It seems only five minutes ago that we had the last ‘GPs dish out antibiotics like Smarties’ story, possibly because it was. This time, it’s GPs dish antibiotics out like Smarties, again – plus a warning that, if we continue to do, so we might be reported to medical regulator the General Medical Council (GMC).

Apparently, the idea is to spot GP outliers using the available antibiotic prescribing data, put them on the Naughty Step, then wave some Serious Sticks if they still refuse to change their profligate ways.

The day this story broke, my first two patients in morning surgery – and I’m not making this up – were each demanding antibiotics from me. Both left empty-handed and disgruntled – and both left me pondering how we GPs are now between the rock of the GMC and the hard place of patient dissatisfaction.

The obvious truth is that GPs, like everyone else, want to avoid complaints – they’re stressful, demoralising and time-consuming. And the likelihood of complaint is far greater from a patient than an appraiser. Particularly when we decline to give patients what they want, rather than need – I’ve never heard of a GP receiving an official complaint for doing too much (amoxicillin prescribing), whereas I know plenty who’ve had complaints of doing too little (amoxicillin prescribing).

So, ultimately, GPs will seriously reduce their prescribing of antibiotics when patients stop demanding them. That’s a massive educational exercise involving GPs, pharmacists, NICE, public health and the media. And it will need a huge amount of time and energy - so why are the powers-that-be wasting both by indiscriminate finger wagging?

Dr Messenger is a GP trying to negotiate the impenetrable structures and commissioning quagmires of the reformed NHS. Genuinely good friends with his local pharmacist, he offers a GP take on the primary care issues of the day. Please don't shoot, he comes in peace

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