Do pharmacists counsel patients less now because of MURs?


MEDICINES Use Reviews (MURs) were introduced to pharmacy about 10 years ago as a sweetener to reduce the bad taste of savage cuts in funding to the sector. What impact have MURs had? How have they changed the relationship between pharmacist and patients? A financial incentive for pharmacists to speak to their patients can only be a good thing, right?

In 1970, Richard Titmuss wrote a book called the The Gift Relationship. In the book he contrasts the difference between the US and UK blood donar service. Donars in the US were paid for their contribution, while in the UK they were not. The UK system was much more successful.

This contrast poses some interesting questions, including: can financial incentives sometimes have a negative effect? In the UK system people donated their blood out of a sense of duty. It was a selfless act for the greater good. By monetizing donations in the US, it become a selfish act and there was less motivation to endure the discomfort of donating.

In Israel, in the 1990s, 10 day-nurseries introduced a small fine for parents who were 10 minutes or more, late to pick up their children. The number of parents late to pick up their children doubled. The feelings of guilt when they were late to pick up their children was off-set by the fine, so they were less motivated to be on time.

Mainstream economists often believe that humans are only motivated by monetary incentives, this is because they believe that everyone else is like them. Thankfully, most of us are not like mainstream economists. Of course people are motivated by money, but they are also strongly motivated by love, friendship, community, duty, pride and family.

Back to MURs, by monetizing the act of pharmacists speaking to his/her patients about their medicines, did we reduce the sense of duty pharmacists felt to speak to all their patients about their medicines?

Do pharmacists speak to their patients less now than 15 years ago when there was no monetary incentive to do so?

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