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Where does medicine stop and social work begin?

Last week I went on a home visit to see an elderly lady who is a patient at my surgery. After some fruitless digging around the presenting complaint of ‘unwell’, she admitted she had no real medical symptoms and was just lonely since her husband had died. She declined to attend a day centre, or let me speak to AgeUK on her behalf.

Back in the surgery that afternoon I saw a young man whose wife was severely disabled. He came to ask my opinion on if him seeing another lady to meet ‘his needs’ was OK.

Neither medical school nor VTS has equipped me to know how to deal with such problems. The man surely needed a priest for moral guidance, or a few good friends at least – why on earth was he coming to me? What would the answer be if he had phoned up 111 to seek a GP’s advice out of hours? I’d like to see the answer to that automated triage call.

My instinct with the lady was to pop over and see her now and again, until a partner in the practice suggested that if we started setting up a lonely-old-lady visiting rota we wouldn’t have time to visit any patients who were actually sick.

My question is this – where are the boundaries of medicine? At what point do we say this isn’t medical and I can’t help - or do we never say that? They didn’t teach me that either.

Dr Julie Fry is a GPST3 in Cheltenham.