A parent’s lifestyle choice – part two


Mrs Smith came to see Dr Pai as she had lost some weight and was finding it hard to concentrate at work.

She told Dr Pai that she has cut out protein and carbohydrate from her and her family’s diet after reading an article that said it helps people live longer. Her and her two young children mainly eat green vegetables now.

When Dr Pai suggested that she sees a dietitian for advice Mrs Smith refuses, becomes upset and leaves the surgery abruptly.  


Dr Pai calls Mrs Smith two weeks after their consultation. He explains that he’d like to see her again to talk about the diet, its effect on her children, and her own health more generally. 

Mrs Smith insists that she’s fine, that she knows what’s best for her family, and doesn’t need to come back in. Dr Pai asks the practice health visitor to help monitor the effects of the diet on the family. 

The health visitor tries to contact Mrs Smith several times over the next two weeks, but her calls aren’t returned. She tells Dr Pai that a routine health visit to Mrs Smith’s youngest child is also overdue because Mrs Smith hasn’t been in contact with her about that either.  

What the doctor did.  

Dr Pai asks for advice from his named doctor for child protection without sharing the identities of Mrs Smith or her children. This discussion doesn’t allay his concerns for the children’s welfare.

Together the doctors agree that if Dr Pai can’t make contact with Mrs Smith in the next few days, he should involve other agencies to help the healthcare team give the family the support they need. 

What the doctor had to consider 

  • If a doctor consider abuse or neglect as a possibility, but does not think the child or young person is at risk of significant harm, he/she should discuss their concerns with a named or designated professional or lead clinician or, if they are not available, an experienced colleague.
  • If possible, doctors should do this without revealing the identity of the patient concerned (paragraph 43).