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Pots, kettles and MURs

QOF-trocities may be few and far between, but GPs should think twice before laying into pharmacists over MURs, warns a disarmingly even-handed Copperfield

Now don’t get me wrong. I’m very firmly in the camp that believes pharmacists’ medicines-use reviews (MURs) are a waste of time, money and paper. They duplicate what we GPs do, make statements of the bleedin’ obvious (‘this patient takes a statin and so ought to have his cholesterol measured once a year’) or spout dumb-ass suggestions which I can’t actually recall any examples of because, to be honest, it’s been a long time since one of these troubled my retinas before finding its way to the bin.

But hang on. Let’s not get too exercised about the notion that these MURs – to quote the story – border on ‘fraud’. Comments from pharmacists like, ‘they were opportunistic, simple as that, actually’, and ‘I just pick the ones who are on the least amount of medication’ sound less like a pharmacy scam and more like the attitude we GPs adopt when faced with a new game.

After all, don’t we cherry-pick QOF according to what gives us the biggest wins/drives us the least bonkers? And the whole concept of dancing to a tune that’s more ‘ker-ching’ than clinical is hardly anything novel. Give a bunch of slightly bored professionals a new diversion and make some of their income dependent on it, and I guarantee they will play the game, sometimes quite creatively – remember health promotion clinics?

So we don’t need another front page story to tell us we’re not whiter than white, even if the real QOF-trocities are few and far between, and their perpetrators get what they deserve. But it does mean that the holier-than-thou card really isn’t ours to play – and, besides, it’s a distraction from the real issue.

Which is that the thinking behind MURs is a pig’s ear – even if pharmacists can make a silk purse out of it.

Dr Tony Copperfield is a GP in Essex.

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