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Killin GP’s future in the balance inappropriate prescription of medication

Killin GP’s future in the balance inappropriate prescription of medication

A village doctor has admitting that he prescribed strong sedatives inappropriately to patients for up to eight years.

Dr David Syme was reported to the General Medical Council (GMC) by Dr Elizbeth Watson, his partner at the Killin Medical Practice, over concerns about his prescribing.

As well as the string of prescribing failures, Dr Syme was found to have made “derogatory” remarks about Dr Watson to other members of staff, an allegation which he had denied.

Giving evidence at a Medical Practitoners’ Tribunal Service (MTPS) fitness to practise hearing, Dr Watson claimed that Dr Syme was aggressive towards her after she reported him.

She said he stormed into her room and shouted “you must really, really hate me” while waving his hands in her face.

Dr Syme’s position was that he had merely said “you must be very angry with me” and he maintained that there was no hand-waving.

The MTPS panel found Dr Syme had not been aggressive towards his colleague but decided that he had made derogatory remarks about her while discussing the case with fellow staff members.

In her evidence to the panel, Dr Watson said she had been scared to go into work after the incident.

She said: “It was just awful. I basically just went into myself, locked myself in my room most of the time.

“Life was horrendous because he was bitching about me to staff all of the time.”

Dr Syme denied talking about Dr Watson in a derogatory fashion but another doctor at the practice said she had heard him discussing the case with staff several times.

MTPS panel chair Katherine Whitehill told Dr Syme: “The panel considers that discussing matters relating to the GMC investigation openly and in front of staff in this way was inappropriate.

“It has determined that your reference to Dr Watson and apportioning blame for the GMC investigation to her during these conversations was derogatory.”

Dr Syme admitted a series of prescribing failures, mainly related to the prescription of the sedative diazepam, the generic term for Valium.

He doled the drug out to some patients for up to eight years and, in some cases, failed to consider other treatments.

In one case, he admitted giving a patient strong painkillers dihydrocodeine and morphine sulphate along with diazepam for more than three years, which an expert witness said fell “seriously below” the standard of a reasonably competent GP.

Dr Syme said he knew his care for the patient was “not good” and he had acted from a “misplaced sense of kindness” for the woman.

He also admitted giving the painkiller ibuprofen to a patient suffering from chronic kidney disease who was on the blood-thinning drug Warfarin, knowing that this can cause a “significant risk” of internal bleeding. Dr Syme said the patient’s case was “effectively terminal” and he was trying to improve her comfort.

He further admitted failing to pay attention to concerns raised repeatedly by other doctors at the practice about his prescribing; and failing to adhere to a prescribing policy which was drawn up.

The panel is now considering whether Dr Syme’s fitness to practise is impaired.

He could face restrictions on his practice, suspension, or could be struck off the medical register if it is found his actions amount to serious misconduct.

Mrs Whitehill said: “You are a man of good character and you have not been the subject of any previous adverse findings by a regulatory body.”

Dr Syme, who qualified as a doctor at the Edinburgh University in 1978, is currently under temporary GMC restrictions that prevent him from prescribing opiate drugs, benzodiazepines or hypnotics.

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