Digest Number 880

[frogsisland.freeserve.co.uk]

This is more or less what I do, and it works. I have 6 weeks in my Notes but
in practice extend it to the normal review time for that particular
patient. ( I have 6-weekers, 8-weekers ,3-monthers and occasionals )
I also feel that it can be quite unprofessional and potentially harmful to
prescribe for people one hasn't seen for a long time. The acute may well be
the tip of some iceberg or more acute than the patient themselves realises.
Young mothers in particular are not always the best judges of how serious a
condition is. I do prescribe over the phone for people I am in regular
contact with and sometimes for the 'occasionals' where, as in the abscess
case quoted, the nature of the acute seems very obvious and I do know the
patient quite well, even though I haven't seen them recently. However to
charge is to formalise the arrangement and make it 'OK' , making it harder
to use your discretion in the future.
Going back to the doctor analogy, doctors themselves seem to be increasingly
reluctant to diagnose and prescribe over the phone, presumably because of
the potential consequences of a mistake for the patient and themselves.

Theresa
Terry wrote:
One fractioned I know, establishes the grounds rules as - if you have not
had a personal consultation in the last 3 months, he insits on an in person
consultation. No advice is given unless the person has a file!