Are you telling me every GP would agree on what ought to be done in such a case?
Yes, the algorithms we use arn't perfect, but we're working on that.
And I think it is important to note that we (I'm not a GP), sometimes need to get away from the paternalistic "doctor knows best," - patient choice is important, indeed paramount in this case. I can prescribe as much poison as I want, it's down to the patient whether he takes it or not.
It's our job to give the advice, the patients choice whether to follow it.
(And please, don't get me started on "QOF"(targets))