Can you just sign this prescription?

18th November 2016 by Rachel Birch

Can you just sign this prescription?

Dr A was doing a busy 10-minute appointment morning locum session in a practice and he received a flashy message on his screen mid-surgery. The message was from “Medical student 1” who asked him to sign a chest X-ray form for a patient. He told Dr A it was in the locum pigeon hole and asked that he give it to the patient who was in the waiting room.

Dr A was not even aware that the practice had a medical student. He telephoned reception to find out where the medical student was consulting and then knocked on his door. The medical student, Mr F told him that he was in his 4th year and had just started his GP attachment. The GP trainer, Dr B was out on a house visit. The patient had a recurrent chest infection. He just wanted to get the patient’s X-ray form signed and he told Dr A he was running late on his own consultations.

Dr A was concerned that Mr F had limited GP experience and remained unclear about the indication for CXR.

What should Dr A do?

  • Dr A should consider reviewing the patient himself as he has concerns about Mr F’s assessment of the patient and the treatment plan. The patient may require antibiotics as well as a CXR.
  • He may wish to invite Mr F to be present during this assessment, since this would be a teaching opportunity and he could ask Mr F to present the patient’s history, thus potentially reducing the consultation time.
  • Dr A is legally responsible for any X-ray request he makes and should be satisfied that he has reviewed and examined the patient and that the X-ray is indicated.
  • Since the GP trainer is out of the building, he should consider whether Mr F requires formal supervision until Dr B returns.
  • If he has concerns about patient safety due to inadequate supervision of Mr F, he should raise his concerns with the GP trainer at the end of his morning surgery.

Case 2 – Can you do me a quick prescription?

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