Yesterday evening (Wednesday) I loaded up BBC iPlayer to watch the first episode of the new ‘Doctor in the House’ series.
In this programme, Dr Rangan Chatterjee, a GP in Manchester, is invited into the houses and lives of the public. He stays with them for 6 weeks, identifying the root causes of their health problems by analysing their lifestyles. After dissecting his patients’ behaviours that fall under the themes of diet, exercise, stress and sleep, he recommends and implements ‘lifestyle medicine’ interventions.
In December 2015 I wrote a blog called ‘The Power of a Doctor on the TV’ in response to this same series. The messages I drew remain the same;
Firstly, that a clinical diagnosis of disease is at one extreme of the disease spectrum. Wellness to sickness is not a binary switch.
This is not new. The progression to become sick is already understood by current healthcare models. We implement cholesterol and blood pressure checks as we appreciate that these give insights to disease.
What this episode added is that our markers of high blood pressure and altered cholesterol levels are signs of earlier, more subtle wrongdoings. Instead of relying on empirical blood result data, we should look at ‘biomarkers’ on a personal level; using a waist-hip ratio, perceptions of sleep and rest, identifying stressors at home and work.
Not only does this focus to softer ‘red flags’ recalibrate our definition of ‘disease’, but it empowers patients to take responsibility of their own health. Instead of relying on a paternalistic recommendation after a blood test at the GP’s laboratory, Mr Anyone can calculate their waist-hip ratio at home. Deeper interventions, such as stress management and meditation, is truly in the realm of the individual and cannot be powered by GP input.
In addition, this program confirms that preventative medicine can be a powerful tool that can be proactively employed by the individual. Rangan did not coerce his patients to complete any of his interventions. The emphasis was, deliberately, on informed consent. I think it would be better to say that Rangan promoted ‘educated’ consent; perhaps it was this extra level of doctor-patient engagement that catalysed the 1.5 stone weight loss, or the ‘metabolic age’ reversal from 55 to 36 years old.
These results emphasise that doctors should continue to promote and educate ourselves and the public of the benefits that lifestyle changes bring. Diet, sleep, exercise, food and stress. As chronic disease forms the main burden (social and economic) of disease in the UK and Western world, it is even more important that we address the overlooked emphasis of public health education.
Furthermore, this stuff isn’t being taught in medical schools with the right degree of emphasis, if at all. There is a HUGE case for making lifestyle medicine a key component of a medical curriculum, alongside the essential knowledge we gain to deal with acute medical scenarios and chronic disease management.
Diet, sleep, exercise, food and stress should be woven in to the teaching of the pathophysiology of a disease, and included as an adjunct to its treatment.
The Success of “Doctor in the House” emphasises the Power of Media.
This programme is on the telly. It would have spent months to be planned, filmed and produced. Finding the right families, staff, locations and practitioners to make it happen will have required a committed team. It took a large investment of time and money to make this program happen. Health education and preventative lifestyle medicine are placed on centre stage. This programme will have a great return on investment.
In my previous blog
, I emphasised that ‘medical TV is a great way to promote education to the public to create positive change.’
In this blog, I emphasise that we don’t need to rely on one doctor on the telly to be our source of education and inspiration.
The power of TV is great. The power of social media is greater.
Right now, I am connected to Facebook, Twitter, Instagram, LinkedIn, ResearchGate and Strava. So are all my family and friends. With a swipe and tap of these apps I can contact someone sitting next to me. Give an extra flick of the finger and I travel much further afield. Australia, France, Japan, America, You Name It.
Social media is so readily accessible that it is as if a population of patients is sitting in your pocket.
It is free – as a doctor, you don’t have to worry about accessibility of your patient to the point of care. 99.99% of people in the Western world have access to a smart phone. Want to help the third world? A rapidly increasing number of people in developing countries have smart phones too, because they are so invaluable as communication and business tools.
YOU DO NOT NEED a production crew or BBC funding to harness the same public health vehicle that Dr Rangan Chatterjee used to create a successful and effective wave of health education. You just need to embrace it’s younger (more powerful and better looking) brother.
I believe that any doctor can have a huge effect by utilising social media.
How many people do you expect to help in your medical career? 10,000?
Social media offers a platform to contact people worldwide, allowing you to help far more people than you would if you were limited to face-to-face contact in the clinic. Want to help people? Have a message? Use social media.
Do you use….
Facebook and Twitter?
– share links, blogs, articles.
– Set up a group on Facebook for your patients to foster an accountable health community.
– write your own blogs and articles!
– Post pictures of your healthy habits. Inspire and educate others.
– Eaten an incredibly nutritious lunch? Post it.
For extra value to your patients, explain why this is a good choice.
Help them make the same decisions.
– Went for a run? Post how great it made you feel.
Inspire someone else to lace up their shoes next time they feel down and out.
– Spent time with a long-lost friend?
Prompt others to pick up the phone to foster their own community.
If you’re on Social Media, let me pitch #MedicineForStudents to you:
When I revise, I find it is easy for my healthy habits to slip. Diet, exercise and sleep are overcome by stress, junk food and desk-time. This deterioration in my wellbeing was the inspiration for this new project.
I believe that students are a perfect audience for a public health movement.
For many, the move from life at home to the excitement of university is a period of huge change. People attend university to learn, make friends and attain a degree.
What they sometimes miss are the skills and habits that make healthy adults.
The aim of #MedicineForStudents
is to foster a community on social media to inspire, educate and promote healthful habits. I envision a scenario where students aid students to choose healthy behaviours, by sharing their exercise, meals or resources they have enjoyed. By making this knowledge freely available for others, it can be accessed before an individual becomes sick. It could trigger positive health behaviours in a generation of young people who will become the adults of tomorrow.
Finally, this is a message to all doctors. Your figures as mentors and educators to medical students is essential for the progression of medicine. If you believe in this even 40% as much as I do, please get sharing posts on social media.
Fostering a community takes community involvement!