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Dispense with pharmacists

Copperfield is in a ruminative mood as he wonders, what's the point of pharmacists and their snake-oil nonsense?


I've reached that age where, after a half of shandy, I go all blubbery and philosophical, and ask anyone who'll listen: ‘What is the meaning of life?'

The subsequent pregnant silence presumably reflects the enormity of the question, or possibly the fact that I've just fallen off my chair.

So let's break ‘The meaning of life' into what educationalists would call ‘manageable chunks'. Starting with: ‘What is the meaning of pharmacists?'

Think about it. You explain to the patient your treatment. You discuss the side-effects. You print the prescription. And you hand it over. Job done. Except it isn't. Because now, the punter has to traipse over to a pharmacist to have it dispensed (yes, I know, unless you're a dispensing GP).

What's the point? What does this add except wasted time for the patient, opportunities to lose the script en route and the potential for dysfunction when the pharmacist queries why I've prescribed Mrs Scrunge and her arrhythmic heart a big dose of tricyclic antidepressant? (Believe me, I know exactly what I'm doing.)

So why do we need pharmacists? I'm sure there must be some rational explanation for their existence, but I can't be bothered to work it out, frankly – and I don't need to, because they're probably already frothing over the ‘comment' tab, ready to tell me. Whatever their desperate justification, the fact is, pharmacists are an inconvenient anachronism.

Which presumably explains their current existential struggle. On the one hand, they want to be taken seriously as health professionals making a significant contribution to primary care, and with ‘much more to offer'. And on the other, they insist on stocking their shelves with vitamins, snake oil and menopause magnets (I'm not making this up – I quote: ‘Attach the magnet to your underwear approximately four inches below the navel.' Jeez. Once, I'd wanted to be a fanny magnet; now I can just buy one).

They'll never have any credibility until they stop peddling rubbish. But then I guess they'd argue they'd never make much of a living if they favoured science over selling. A tricky dilemma, but it's theirs to solve.

Their current approach is to justify their existence, and distract attention from the nonsense, by expanding their role. Hence medicines use reviews, over-the-counter testing, forays into risk assessment and bluster about taking on chronic disease monitoring. In other words, duplicating what we GPs do already, but much worse.

Look, pharmacists, face facts. Either you're a collection of shopkeepers. Or your professional role largely boils down to pharmaceutical stock control. No wonder you get tetchy at the old jibe about being glorified pill-counters – it's a bit close to the truth.

And if it really is simply about ordering and providing drugs, I suspect most practices could manage that – given a cupboard, funding for a part-time post and someone who can count to 28. It would be more convenient for patients and a lot cheaper for the NHS. After a few years, we would wonder why pharmacists ever existed.

Anyway, I still don't know the meaning of life. But I do know why my fly zipper seems irresistibly drawn to menopausal women.

'Sick Notes' by Dr Tony Copperfield is out now, available from Monday Books

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