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​GPs’ actions ‘responsible for increasing patient demands’, claims BJGP piece



GPs have to take some responsibility for overdemand from patients because they overprescribe and build on ‘fan the flames’ of society’s health concerns, an editorial in the BJGP has claimed.

Dr Des Spence, a GP in Glasgow, and a tutor at the University of Glasgow, wrote in the British Journal of General Practice that GPs should ‘prescribe less, intervene less and refer less’, as they are ‘fanning health anxiety’ by handing out antibiotics unnecessarily. 

He says over-prescribing is having a ‘far-reaching cascade effect on our time’, which results in a higher number of referrals and an increased workload.

The opinion piece concludes that society’s ‘health-seeking behaviour’ is a product of clinical practice, adding that the debate on workload should instead be a debate about clinical practice because ‘good medicine can only be achieved through good access, and good access can only be achieved by less medicine’.

Dr Spence writes: ’We can blame a scaremongering media, Dr Google, or those dumb popularist disease-awareness campaigns. But they are not to blame. A society’s health-seeking behaviour is in fact the product of the clinical practice of their doctors.

’The current clinical practice of us GPs is responsible for the increasing demands on general practice in the UK.’

GPs themselves can help reduce their workloads, he says: ’If we want to reduce stress and workload the solution is in our hands only. We need to prescribe less, intervene less, and refer less. This can be done at practice level by implementing non-prescribing policies, actively stopping medications, and analysing referral patterns.

’Nationally, GPs need to seize total ownership of primary care guidelines, and kick off the idiot aristocrat specialists who know nothing of primary epidemiology and project unrealistic guidance from flawed hospital-based research. Finally, good medicine can only be achieved through good access, and good access can only be achieved by less medicine.’