Patient’s name: Elizabeth Freeman
Age: 50 years old female
Past Medical History
Medication history/ Allergies
You are Elizabeth, 50-year-old female. You are here to report some concerns as regards your last consultation with Dr. Barnes.
You had booked to see Dr. Barnes because your osteoarthritis pain in the right knee was not controlled with topical ibuprofen. During the consultation, you noticed the doctor looked exhausted, had red eyes and was sleepy like he had not rested for many days.
He rushed the consultation and did not even examine your knees like other doctors would do.
He then prescribed amitriptyline. You experienced dizziness as a side effect of amitriptyline and you were not told about this side effect. When you checked this up, you saw that amitriptyline is an antidepressant and a neuropathic pain medication and do not agree with Dr. Barnes judgement. You had to get codeine from the chemist and this is helping with your pain. You no longer feel dizzy since stopping the Amitriptyline.
Idea: You think Dr. Barnes was not fit to see you on the day he saw you.
Concerns: You are worried about other patient he saw on that day and their safety.
Expectations: You want the doctor to tell you how to file a complaints.
Questions for the doctor
Was Dr. Barnes decision to prescribe amitriptyline the right thing to do?
Seen by Dr. Phil Barnes (Clinical practitioner access role) 2 weeks ago
History: Recent X-ray confirmed osteoarthritis of right knee.
Patient says pain is not controlled with topical ibuprofen and sometimes affects her at night. No red flags, walking freely and not limping.
Plan: Start on Amitriptyline 25mg nocte. Worsening advice given.
Patient booked telephone consultation to discuss some concerns.
History
Let’s discuss the next steps we’ll take to address this OR you can say— thank you for sharing your concerns. I’m sorry to hear that you felt uncomfortable during the consultation, and I want to assure you that we take this matter seriously. Can I ask few questions to help understand what happened to see how I can be of help?
Patient booked routine appointment to discuss concerns
Management
How do you reply to her question as to whether your colleague did the right thing by prescribing amitriptyline?
Thank you for your question. Amitriptyline is often used to manage certain types of pain, especially nerve-related or chronic pain that may not respond well to standard painkillers. I can’t fully comment on Dr. Barnes’ decision since I wasn’t involved in you care at the time or able to assess the situation as he did. However, we can review your treatment plan if you are still in pain and see how best we can manage your situation.