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We rely on self-prescribing

I just can’t wait for the next instalment in the life of the GMC’s long-suffering fictional GP, Dr Julia.

Insiders assure me that in a real nail-biter of an episode, she drags herself off to work despite awful period pain, writes herself a private prescription for a few diclofenac tablets to get her through the day and finds herself facing a fitness to practise tribunal after a valiant pharmacist grasses her up. After taking her money plus a 35% dispensing fee, naturally.

So, there must no more dipping of our sticky paws into the emergency bag for an occasional omeprazole capsule after a night out on the town, a tasty wafer-based triptan to deal with a heartsink-induced migraine or even half a dozen trimethoprim tablets for the girlfriend’s cystitis.

The Medical Defence Union puts it this way: ‘Of seven cases involving a prescription for antibiotics, there was a GMC investigation into the practitioner’s fitness to practise in three cases.’

And all the GPs I know put it this way: ‘What the f**k???’

Before we know it, we’ll be reading news stories about electricians being held to account after changing their own light bulbs. 

All right, maybe not – anyone can change a lightbulb – but how about the thing under the stairs with all the fuses in? Now messing with that must be a job for a professional. But if ‘Mr Sparks – No Job Too Small – Free Estimates – No Call Out Charge’ replaced the one in his own house, would anyone accuse him of placing his family at risk?

Patients, we are warned, might have concerns about doctors who self-diagnose and self-prescribe.

How come? Surely they would be better advised to worry about doctors who can’t self-diagnose and self-treat, at least as long as that process includes an awareness that some things are serious enough to consult a colleague about.

Imagine: one night you’re chatting to your mate in the pub, a car mechanic who, by a credibility-stretching – but stay with me, it’ll be worth it – coincidence, owns the exact same make and model of car as you do.

You ask him: ‘How do you go about changing the front brake pads?’ He replies: ‘Oh, I would never service my own car, I couldn’t trust myself to get it right.’ How much of your business would he get in future?

Don’t get me wrong, I’m all in favour of GPs having GPs of their own. I’m absolutely about letting the family doc know if I’ve blagged some prescription-strength steroid ointment from the chemist’s shelf. And obviously I don’t think any doctor, GP or hospital-based, should be shopping in the BNF’s hypnotics, tranquillisers and controlled drugs section. But five days’ amoxicillin or a few metronidazole tablets? Come on.

I’m not in the running for any of my practice’s popularity awards at the best of times. Cancelling the morning’s surgery to consult my own GP every time I get a snotty nose or a bout of diarrhoea might not go down too well with the others at the coal face.

It’s not illegal, or even immoral, to self-treat if it saves time and minimises inconvenience to patients and our colleagues. And spare me the ‘thin end of the wedge’ routine. We all know where to draw the line.


Dr Tony Copperfield is a GP in Essex