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GPs ‘risk conflict’ when asking about alcohol

GPs risk potential conflict with patients after asking them about their alcohol intake, as they may be asked to disclose this in future, warn medical defence experts.

The Medical and Dental Defence Union of Scotland says they have dealt with a number of situations where asking about alcohol has subsequently led to conflict between doctors and patients, for instance when they have been asked to declare any alcohol issues for insurance or work-related reports.

The MDDUS said GPs may have to breach patient confidentality at times, and consider whether the actions of a patient posses a risk to themselves and others – without the patient’s consent.

Under GMC guidance, GPs must ensure that any smoking and alcohol history is written on a patient’s medical report, but a patient must consent to this – if they choose not, these details can be hidden.

MDDUS medical adviser Dr Barry Parker said GPs should not shy away from asking about alcohol intake, but should ensure they communicate clearly when they may have to disclose this information.

He said: ‘It is extremely important that excess alcohol intake is identified in order to make patients aware of the risk. But patients may not always be aware of the consequences of such a disclosure.

‘For example, insurance or occupation-related medical reports sent to the patient’s GP for completion may ask specifically about smoking and alcohol history and, under GMC guidance, the doctor must ensure that any such reports are accurate and do not omit relevant information or be misleading.

‘Patients must consent to the release of reports, but they may wish the report completed but dispute the inclusion of the documented alcohol history, leading to disagreements.

‘Furthermore, those with significant alcohol misuse may pose a risk to themselves or others, either in the workplace, if using firearms, or if continuing to drive when under the influence of alcohol.’