Multidisciplinary care

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‘Mate I’m getting seriously black poo — definitely getting my iron intake, lol!’

I received the above text message from a friend and, unsurprisingly, it raised a few alarm bells. And not just because a grown man had written ‘lol’ in a text message.

‘I spoke to the pharmacist, he said nothing to worry about, it’s all the vitamins I’m taking.’

And herein lies my concerns about the ways in which GP work is increasingly being shifted to other healthcare professionals.¹

In the case of my friend, although I’m not his doctor, I know his medical history well. I knew he suffers from indigestion. I knew he recently had a tooth removed. I knew he likes a few beers after football and that he smokes five cigarettes a day.

It emerged he had been taking high doses of ibuprofen to control his toothache. The multivitamin he was taking contained just 14 mg of iron. He went straight to A&E, and by the following morning had been diagnosed with a gastric ulcer. Thankfully, he is now on the road to recovery.

This is in no way meant to be disparaging towards pharmacists, colleagues whom I respect immensely. But it does concern me. The RCGP’s The 2022 GP talks about working in federated organisations, with patients receiving routine care from a variety of healthcare professions.² But who will take overall responsibility for patients’ care?

I fear that in our need to alleviate pressure, we run the risk of going too far in asking other professionals to take on some of our duties. With this we not only lose part of what makes our job the one we chose, but also risk doing our patients harm.

As GPs we have a unique and privileged role. We get to know our patients well. We take on all aspects of their clinical care, and have the breadth of training to enable us to do so, safely and effectively. Although multidisciplinary teams are no doubt effective, we must remember to ensure that someone is looking at the wider picture.