Working with doctors Working for patients

 

Introduction

Katy is a 20 year old student who's been going out clubbing a lot, experimenting with illegal drugs and casual sex. Dr Newell has strongly-held views based on her faith (she's Catholic) and personally disapproves of Katy's lifestyle.

Katy has come to see Dr Newell because she's been having anxiety attacks ever since she "took too many pills two or three weekends ago". These attacks have stopped her sleeping at night and her health is suffering as a result.

Katy

Katy

I just lie awake with my heart racing and my breathing getting shallower and shallower, like I'm going to die. I can't relax - I'm a million miles from relaxing - and I'm terrified that I'm never going to get any sleep and it'll just get worse and worse...

Dr Newell

Dr Newell

Yes it does sound like you're having anxiety attacks. They may well have been brought on by taking drugs. Katy you really need to think carefully about your lifestyle. If you're serious about your exams...

Katy

Katy

Of course I'm serious about them! I'm only doing what every other student my age is doing. Except sleeping! Can you help me Doctor Newell? My sister had panic attacks for a while when she was about my age and had some dizie-...diaz.

What should the doctor do...? (Select A,B or C)

A

Refuse to provide treatment for Katy unless she agrees to settle down and not take any more illegal drugs?

B

Refer Katy to the practice counsellor and prescribe her a small amount of tranquilisers (benzodiazepines) and stress that she must avoid alcohol and illegal drugs as there could be a dangerous interaction with the medication?

C

Don't prescribe her the tranquilisers but refer her to the practice counsellor for management of anxiety and discussion about her risky behaviour?

Dr Newell

See what the doctor did

Dr Newell decided to prescribe Katy the tranquilisers, and told her about the dangers of taking them while drinking alcohol or taking other drugs. She also referred her to the practice counsellor.

Dr Newell also advised Katy about the potential effects of her lifestyle on her health and well-being and suggested that if she was serious about her exams she really must settle down. She also gave Katy a follow-up appointment for two weeks' time.

References

You must treat patients fairly and with respect whatever their life choices and beliefs.
(Good Medical Practice paragraph 48)

You must support patients in caring for themselves to empower them to improve and maintain their health. This may, for example include improve and maintain their health. This may, for example, include:
a. advising patients on the effects of their life choices and lifestyle on their health and wellbeing.
b. supporting patients to make lifestyle changes where appropriate.
(Good Medical Practice paragraph 51)