At 00:07 16/11/1996 -0800, Chris wrote:
>Hi there, repository of all wisdom!
>
>Please consider this scenario. All replies apprecicated. When all replies
>are posted, I will post what "my friend" actually did.
>
>GP (non-fundholder) suspects motoneurone disease in one of his Patients,
>refers to local Consultant. Local Consultant refers to Neurologist at
>teaching hospital. Neurologist does all the tests confirms diagnosis and
>starts Patient on riluzole
>
>Riluzole is a potentially toxic drug with a low therapeutic index. It
>requires regular monitoring, both of any therapeutic effect (which may be
>slight or not occur at all) and the side effects. It is also very
>expensive.
>
>Neurologist writes to GP begging him to continue the prescribing while
>not explicitly describing the management plan.
>
>What should the GP do?
>
Refuse. Clinical responsibility falls solely on the prescriber, not the
adviser:-(
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Dr David J Plews
email: [log in to unmask]
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