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Ten alternatives to saying no to patients (1 CPD hour)

Dr Malcolm Thomas lists ways that GPs can refuse inappropriate patient requests for prescriptions and reject demands for particular investigations or treatments without prompting complaints


This module offers advice on ways that GPs can refuse patient requests for inappropriate drugs, investigations and referrals, covering:

  • How to set up a practice protocol and informing patients of its existence
  • Ways to develop new consultation techniques
  • Alternatives to giving patients a ready prescription

After reading these articles you will be asked to record your learning points and some action points to earn a suggested 1 CPD credit. Below are some suggested questions to reflect on as you work through the module:

  • Have you the necessary prescribing, investigation and referral protocols in place to ensure a consistent approach?
  • Have you devised and agreed ‘practice rules’ e.g. the number of problems patients can reasonably bring to the doctor per appointment? Have you thought through how to communicate these to patients e.g. posters, doctor-patient contract?
  • Consider learning simple consultation techniques and phrases to soften a ‘no’.
  • Do you write delayed prescriptions? Under what circumstances might you consider doing this?
  • Are you familiar with alternatives to offer instead of prescriptions and referrals? Have you a directory of social/voluntary sector alternatives to offer patients?

Readers' comments (1)

  • Good suggestions to have protocol beforehand. The only exception is for a Locum when demand is more & complaints are more as well. Best is know & hold surgery when practice staff are around & supportive

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