GPs increasingly investigated for self-prescribing

GPs are facing heightened scrutiny over self-prescribing with those who prescribe themselves even non-addictive drugs such as antibiotics increasingly under investigation, medical defence experts have warned.

An analysis by the Medical Defence Union of self-prescribing cases - the first such analysis since the GMC issued revised guidance on the issue in 2008 - shows that a growing number of pharmacists and medical colleagues are reporting GPs who self-prescribe to the GMC and PCTs.

The MDU handled 38 self-prescribing cases between 2008 and 2011, up a fifth since the previous three-year period, with antibiotics the second most common class of drug behind benzodiazepines.

A Pulse poll in 2007 found some 43% of GPs admitted to writing prescriptions for their own personal use, including antibiotics and strong painkillers.

The MDU analysis found: ‘Doctors are likely to appreciate that self-prescribing a drug such as a hypnotic or an antidepressant may lead to concerns that they might have a health problem potentially impacting on their fitness to practise, but many may consider that a prescription for a drug such as an antibiotic would not be likely to be a cause for concern.'

'However, of the seven cases involving a prescription for antibiotics, there was a disciplinary investigation by the employer in two cases and a GMC investigation into the practitioner's fitness to practise in three cases.'

Dr Jacqueline Phillips, MDU medico-legal adviser and a former GP in Hampshire, told Pulse: ‘There does seem to be a trend that these more innocuous drugs are causing concern – antibiotics didn't feature much before 2008. There is a much more regulatory climate in medicine and it seems people are far more aware that GPs should not be self-prescribing.'

LMCs have also reported that GPs are coming under greater scrutiny. In a recent newsletter Bedfordshire and Hertfordshire LMC told GPs ‘we have reasons to remind doctors that it is unwise to self-diagnose and self-medicate', while earlier this year NHS Leeds reported it had investigated a ‘number of cases of doctors prescribing controlled drug's, hypnotics, or significant quantities of analgesia for themselves of their family.'

Dr Richard Vautrey, GPC vice chair and a GP in Leeds, said: ‘Doctors rightly take pride in looking after their patients well but sometimes they are not so good at looking after their own health. All doctors should be registered with a GP and should use them rather than self-treating. It is much safer for them to get an objective view from a fellow GP.'

Table:

Medication	Number of cases
Benzodiazepines	10
Antibiotics	8
Opiates	7
Non-benzodiazepine hypnotics	5
Antidepressants	4
Proton-pump inhibitors	1
Steroids	1
Nicotine preparations	1
Cardiac medication	1
Appetite suppressants	1