The LMC is regularly involved in representing and supporting doctors who have been identified as having "performance" issues. The LMC has identified themes which recur, and this regular feature from our newsletter will highlight these, so that our members can avoid these pitfalls.

Informing specialists when GPs change medications

Clinicians in general practice often stop or alter doses of medications which have been initiated by specialists as a result of patient reactions or poor response.  When clinicians do this, they should inform the relevant specialist that they have made this change to avoid confusion and potential harm when the specialist next has contact with the patient.

In a recent example, a patient was started on an antidepressant by a specialist and the practice continued to prescribe this.  After a few months the patient reported feeling no better, so the GP increased the dosage, but did not inform the specialist.  The specialist then spoke to the patient, who did not divulge that they had already increased the dose.  The specialist advised the patient to double their dose, based on the belief that they were still on the starting dose.  The patient unfortunately had significant cardiac side effect from this excessive dose.

LMC recommends that clinicians inform specialists when medications initiated by specialists are amended in general practice