From the case files: A family matter

In this issue we share a case where a GP got in trouble prescribing for a family member, when a pharmacist reported him to the GMC

Dr T was an experienced GP in a busy practice. He went out one evening with his sister in the city centre; they were having dinner before attending the theatre. His sister complained of pain and discharge from her left ear, which was making her feel nauseous, dizzy and also affecting her hearing.

Dr T made a quick assessment of her ear and noted that it looked inflamed, swollen and tender, consistent with otitis externa. As this was a condition he came across frequently he felt confident in diagnosing and treating this condition. As it was in the evening and his sister was keen to attend the theatre performance Dr T felt the simplest solution was for him to prescribe some treatment for his sister. He also felt this would avoid wasting the time of an out of hours treatment centre and would speed the recovery of his sister.

He went with his sister to a large pharmacy in the city centre where they allowed him to write out a private prescription. Dr T prescribed some Gentisone HC ear drops for the infection and some cyclizine for her nausea. After a short wait the pharmacist reappeared and advised Dr T that she had discussed the matter with the GMC and stated that they were not willing to dispense the medications and the matter had now been reported to the GMC. Dr T advised his sister to attend her own GP the following day.

Several weeks later Dr T received a letter from the GMC asking for his employer’s details and also asking him to comment on the incident. The GMC advised Dr T that his revalidation would be put on hold until the investigation was completed. Dr T provided his employer’s details immediately and the GMC wrote to the Local Area Team to check that no previous concerns the response on the basis of Dr T’s instructions, setting out the reasons that led him to prescribe in these circumstances and demonstrating that as a consequence of this incident he had fully familiarised himself with the relevant GMC guidance.

"Wherever possible you must avoid prescribing for yourself or anyone with whom you have a close personal relationship"

Several weeks later Dr T received a further letter from the GMC advising him that they had considered the matter carefully and had noted that the prescription was for a drug that is not commonly abused or addictive. Dr T’s employers did not have any concerns about his clinical practice and he did not have a fitness to practise history with the GMC. As a result of all these factors they had decided not to take any further action; however, they did remind Dr T of the GMC prescribing guidance and advised him to reflect further on the incident at his next appraisal.

What the GMC says:

Wherever possible you must avoid prescribing for yourself or anyone with whom you have a close personal relationship.

If you prescribe for yourself or someone close to you, you must:

• Make a clear record at the same time or as soon as possible afterwards. The record should include your relationship to the patient and the reason it was necessary for you to prescribe.
• Tell your own or the patient’s GP what medicines you have prescribed and any other information necessary for continuing care unless (in the case of prescribing for somebody close to you) they object.