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Apparently anything and everything a patient ever does is my fault

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According to the BBC (and Asthma UK), GPs are neglecting patients by prescribing the wrong sort of inhaler to the wrong sort of asthmatic. Apparently we never seem to notice that Vlad the Inhaler puts a request in for four salbutamol MDIs every week or that Wheezing Bob is still picking up prescriptions for LABAs but no ICSs, or whatever.

And of course, it’s our fault that these precious lives are put at risk.

This is complete (and I mean complete ) b*llocks. I weep when I see the number of patients booked into my nurses’ asthma review clinics who simply can’t be arsed to turn up, despite responding to a text reminder.

As these patients have gone out of their way to receive second-rate medical care, it’s no surprise that they’ll have a significant asthma attack in no time at all.

And when they do, even if my surgery is open and able to see them at a moment’s notice, they’ll toddle off to A&E, because they know that we’ll insist on performing a proper review before we renew their (outdated) repeat prescription.

But A&E staff have better things to do. They’ll ‘treat and street’ the patient: hand over a new rescue inhaler and send them on their way with a solemn reminder to get an asthma check-up PDQ at their GP surgery. 

Of course, as it’s an entirely unnecessary waste of A&E’s time, I can look forward to a b*llocking from NHS England, seeing as anything and everything a patient ever does is ultimately my fault if it goes wrong.

There is, of course, no connection between this Kafkaesque state of affairs and the fact that each and every GP who is within sight of his or her pension is heading for the door marked EXIT. Not even 5,000 newly-recruited GPs - and God alone knows which sofa the Secretary of State has been hiding them behind - can compensate for a resignation on that scale, let alone provide the NHS with enough trained medics to deal with current workload.

Frankly I’m amazed at how few of my patients get away without at least an annual check-up, but that’s testament to the amount of work the practice nurses put into to hunting them down or ambushing them in the waiting room when they’ve turned up to see a GP about something else.

By the way, someone ought to tell the bloke in the picture on the BBC story that his metered dose inhaler will work far better if he uses a spacing device with it. That’s Asthma 101. Perhaps he ought to have a chat to his practice nurse about it?

Dr Tony Copperfield is a GP in Essex. You can follow him on Twitter @DocCopperfield.

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Readers' comments (4)

  • Drachula

    Oi. Pulse. I want to rate this 5, not 1! Why won't your interface let me change it?
    (Sorry Copperfield - 5 stars really. I always love your rants)

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  • Maybe the reason they don't come for their asthma reviews is because they can't come at 7pm on a Sunday night? Surely the answer must be for us to be open 12 hours a day 7 days a week?

    And maybe in the other 12 hours a day we should be making sure they are OK, maybe by going to their houses and administering their preventers ourselves? After all, there are 24 hours in a day and why should GPs not work all of them, just like the politicians do?

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  • Apparently anything and everything a patient ever does is my fault

    - yes it is.

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  • As a (relatively mild) asthmatic I can't be arsed to see my GP for an asthma review. And I'm a GP - oops! There's something about asthma that makes us sufferers deny its severity or need for review until desperate. Not the GP's fault!

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From: Copperfield

Dr Tony Copperfield is a jobbing GP in Essex with more than a few chips on his shoulder