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Independents' Day

Letter: GMC has not banned doctors from treating family

One of Pulse’s bloggers wrote that GMC guidance banned her from treating family members, but she was wrong

From Niall Dickson, chief executive of the General Medical Council (GMC)

Dr Shaba Nabi’s article, ‘GMC rules shackle GPs who want to care for their kids’, gives your readers the mistaken impression that GMC guidance bans doctors from treating family members in all circumstances.

Objectivity is essential to good clinical care – that is why our guidance does advise that, wherever possible, doctors should avoid giving medical treatment to themselves or anyone with whom they have a close personal relationship. That does not mean abandoning common sense or worse putting patient safety at risk. Of course doctors must exercise their professional judgement – and in an emergency it would obviously be wrong not to treat, if there were no alternative.

What we do expect of doctors is that they apply the principles within ‘Good Medical Practice’ and our explanatory guidance on prescribing in the context in which they find themselves – we also expect them to document clearly what action they have taken, not least for the benefit of the patient’s continuity of care.

Readers' comments (14)

  • The advice given by Mr Dixon is barely any different from an outright ban.

    There are very few circumstances, other than an out and out emergency, where alternatives are not available.

    The example given by Dr Nabi could still leave her falling foul of the GMC unless she could show there was no prospect of an assessment by another doctor within a reasonable timescale.

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  • Who are the high and mighty at the GMC who have ordained this ban on treating family?

    This is an organisation run for the benefit of GPs and I don't remember any vote which put this in place.

    Just because some ivory tower doctors have achieved political power doesn't mean they actually speak for all doctors, especially where they are making judgements limiting care which is the key skill of all doctors.

    Not prescribing controlled drugs for family or friends unless there is a genuine emergency and you are willing to declare that you have is entirely reasonable.

    Failing to provide care for anyone who needs it is unjustifiable, and goes against the basic Hippocratic oath.

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  • NHS is free. In any other country if you see a doctor for migraine it will cost you lot of money. do you really expect doctor to seek other doctor's advise??all doctors where there is no nhs treat there family friends and neighbours. GMC should have advice which applies to all doctors of the world.
    do they have same principal for dentist???

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  • This is always a tricky one for the Pharmacist when presented with a Private Script (usually) or ocassionalyy a hand written GP10. I usually laugh it off as trying to get me in trouble with the GMC but do dispense what is most frequently antibiotics. I have Colleagues however who refuse to dispense a prescription for a family member under any circumstance. The GMC needs to regulate the matter beyond interpretation.

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  • I have got colleagues who state that they have no option as the family member refuses to change the practice as they say that it is their human right to choose the practice of their choice.what does the GMC advice then.

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  • The GMC guidance does not form a ban. It reinfoirces exactly the same professional standards in a specific exemplar of family.
    As in any other circumstances,you should ensure your professional opinion is expert and objective enough to meet the pateints needs; that in circumstances of clinical urgency even where you are aware your objectiveity or expertese may not be of the usual high standard you can treat but be required to explain the " risk ;benefit" assessment that took place to the GMC.
    All it changes was the widespread impression it was "ok to treat your family , bcause they are not exactly going to sue you if you've messed up."
    I would want my family to have the same standard of care as any other person, i would treat in urgency and be happy to account for a weighted decision as to how it was in the patients best interests at that point, but i insist they are registered as I am with a local GP.
    Maybe I am lucky in where I live as unlike the Daily mail and NHS England perfomance meme, there is not a GP in a 10 mile radius I would not be happy for me or my family to recieve care from.

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  • GP's should not be allowed to treat their own family in the same way as staff at a practice cannot be a patent at the same practice, neither can GP's be patients within their own practice.

    It is about being fair and feel sure if it were allowed, the system would be abused.

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  • You have to remember that a lot of GMC advice is impossible to follow and just put there to try and entrap doctors. Read their impossible guidance on the use of chaperones for example.

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  • If there was one available appointment and it was your child or someone else, who would get the appointment?

    GP's cannot treat their own staff or colleagues so why should they be allowed to treat their own kids?

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  • Part of the problem here is - as so often with the GMC - that it produces guidelines that are vague and woolly.

    Clearly there would be issues with e.g. prescribing controlled drugs for a family member without the detachment necessary to be cope with manipulation; or with treating a seriously ill family member when it's outside your competence without asking for help.

    But there are so many instances when there is no good reason why a doctor shouldn't treat a family member, if they'r competent to do so. A GP who prescribes antibiotics for a routine infection in the same way as they would for a patient with the same clinical picture is surely doing no harm.

    But the way the guidance is written makes it difficult to behave in the way we tell our patients to behave. We ask them to self-care instances of minor illnesses (for themselves and their children). Are doctors permitted to give their febrile (but not apparently seriously ill) child paracetamol? That's treating the child, after all.

    "Oh, but the GMC won't be interested in that!", you'll retort. But they will if the febrile illness turned out to be the onset of a fulminating septicaemia. The fact that given what you saw at the time it was perfectly appropriate, exactly what you'd expect any parent to do at the time, and you'd need a crystal ball to know the child was going to be dead from meningococcal infection in the morning won't stop the GMC from hounding you to suicide, especially if the gutter press get in and give you a kicking first. (They do respond more punitively when there's press interest as we've seen on many occasions.)

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