1

The patient has been diagnosed with a condition by a specialist, unknown to the GP. The specialist prescribes a medication. A month later the patient visits his GP, but three days prior to his appointment he discontinues the medication prescribed by the specialist.

What should the GP do:

  1. He should advise the patient to resume the medication.
  2. He should advise the patient not to resume the medication until the GP has seen the report from the specialist.
  3. He should not advise anything until seeing the specialist's report.
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    None of the above – Graham Chiu Mar 4 '18 at 8:33
  • This is impossible to answer, as it depends entirely on the medication, the reasons it was prescribed, the reasons the patient stopped it, the patient's other medications and conditions, and a myriad of other factors. Voting to close, unless someone can edit this to be a narrow enough case to have an answer, while at the same time is NOT personal medical advice - if that's even possible. – DoctorWhom Mar 5 '18 at 3:16
  • Also, the intent of asking this question is obviously not a GP wondering what to do about their patient who saw a specialist... So is this a patient asking what they should expect their GP to do? – DoctorWhom Mar 5 '18 at 3:24
  • The patient was diagnosed by the specialist as having dementia. I am questioning the professional ethics of the GP being complacent with the patient, unsupportive of the specialist, and indifferent to everyone who has to deal with the patient in an unmedicated state. I've instructed the nurse of the home he's staying in that he now needs to be supervised, and to hell with what the GP did or didn't say to him. The GP's equivocation is contributing to the patient's paranoia. – caduceus Mar 8 '18 at 6:27
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If the patient quit without sophisticated reason, a GP usually would advise the patient to resume the medication. They would also, of course, review the specialist's report when available.


Sophisticated reasons include:

  • quitting due to side effects.
  • quitting due to intake provides difficulty (fear of injections, fear of pills etc.).
  • other medical conditions the specialist wasn‘t aware of.
  • new medication prescribed from another therapist

and many more.

In such cases, the GP would do whatever is appropriate, but these edge cases are very much reliant on every single case, and as such unfitting for the Q&A format of SE.

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    It's the patients responsibility to communicate with the specialist regarding non adherence. – Graham Chiu Mar 4 '18 at 8:46
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    Patients experience side effects all the time. Need to communicate back and not just restart. – Graham Chiu Mar 4 '18 at 9:26
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    This is an unanswerable question as it stands, as it entirely depends on the situation. You might consider that a GP is a kind of specialist in bringing together the "big picture" of an individual's health. Usually there isn't a reason to discontinue or alter specialist recs, but sometimes there is very good reason to. I could give plenty of examples, but often healthcare is very disjointed, which is why someone who sees multiple specialists really needs a GP to evaluate and monitor the big picture. \ – DoctorWhom Mar 5 '18 at 3:09
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    Ideally the specialist would have had access to the patient's full medical records, and the GP would be able to read the specialist's notes. In that case, usually the GP would discuss with the patient the reasons he/she decided to stop the meds, and assess how best to proceed. The risks/benefits of continuing medications depends entirely on the medication and the individual's conditions. – DoctorWhom Mar 5 '18 at 3:14
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    Made a slight edit for word choice. Still hoping it gets closed but we ended up making a decent band-aid for it meanwhile, – DoctorWhom Mar 6 '18 at 7:59

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