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Dilemmas

Dilemma: My trainee reacts badly to feedback
Dilemma: My trainee reacts badly to feedback

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Dilemma: Partners complain when I take time out for childcare
Dilemma: Partners complain when I take time out for childcare

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Dilemma: Partner says I make too many referrals
Dilemma: Partner says I make too many referrals

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Dilemma: Patient with white-coat hypertension refused surgery
Dilemma: Patient with white-coat hypertension refused surgery

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Dilemma: Patient shares a recorded consultation on social media
Dilemma: Patient shares a recorded consultation on social media

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Dilemma: Hospital sends patient for pre-op MRSA screening
Dilemma: Hospital sends patient for pre-op MRSA screening

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Dilemma: Patient calls for advice from overseas
Dilemma: Patient calls for advice from overseas

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Dilemma: Patient always attends with suspected abusive partner
Dilemma: Patient always attends with suspected abusive partner

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Dilemma: Practice criticised for having no male GP
Dilemma: Practice criticised for having no male GP

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Dilemma: Care home demands GP visit after resident falls
Dilemma: Care home demands GP visit after resident falls

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Dilemma: My partners are refusing to let me pay my own tax
Dilemma: My partners are refusing to let me pay my own tax

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Dilemma: Partner reacts aggressively to workload ‘dumping’
Dilemma: Partner reacts aggressively to workload ‘dumping’

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Dilemma: Patient with learning disability refuses care
Dilemma: Patient with learning disability refuses care

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Dilemma: A frail patient has no means to pick up an urgent script
Dilemma: A frail patient has no means to pick up an urgent script

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Managing a distracted GP partner
Managing a distracted GP partner

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Dilemma: Dealing with a difficult reference request
Dilemma: Dealing with a difficult reference request

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Dilemma: Tackling a colleague’s racist remark
Dilemma: Tackling a colleague’s racist remark

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Dealing with a patient angry about rationing
Dealing with a patient angry about rationing

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Dilemma: A patient tells you he plans to travel to Syria
Dilemma: A patient tells you he plans to travel to Syria

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How to deal with a patient selling on prescription drugs
How to deal with a patient selling on prescription drugs

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What should I do if a patient asks to see a ‘proper’ GP?
What should I do if a patient asks to see a ‘proper’ GP?

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Brow-beaten by a senior partner? Here’s what you should do
Brow-beaten by a senior partner? Here’s what you should do

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Train driver on tricyclic refuses to inform employer. What should I do?
Train driver on tricyclic refuses to inform employer. What should I do?

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A carer proposes covertly medicating a patient – what should I do?
A carer proposes covertly medicating a patient – what should I do?

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Can I refuse to treat a dental abscess?
Can I refuse to treat a dental abscess?

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What do I do if a patient forges a sick note?
What do I do if a patient forges a sick note?

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A patient won’t see a ‘non-white’ GP
A patient won’t see a ‘non-white’ GP

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Can I allow access to a deceased patient’s notes?
Can I allow access to a deceased patient’s notes?

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Can I insist patients get vitamin D over the counter?
Can I insist patients get vitamin D over the counter?

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Can we issue private prescriptions to NHS patients?
Can we issue private prescriptions to NHS patients?

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How should we respond to negative comments on social media?
How should we respond to negative comments on social media?

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Locum dilemma: What do I do about a practice that hasn’t paid me?
Locum dilemma: What do I do about a practice that hasn’t paid me?

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Locum dilemma: A practice is assigning me the most difficult patients
Locum dilemma: A practice is assigning me the most difficult patients

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Locum dilemma: Do I have to sign these prescriptions?
Locum dilemma: Do I have to sign these prescriptions?

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How do I discipline a member of staff who is also a patient?
How do I discipline a member of staff who is also a patient?

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How do I encourage a patient to see our pharmacist?
How do I encourage a patient to see our pharmacist?

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How can I protect a patient ‘forced’ to change their will?
How can I protect a patient ‘forced’ to change their will?

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Do I have to refer a patient for homeopathy?
Do I have to refer a patient for homeopathy?

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How should I clear common hurdles of revalidation?
How should I clear common hurdles of revalidation?

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Do we continue prescribing BP drugs without review?
Do we continue prescribing BP drugs without review?

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Do I have to record drug taking in a patient’s notes?
Do I have to record drug taking in a patient’s notes?

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Can I accept a Valentine’s Day gift?
Can I accept a Valentine’s Day gift?

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Five ethical dilemmas from 2015 – what would you do?
Five ethical dilemmas from 2015 – what would you do?

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Can I share a photograph of a patient’s skin condition?
Can I share a photograph of a patient’s skin condition?

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My colleague is depressed, but won’t see their GP. What should I do?
My colleague is depressed, but won’t see their GP. What should I do?

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Should we reimburse a wasted prescription charge?
Should we reimburse a wasted prescription charge?

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What do I do about a partner who seems too close to pharmaceutical companies?
What do I do about a partner who seems too close to pharmaceutical companies?

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Can I stop a patient recording our consultation?
Can I stop a patient recording our consultation?

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What do I do if a patient’s parents fundraise for an illness their child doesn’t have?
What do I do if a patient’s parents fundraise for an illness their child doesn’t have?

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Should I worry about being trapped in a sinking practice?
Should I worry about being trapped in a sinking practice?

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Are Good Samaritan acts a bad idea?
Are Good Samaritan acts a bad idea?

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Should I report a patient I suspect of benefits fraud?
Should I report a patient I suspect of benefits fraud?

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How to manage rising workload
How to manage rising workload

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Patient continues to drive despite warning
Patient continues to drive despite warning

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What will happen if I leave the UK?
What will happen if I leave the UK?

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How can I protect these girls from FGM?
How can I protect these girls from FGM?

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What should I do if a 12-year-old girl wants contraception?
What should I do if a 12-year-old girl wants contraception?

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Tackling common problems for new GPs
Tackling common problems for new GPs

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What should I do if my colleague isn’t following our prescribing policy?
What should I do if my colleague isn’t following our prescribing policy?

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How should we deal with fit note fraud?
How should we deal with fit note fraud?

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My practice manager has missed a LES payment. What should I do?
My practice manager has missed a LES payment. What should I do?

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We want to cancel appointments if a patient is over 10 minutes late
We want to cancel appointments if a patient is over 10 minutes late

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A local paper criticised wait times at our practice. How can we cope with the fall-out?
A local paper criticised wait times at our practice. How can we cope with the fall-out?

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I am facing big losses following a PMS review. How can I make savings?
I am facing big losses following a PMS review. How can I make savings?

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We know our PMS review is in the pipeline. What can we do to prepare?
We know our PMS review is in the pipeline. What can we do to prepare?

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Can we say no to requests for medicals from a local school?
Can we say no to requests for medicals from a local school?

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Disparaging social media comments – is a ‘zero-tolerance’ policy acceptable?
Disparaging social media comments – is a ‘zero-tolerance’ policy acceptable?

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Should I join a partnership that relies on MPIG funding?
Should I join a partnership that relies on MPIG funding?

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We have been denied permission to close our list. What should we do?
We have been denied permission to close our list. What should we do?

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How can I retire from my singlehanded practice if no-one takes it over?
How can I retire from my singlehanded practice if no-one takes it over?

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What can we do to prepare for an influx of new patients?
What can we do to prepare for an influx of new patients?

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Dilemma: Practice website undermines CCG
Dilemma: Practice website undermines CCG

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I can’t get the locum cover for maternity leave, what should I do?
I can’t get the locum cover for maternity leave, what should I do?

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Dilemma: Can you train health care assistants to syringe ears?
Dilemma: Can you train health care assistants to syringe ears?

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Dilemma: Locum cancels at last minute
Dilemma: Locum cancels at last minute

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Dilemma: Staff use training sessions for holiday
Dilemma: Staff use training sessions for holiday

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Dilemma: GP criticises colleagues in public
Dilemma: GP criticises colleagues in public

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Dilemma: GP prescribes antidepressants for her daughter
Dilemma: GP prescribes antidepressants for her daughter

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Dilemma: Demand for information on vulnerable child
Dilemma: Demand for information on vulnerable child

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Dilemma: Vulnerable patient reveals relationship with receptionist
Dilemma: Vulnerable patient reveals relationship with receptionist

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Dilemma: Woman accuses her carer of abuse
Dilemma: Woman accuses her carer of abuse

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Dilemma: Retiring partner won’t sell up
Dilemma: Retiring partner won’t sell up

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Dilemma: Publishing your CQC rating
Dilemma: Publishing your CQC rating

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Dilemma: Care home too demanding
Dilemma: Care home too demanding

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Dilemma: Adding patients from outside practice boundaries
Dilemma: Adding patients from outside practice boundaries

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Dilemma: Rumours one partner has an online gambling problem
Dilemma: Rumours one partner has an online gambling problem

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Dilemma: D-dimer testing
Dilemma: D-dimer testing

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Dilemma: Should you treat an overseas visitor?
Dilemma: Should you treat an overseas visitor?

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Dilemma: Disgruntled patient
Dilemma: Disgruntled patient

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Dilemma: Uncomfortable request for reference
Dilemma: Uncomfortable request for reference

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Dilemma: GP writes NHS scripts instead of private ones
Dilemma: GP writes NHS scripts instead of private ones

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Dilemma: LES row among partners
Dilemma: LES row among partners

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Dilemma: Suspicions a patient may be selling medicines on
Dilemma: Suspicions a patient may be selling medicines on

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Dilemma: Referral management centre introduced
Dilemma: Referral management centre introduced

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Dilemma: Self-prescribing
Dilemma: Self-prescribing

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Dilemma: Recreational drugs
Dilemma: Recreational drugs

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Dilemma: Vested interests
Dilemma: Vested interests

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Dilemma: A staff complaint about bullying
Dilemma: A staff complaint about bullying

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Dilemma: Drunk-driving patient concerns
Dilemma: Drunk-driving patient concerns

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Dilemma: Practice manager needs support
Dilemma: Practice manager needs support

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Dilemma: Incentive scheme to reduce referrals
Dilemma: Incentive scheme to reduce referrals

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Dilemma: Doubt over thyroxine prescription
Dilemma: Doubt over thyroxine prescription

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Dilemma: Partners disagree over QOF strategy
Dilemma: Partners disagree over QOF strategy

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Dilemma: Ambulatory blood pressure monitoring
Dilemma: Ambulatory blood pressure monitoring

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Dilemma: Downsizing partner
Dilemma: Downsizing partner

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Dilemma: Replacing a retiring partner
Dilemma: Replacing a retiring partner

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Dilemma: Sick partner asks you to skip child’s birthday party
Dilemma: Sick partner asks you to skip child’s birthday party

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Dilemma: Contraception request raises an abuse concern
Dilemma: Contraception request raises an abuse concern

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Dilemma: Late termination
Dilemma: Late termination

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Dilemma: Conflict of interest with a referral
Dilemma: Conflict of interest with a referral

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Dilemma: Anti-privatisation pledge cards
Dilemma: Anti-privatisation pledge cards

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Dilemma: Underperforming salaried GP
Dilemma: Underperforming salaried GP

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Dilemma: Your patient forges a doctor’s letter
Dilemma: Your patient forges a doctor’s letter

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Dilemma: Recruiting an extra partner to deal with demand
Dilemma: Recruiting an extra partner to deal with demand

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Dilemma: A GP overprescribes benzodiazepines
Dilemma: A GP overprescribes benzodiazepines

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Dilemma: Poor communications with your CCG
Dilemma: Poor communications with your CCG

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Dilemma: A slow-consulting partner
Dilemma: A slow-consulting partner

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Dilemma: Path lab confidentiality
Dilemma: Path lab confidentiality

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Dilemma: Child safeguarding
Dilemma: Child safeguarding

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Dilemma: When a partner burns out
Dilemma: When a partner burns out

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Dilemma: Treating an overseas patient
Dilemma: Treating an overseas patient

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Dilemma: An employee burns out
Dilemma: An employee burns out

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Dilemma: Suicidal patient
Dilemma: Suicidal patient

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Dilemma: Racist patient
Dilemma: Racist patient

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Dilemma: Borderline trainee
Dilemma: Borderline trainee

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Dilemma: Patient record contains distressing details
Dilemma: Patient record contains distressing details

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Dilemma: Partner is ‘nominated parent’ for time off
Dilemma: Partner is ‘nominated parent’ for time off

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Dilemma: Estranged parent’s request for record access
Dilemma: Estranged parent’s request for record access

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Dilemma: Harassing calls from the parent of a patient
Dilemma: Harassing calls from the parent of a patient

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Dilemma: A conflict of interest between partners
Dilemma: A conflict of interest between partners

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Dilemma: Prescribing fertility treatment on the NHS for self-funding patients
Dilemma: Prescribing fertility treatment on the NHS for self-funding patients

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Dilemma: Honour-based violence
Dilemma: Honour-based violence

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Dilemma: Should I make staff cutbacks?
Dilemma: Should I make staff cutbacks?

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Dilemma: Cancer records request
Dilemma: Cancer records request

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Dilemma: A patient moves but doesn’t want to deregister
Dilemma: A patient moves but doesn’t want to deregister

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Dilemma: Renting premises to a complementary therapist
Dilemma: Renting premises to a complementary therapist

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Dilemma: Family conflict over end-of-life care
Dilemma: Family conflict over end-of-life care

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Practice dilemma: Should we track our urgent referrals?
Practice dilemma: Should we track our urgent referrals?

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Dilemmas: Revalidation
Dilemmas: Revalidation

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Practice dilemma: Records change request
Practice dilemma: Records change request

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Practice dilemma: Return address may breach confidentiality
Practice dilemma: Return address may breach confidentiality

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Practice dilemma: Patient dependant on prescription medicine
Practice dilemma: Patient dependant on prescription medicine

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Practice dilemma: Nurse injured at work
Practice dilemma: Nurse injured at work

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Should my practice register asylum seekers?
Should my practice register asylum seekers?

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Practice dilemma: Patient’s parent upset over contraceptive script
Practice dilemma: Patient’s parent upset over contraceptive script

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Practice dilemma: Flexible working arrangements
Practice dilemma: Flexible working arrangements

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Practice dilemma: Gym certification
Practice dilemma: Gym certification

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Can you remove a patient from your list without complaint?
Can you remove a patient from your list without complaint?

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Practice dilemma: Police request patient records
Practice dilemma: Police request patient records

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Quality and productivity QOF dilemmas
Quality and productivity QOF dilemmas

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Practice dilemma: Wrong flu vaccine
Practice dilemma: Wrong flu vaccine

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Practice dilemma: Parents’ request for medical records
Practice dilemma: Parents’ request for medical records

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Practice dilemma: Administering flu vaccine without consent
Practice dilemma: Administering flu vaccine without consent

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Practice dilemma: Delegating flu administration
Practice dilemma: Delegating flu administration

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Practice dilemma: Sexually harassed receptionist
Practice dilemma: Sexually harassed receptionist

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Practice dilemma: Assessing mental capacity
Practice dilemma: Assessing mental capacity

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Practice dilemma: Sharps box injury
Practice dilemma: Sharps box injury

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Practice dilemma: Changing working hours
Practice dilemma: Changing working hours

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Practice dilemma: Flexible working
Practice dilemma: Flexible working

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Dilemmas in consent and capacity
Dilemmas in consent and capacity

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Practice dilemma: An elderly patient
Practice dilemma: An elderly patient

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Practice dilemma: Fake sick note
Practice dilemma: Fake sick note

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Practice dilemma: Missing diamorphine
Practice dilemma: Missing diamorphine

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Practice dilemma: Sharing paternity leave
Practice dilemma: Sharing paternity leave

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Practice dilemma: Maternity leave
Practice dilemma: Maternity leave

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Practice dilemma: An offensive comment
Practice dilemma: An offensive comment

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Practice dilemma: Risk of infection
Practice dilemma: Risk of infection

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Practice dilemma: Breach of patient confidentiality
Practice dilemma: Breach of patient confidentiality

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Practice dilemma: Sexist comments
Practice dilemma: Sexist comments

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Practice dilemma: Positive discrimination?
Practice dilemma: Positive discrimination?

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Practice dilemma: Bowel cancer
Practice dilemma: Bowel cancer

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Practice dilemma: Time off for language classes
Practice dilemma: Time off for language classes

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Practice dilemma: Sick leave for IVF?
Practice dilemma: Sick leave for IVF?

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Practice dilemma: New salaried GP
Practice dilemma: New salaried GP

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Practice dilemma: Request to remove depression diagnosis
Practice dilemma: Request to remove depression diagnosis

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Practice dilemma: PCT wants access to records
Practice dilemma: PCT wants access to records

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Practice dilemma: Shared care
Practice dilemma: Shared care

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