Abstract
You are working as a ST3 in general practice and your trainer has asked you to discuss your referrals with him or other senior colleagues. You see a 61-year-old lady in surgery who is very concerned about a pigmented lesion on her back. You share her concern about the lesion and decide to refer her to the local dermatology clinic through the 2-week-wait pathway. You ask your trainer to review the lesion and to confirm the management plan. Your trainer dismisses your concerns and feels that the lesion is a seborrhoeic keratosis and proceeds to reassure the patient that a referral is not necessary. Several weeks later the patient returns to see a different GP at the practice and is referred to the local dermatology clinic where the diagnosis of malignant melanoma is subsequently confirmed. You read the clinic letter and are very upset to learn about the diagnosis.
Who would you talk to in the practice about this experience? How might you discuss this with your GP trainer? Where does the responsibility lie for the initial decision not to refer?