Can a doctor overrule a consultant

Hi everyone

Hope you are all well

Just a quick question. Holly's consultant advised our gp that we should have a supply of pred at home to be used as required and stated we had to consult a doctor at some point after she had been given it. We've done this for months and when I ask the doctors have said that I've never given her it when it hasn't been necessary.

Got a phone call from doctors today saying that we wouldn't be getting her prescription for pred because the doctor who signs them doesn't think we should have a supply at home and if she needs them we'll have to go to on call, hosp or gp as and when required.

Can she overrule the consultant?

Anne

xx

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Ooooh, what a potentially prickly question you have there!

In short, yes, they can. Legally the doctor signing the prescription maintains the clinical responsibility for the medication and how it is used. If there were to be any come back as a result of the prescription being given, then it would fall on the doctor whose signature appeared on the script itself. If a doctor cannot satisfy themself that there is a clinical need, or feels that there are unacceptable risks associated with giving that drug, then they are quite within their professional right to refuse to sign the script - no matter who ordered it in the first place.

This is a problem that comes up more frequently than you might imagine - for example, a tertiary consultant specialist may prescribe some whizz-bang special drug that's not yet licensed. The GP would be medico-legally in a very dodgy position to continue scripts for this drug after the consultant's initiation, as prescribing off-license is a dodgy area and the GP could then be culpable if anything went wrong.

Perhaps in this case the doctor in question feels that if Holly needs pred then they would prefer for her to be seen first. Different doctors have different ways of doing things, and different comfort zones and concepts of acceptable risk - we *all* practice in slightly different ways.

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Thanks Cathy

It's good to have a logical side to the arguement. I think I've taken it quite personally and feel that it is a reflection on me and my ability to deal with Holly's asthma.

It was also just really handy to have the pred there instead of having to rush and drive for miles to the hospital or on call doctor or to have to wait for appointments, it gave us that extra bit of time.

However I'm sure it'll work out fine and I'll just need to go with it and see what happens.

Anne

xx

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I had simmilar prob with antibiotics, cons wanted but gp wouldnt supply so in the end got a supply from out patient? cant hollys cons do that?

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yep, but they can only overrule a consultant if they feel its in the best interests of the patient. I asked my GP the same thing when she upped my seretide last month. i think you may need to ask why the consultant was overruled