Thirty-year-old Mr P had suffered from facial and palmar hyperhidrosis and blushing since he was fourteen. Over the years, he had tried various over-the-counter remedies and a period of psychotherapy with no success. Although he had learned to live with his condition to some extent, he found it socially inhibiting and believed that it was preventing him from progressing in his career as an accountant.

Non-therapeutic circumcision of male children is carried out for religious or ritual reasons and is generally not available on the NHS.1 There is also a significant issue related to the appropriateness of the facilities in which the operation is carried out and a lack of formal training and certification in circumcision.

Baby T was eight weeks old when his mother brought him to his GP’s morning surgery. His mother had become increasingly concerned about his general irritability and frequent crying episodes, which lasted up to two hours. These had become apparent over the past three days, not settling with breast feeding.

Mr S was a 60-year-old lorry driver. He was overweight and smoked, and couldn’t walk far because he suffered with pain in his calves.

When Mrs C, a keen golfer in her early forties, began to experience constant pain in her lower back, she consulted a GP at her local surgery. Dr P took a history of slow onset of pain with restricted mobility. He did not examine her, but prescribed an NSAID and advised Mrs C to return in two weeks if there was no improvement.

Dealing with claims accounts for about 1/5 of the cases we handle. This video examines a claim made against a consultant surgeon because he left out critical information from a patient’s notes.

Mr G was a 62-year-old office worker; he was overweight (BMI 29) and suffered from exercise-related angina. Mr G had several risk factors for ischaemic heart disease including smoking, diabetes mellitus and hypercholesterolaemia. Following a positive exercise test, a coronary angiography confirmed triple vessel coronary artery disease with a left ventricular ejection fraction of 45%. He was referred to Mr F, a consultant cardiothoracic surgeon, for consideration of coronary artery bypass graft (CABG) surgery.

Mrs M was a 64-year-old care assistant in a retirement home. She visited her GP with a two-month history of blood in her stools, altered bowel habit, and intermittent lower abdominal discomfort.

Retired engineer Mr S, 77, went to see his GP, Dr J, with symptoms of dizziness. He had returned from a pacemaker check at the hospital that morning and while travelling home on the train he had started to feel off-balance. He managed to get an emergency appointment to see Dr J, by which time the symptoms were resolving.

This Essential Guide to Clinical Management was produced as a resource for Medical Protection members in the UK. It is intended as general guidance only.