ALL doctors should have their own treating GP, but according to the Doctors’ Health Advisory Service, more than 50% of doctors don’t.
But where’s the harm? Surely a script or two can’t hurt? We take a look at two different scenarios.
The GP registrar
You are enjoying a long-awaited family BBQ after the end of lockdown and everyone is enjoying the beautiful spring weather. You are feeling relaxed and not thinking about work when your younger sister comes over.
“Can I ask a really big favour?”
Your heart sinks because you know she is going to ask you for a script. She says she has run out of Panadeine (GlaxoSmithKline) and she has a terrible headache. She is due to work that night, and she doesn’t want to call in sick. You write the script and tell her this is the last time.
You forget all about it, until two months later when you receive a letter from Ahpra asking for a medical report and medical records for one of your patients. The patient, a nurse with a different surname to you (your sister), is being investigated by the Nursing and Midwifery Board for concerns about misuse of codeine. You realise you have no notes, and you now have to confess and disclose your relationship to Ahpra.
The impaired GP
You are a year away from retiring after 45 years in practice. Your staff have worked with you for a number of years, and they often tease you about your terrible memory. You continue to work full time, despite chronic pain from osteoarthritis, declining cognition and issues with sleep.
You don’t have your own GP, and you don’t think you need one! As a solo practitioner, you don’t have time to see a doctor; if you need a script or referral, you just write it yourself.
Most of your patients are older, long term patients, and they seem happy to laugh off your “funny ways”, but this changes when the son of one of your patients makes a report to Ahpra.
The lengthy complaint includes a number of examples of when you were not at your best. Ahpra starts talking about possible impairment, and you are shocked when they issue a Notice of Immediate Action on receipt of your prescribing history.
You are surprised by the number of scripts you wrote for yourself over the previous year, including Valium (Roche), Amitriptyline (Sandoz) and Endone (Aspen Pharma). You remember writing the odd script, but it looks so much worse now that it is all listed.
According to Good medical practice: a code of conduct for doctors in Australia, good medical practice includes:
- Having a GP.
- Seeking independent, objective advice when you need medical care, and being aware of the risks of self-diagnosis and self-treatment.
- Not self-prescribing.
- Keeping accurate, up-to-date and legible records that report relevant details of clinical history, clinical findings investigations, diagnosis, information given to patients, medication, referral and other management in a form that can be understood by other health practitioners.
- Whenever possible, avoid providing medical care to anyone with whom you have a close personal relationship.
If treating yourself or those close to you puts you on the wrong side of the Code of Conduct, it may be time to re-think your approach.
Dr Nerissa Ferrie is a Medico-Legal Advisor with MDA National.
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