Most of you will have seen this article but if not don't miss it- the online responses are well worth a read to..
http://www.bmj.com/content/344/bmj.d8360
A particular challenge for budding GP commissioners in the second response- do away with QOF and replace it with targets to promote sustainable living for our patients..seriously..
Wow! I am amazed at the second response to this article...what guts to stand up and write about what many doctors are too scared to say. This really does stir up a debate!
I's so true that 'if doctors began to shift their behaviour en masse, they might inspire a far wider and more rapid social and environmental change....the NHS, being so ingrained in society- could set a powerful practical example'. It has to come from the healthcare professionals 'on the ground', and not from the government 'on high'. We need to make these changes... any thoughts?
See:
Wow! I am amazed at the second response to this article...what guts to stand up and write about what many doctors are too scared to say. This really does stir up a debate!
I's so true that 'if doctors began to shift their behaviour en masse, they might inspire a far wider and more rapid social and environmental change....the NHS, being so ingrained in society- could set a powerful practical example'. It has to come from the healthcare professionals 'on the ground', and not from the government 'on high'. We need to make these changes... any thoughts?
See:
For thousands of years humans have used stories, fables & allegories to get important messages across and save them down the generations. Since reading Dr Liam Farrell's lastest column I have begun to wonder if this isn't something we should be learning from, and perhaps even integrating into our armoury to persuade the masses?? Dr Farrell's column isn't a million miles away from a childrens' story book with a message for parents too??
As to the point made by Christelle about having the courage to institute watchful waiting for hypertensive patients. I have begun to feel strongly that we are under-selling diet change as an intervention. I don't think it helps that as a profession we know precious little about diet change, compared to the reams of words we are expected to inhale about hypertensive medication constantly. This strikes me as the elephant in the room. I try to be as positive to patients as I can about diet as a way forward, and tell them as much as I can about it (the little I know), and am aware that I need to expand my knowledge further still.
Dr Liam Farrell's column from 11 January http://www.bmj.com/content/344/bmj.e68
Can lower BP by at least as much as a single antihypertensive drug- trials quote reductions in systolic 11.4 and diastolic 5.5mmHg respectively
Maybe this should be first line?
Make knowing what the local community can offer in terms of places to exercise and ways to meet new people and learn new things obligatory for all trainees/locums undergoing induction at every practice.
Make better use of exercise referral schemes, life skills courses, community voluntary organisations and faith-based groups,
Commission groups for mums with young babies to get to know others, run by the health visitor, which promote exercise, healthy eating, bonding and attachment, etc.
Put posters up about these things and link them with sustainability.
Have the practice call all over 75s to offer them an opportunity to speak to a doctor about making a living will.
Have the courage to undertake 'watchful waiting' for hypertensives determined to change their lifestyles in order to avoid medication..