The Boerewors Emergency Medicine Chronicles: Dr Feelgood and his magical prescription pad

Friday 17 July 2009

Dr Feelgood and his magical prescription pad

So this young woman comes in , in the process of experiencing an allergic reaction to Suboxone,a drug that is used to treat opiate addiction . She had just taken her second dose in an attempt to wean herself off of codeine.

After pumping her full of anti-histamines and steroids,I also decided to give her a nebuliser,as she was asthmatic and was having a slight bronchospasm.Whilst she was sucking the salbutamol,her partner was talking to me ,busily trying to excuse her addiction.

(I have no time for addicts...or their pathetic lies and excuses and lifestyles...perhaps one day the Human Genome project will find a gene that predisposes people to destructive addictive behaviour...and when it does...well...bite me!!)

It all the doctors fault!!

"Uh huh...does he come over to your house and shovel the tablets down her throat then?"

Well...no

"So why is it his fault then...and not hers?"

Well...she is getting 900 codeine tablets a month from him...and has been for eight years!

Say what!!!

This guy is prescribing 900 x 30mg-tablets...every month for this patient...for her back ache!!

And she gets them for about £7-10 per month from a nice clean well lit pharmacy...you wouldn't even be bothered to try and score some free-market pharmaceuticals on the street would you?

Good grief...I can't eat 900 M&M's in a month!!And I love M&M's!!

Honestly...if you really...really thought that your patient required that much codeine for a back ache,wouldn't you at least send her for an x-ray...even a physio assessment perhaps?

So...for 10 points...which of the following explains the GP's prescribing habits

he is bored
he is venial
he doesn't care any more since the Labour Party locked him into a fat-cat contract that really only requires him to pitch up at work every day and send everything to the teaching hospital
he doesn't look at the repeat-prescriptions handed to him by his staff on a daily basis before signing them because it interferes with his golf tee off time
he hasn't bought any drug-tracking software
he is bribing the regulatory authorities
he is getting sexual favours from the patient...and all the others
And is therefore chronically exhausted

all of the above

Answers on a postcard to the Chief Medical Officer...

Image from Jupiterimages.com -Royalty free- as usual

1 comment:

Anonymous19 July 2009 at 19:29
do you think the south africans are the best at trauma or the isralis?
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I work as an autonomous Emergency Nurse Practitoner serving a charming English seaside town called Little-Ghetto-on-Sea, on the East coast, closer in fact to Europe than to London.
We treat a wide range of minor illness and injury , with admitting privileges to St Vulva's, the main academic hospital some 20 miles away .
It is apparently one of the UK's most densely populated city's...and fits Littlejohn's discription in the Daily Mail when he says,"most British seaside towns are run-down dole-claimant dormitories,which seem to take a perverse delight in driving people away through a combination of rip-off prices , tatty boarding houses and disgusting food and draconian parking regimes" . It often feels as if it is the setting for 'Little Britian' which most foreign readers will know is more social commentary than cutting-edge comedy.Indeed most of the male patients are typically shaven headed pierced,inked,dirty-fingered,dull eyed ,baseball-cap wearing, unemployed smokers with prodigious drinking skills. The women have a limited vocabularly, ranging from "innit" to "my (human) rights" with not much else inbetween.Invariably they have several children from different consorts (love that word!) and walk through the town talking on their cell phones and ignoring their children.There are few vegetarians and even fewer graduates.

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