Helen Salisbury: Where the buck stops

General practice is often promoted as a place where holistic care is offered. In our work we consider not just the patient in front of us but their family and employment—and not merely the physical symptoms of their illness but their effect on every area of the patient’s life. There’s a problem that follows from this: after these issues have been discussed, how do we then set boundaries around what is and is not our job to sort out?I can refer mobility issues to a physio or an occupational therapist, or care needs to social services, but a whole host of problems have no such obvious pigeonholes. Every GP will have tales of tasks they were asked to undertake outside their usual scope of practice. To persuade a very sick patient into an emergency ambulance, a colleague once promised that the practice would ensure that her dog was given its…
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