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Sympathy for Phil

From Lesley Frater, advanced clinical practitioner, Washington, Tyne and Wear

I think Phil Peverley is stuck between a rock and a hard place with the dilemma he tackled in 'Undone by a red nose' (Columnists, 31 May).

I agree with his initial decision about using the money for this woman's treatment for hip replacements, or you could argue more towards treatment for cancer. It depends if this young woman's condition is causing her psychological and emotional problems, which I presume she thinks it is as Phil says she has been requesting help for the past six years. Does she have bulbous nose rosacea, which I understand will just worsen with age? I also presume she was referred to dermatology as conventional treatments were not working. I think Phil has to take a good hard look at his caseload to determine if the money could be better spent, not just because he does not think the laser treatment is worth it, but will the patient benefit?I don't envy Phil this decision.

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