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Don't be 'too helpful', GPs warned

By Gareth Iacobucci

GPs should beware of the risks of being ‘too helpful' to their patients, such as by prescribing unlicensed medicines or getting drawn into their life 'beyond the surgery'.

Medical defence experts are warning that getting too closely involved in non-clinical matters and ‘going that extra mile' for patients can backfire on GPs.

The Medical and Dental Defence Union of Scotland (MDDUS) said it had dealt with cases of GPs giving in to patients' demands for banned medicines such as coproxamol; and prescribing ‘weird and wonderful' medicines that patients have read about or seen on the internet.

Other GPs were said to be going to ‘extraordinary lengths' to refer patients, such as hand-delivering letters after work or driving patients to appointments.

A recent Pulse investigation found that GPs are increasingly unwilling to take the legal risk of prescribing coproxamol, with the number of scripts halving in six months.

But Dr Jim Rodger, medico-legal adviser and head of professional services at MDDUS, said that there was still evidence that compassion for patients in difficulties may blind a doctor to the risks, and advised GPs to adopt ‘healthy emotional disengagement'.

Writing in the latest edition of Summons, the magazine of MDDUS, Dr Rodger said GPs should avoid giving help and advice to families in relation to such matters as ‘powers of attorney, capacity or incapacity, or the validity of wills.'

‘Becoming too closely involved in such matters risks legal proceedings or getting embroiled in family disputes,' he said.

Dr Rodger also warned GPs not to involve themselves in disputes with employers over a patient's suitability for work, or work-related illness. ‘Unless you have expertise in occupational medicine, tread very carefully,' he said.

He advised GPs that getting too drawn in to a patient's life ‘beyond the surgery' could lead to questions of competence, and to complaints if advice offered on things like tackling debt problems go wrong.

Dr Rodger warned that doctors also risk harm to their own emotional and mental health.

‘Burnout and compassion fatigue are real issues for GPs,' he said.

‘GPs are well suited to having a holistic view of patients' physical, social and psychological issues. But some patients present with a seemingly irresolvable tangle of interrelated problems.

‘Trying to ‘take on' such patients can be exhausting and thankless. Often the best a doctor can hope for is to manage problems and conditions as they arise.'

GPs should avoid getting too drawn into a patient's life 'beyond the surgery'

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