Use of Prescription Drugs and Investigations by Doctors in Primary Care Settings in Oman and the UK

he rising cost of healthcare around the world is a source of increasing concern for many governments.1,2 Although there are many factors driving this trend at both the national and international levels, every doctor has a responsibility to justify ordering investigations and prescription medications.Patient demand and a consumerist approach to healthcare puts pressure on doctors to investigate and prescribe more; however, this may not always be in a patient's best interests and can lead to overdiagnosis and the development of iatrogenic disease.3,4 The National Health Service (NHS) in the UK has struggled with these problems for years and doctors working within the NHS-especially in primary care-have become increasingly aware of the predictive value of investigations and the cost-effectiveness of medical treatments.5 In Oman, doctors often want to offer, and patients increasingly expect to receive, the latest treatments and investigations.Although these are often more expensive, they are not always more effective; to this end, the World Health Organization (WHO) runs a programme promoting the rational use of medicines in countries where polypharmacy is a major problem.6 It is important that doctors in training have an appreciation of these financial issues in order to carry forward best medical practices.The UK and Omani governments both provide socialised comprehensive national health services to all citizens, free at the point of delivery.7,8 Additionally, in both countries, primary care physicians are the gateway to secondary care services and have easy access to blood tests, medical imaging and clinical physiology tests.Trainees in