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Apparently anything and everything a patient ever does is my fault



According to the BBC (and Asthma UK), GPs are neglecting patients by prescribing the wrong sort of inhaler to the wrong sort of asthmatic. Apparently we never seem to notice that Vlad the Inhaler puts a request in for four salbutamol MDIs every week or that Wheezing Bob is still picking up prescriptions for LABAs but no ICSs, or whatever.

And of course, it’s our fault that these precious lives are put at risk.

This is complete (and I mean complete ) b*llocks. I weep when I see the number of patients booked into my nurses’ asthma review clinics who simply can’t be arsed to turn up, despite responding to a text reminder.

As these patients have gone out of their way to receive second-rate medical care, it’s no surprise that they’ll have a significant asthma attack in no time at all.

And when they do, even if my surgery is open and able to see them at a moment’s notice, they’ll toddle off to A&E, because they know that we’ll insist on performing a proper review before we renew their (outdated) repeat prescription.

But A&E staff have better things to do. They’ll ‘treat and street’ the patient: hand over a new rescue inhaler and send them on their way with a solemn reminder to get an asthma check-up PDQ at their GP surgery. 

Of course, as it’s an entirely unnecessary waste of A&E’s time, I can look forward to a b*llocking from NHS England, seeing as anything and everything a patient ever does is ultimately my fault if it goes wrong.

There is, of course, no connection between this Kafkaesque state of affairs and the fact that each and every GP who is within sight of his or her pension is heading for the door marked EXIT. Not even 5,000 newly-recruited GPs – and God alone knows which sofa the Secretary of State has been hiding them behind – can compensate for a resignation on that scale, let alone provide the NHS with enough trained medics to deal with current workload.

Frankly I’m amazed at how few of my patients get away without at least an annual check-up, but that’s testament to the amount of work the practice nurses put into to hunting them down or ambushing them in the waiting room when they’ve turned up to see a GP about something else.

By the way, someone ought to tell the bloke in the picture on the BBC story that his metered dose inhaler will work far better if he uses a spacing device with it. That’s Asthma 101. Perhaps he ought to have a chat to his practice nurse about it?

Dr Tony Copperfield is a GP in Essex. You can follow him on Twitter @DocCopperfield.