussing allopurinol anyway.
I would have thought this would be good news? Cut polypharmcay, cut expense, cut workload, cut risk.... why are we moaning?
If you are an A&E consultant how much sick pay, annual leave, study leave, training, pension and indemnity does your pay include?
With a positive spin from the press.... "Incredible efficiency in General Practice as GPs manage increasing workload with decreasing numbers of staff and funding".
If I saw a raised Plt count with no obvious cause I wouldn't think it would be too unreasonable to have a quick feel of the tummy, PR, CXR, faecal calprotectin and urine dip. Cheap and cheerful and could potentially save a life or two? It would put you in a much safer position to then recheck the Plt in a month or two.
Brew the perfect storm and then deconstruct.
When is debrief? In the middle of the trainer's afternoon surgery?
Its a difficult line to draw for longer term regular medications - paracetamol for example - where it is unrealistic for someone with severe OA to restock every four days from the pharmacy. But I completely agree with the sentiment. I think there would have to be a clear set of terms. This, however, would not be a challenge to draw up. I often refuse OTC meds and with a little explanation - "if we save money on this we have more money to spend on more complicated things like treating cancer" - even the most hardened free prescription user often shrug and accept the outcome.