Abstract
You are a GP trainee in a busy city centre practice. You suffer with chronic back pain, which can be severe and requires regular analgesia. One day you are suffering with acute back pain while at work and phone your own GP to ask for a pregabalin prescription. This has worked well for you in the past. You decline assessment, as you would struggle to take time away from the practice and persuade your GP over the telephone to issue a script. You restart the pregabalin and find it very effective, although it does make you feel dizzy. Much later you discuss your pain and the side effects of the medication with your practice manager as you are worried about driving and the effect on your work in the practice. He is sympathetic but mentions how busy the practice is and that taking time off would have to be an absolute last resort. You feel compelled to carry on working and continue to take the pregabalin. You are fearful of weaning off the pregabalin, as recommended by your GP. You are worried you may become dependent on it.
What factors affect the appropriateness of prescribing analgesia following a telephone consultation rather than a face-to-face review? Who could you discuss your conversation with the practice manager with? Where else might you access support?