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Singlehanded GPs give more unnecessary prescriptions

Singlehanded GPs are more likely to have high prescribing costs than those in group practices, a major Government-funded study has revealed.

The GP-led study found singlehanders were 59 per cent more likely to be in the top quintile of prescribing costs than GPs in group practices.

GPs with high drugs bills also saw drug industry representatives more frequently, prescribed newly available drugs more readily and gave in to patient pressure to write prescriptions that were not clinically indicated, the study of 1,096 GPs showed.

Study leader Dr Chris Watkins, a GP in Bristol, said GPs were not aware how much their prescribing habits were influenced by seeing drug company reps.

Singlehanded GPs were more likely to be isolated and to have to rely on drug reps for information about new products, he added. 'The results imply that drug reps may fulfil a pastoral need in these GPs.'

Earlier results ­ trailed in Pulse in 2001 but published last week in Quality in Safety and Healthcare (February) ­ showed 56 per cent of GPs in the top quintile of prescribing costs saw a drug company rep at least once a week compared with 29 per cent of GPs in the bottom quintile.

Only 34 per cent of GPs in the highest prescribing quintile resisted patient pressure to write a prescription that was not clinically indicated, compared with 48 per cent of GPs in the lowest quintile.

Highest-prescribing GPs were also three times more likely to try out new drugs on patients than lowest-prescribing GPs ­ 34 per cent compared with 9 per cent.

Apart from singlehanders, dispensing GPs, those working in deprived areas and those working in practices without a GP trainer were more likely to have high prescribing costs.

Small Practices Association chair Dr Michael Taylor was concerned the Government would use the results to bolster claims that singlehanded GPs provide inferior care.

He said: 'We are totally unfrightened of a debate. It will be great fun.'

But Dr Watkins hoped his study would not be used to vilify singlehanders. He said: 'There are very many singlehanded GPs who provide an exemplary service.'

Are singlehanded GPs too isolated?

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