Dr George Fernie, Senior Medicolegal Adviser, introduces this issue’s round-up of case reports.
When treating patients who attend the surgery frequently, especially within a short space of time, it can be all too easy to be blinded by a familiar diagnosis based on pattern recognition, particularly if it is a commonplace, and seemingly innocuous, condition.
The safest approach when treating frequent attenders is to go back to basics: document a thorough history and be prepared to re-examine the patient if their symptoms change. Back pain is one of the most common complaints seen in general practice. Doctors may easily discount it, but it is important to remember that a small proportion of such cases mean serious or life-threatening pathologies.
In “Back with back pain”, Mrs S’s recurrent urine infections and back pain were found to be co-existing with non-Hodgkins lymphoma. Despite a claim being made against Dr F for failing to refer Mrs S earlier, Dr F’s good documentation of the history and each examination meant that this was discontinued. Experts found that there was a careful, well-documented assessment of Mrs S on every occasion, which showed that at no time was an emergency referral warranted.