A disturbing study published in BMJ Open shows that 1 in 3 doctors in the UK are 'burned out' and over a quarter experience secondary traumatic stress. One-third, the highest number being GPs, had low compassion satisfaction, failing to derive pleasure either from being able to help others and from doing their work well, often the main reasons GPs choose their specialty in the first place.
With GPs and emergency care docs being the most at risk of exhaustion, stress and ‘compassion’ fatigue, it’s no wonder that the Prescribing Lifestyle Medicine course on Saturday 25th January was filled to capacity with around 200 doctors and a waiting list for the not-so-lucky. Clinical Education, the not-for-profit company founded by Michael Ash, also one of the presenters, who delivered the course, can now attest to having trained over 1000 doctors. With around 40,000 GPs in practice, that’s about halfway to being a ‘significant number’.
Such is the demand from doctors now that the course is projected to be available online from the end of the year with further, possibly longer, in-person study for those that would like to progress.
Rob Verkerk and Meleni Aldridge were honoured to be invited to attend the course last Saturday and gain first-hand experience.
Prescribing Lifestyle Medicine is the brainchild of registered nutritionist and mucosal immunology specialist, Michael Ash, Dr Rangan Chatterjee of BBC Doctor in the House fame and Dr Ayan Panja, an NHS GP who has long been using lifestyle and preventative medicine in his practice. The 1-day course offers NHS GPs and interested clinicians from other specialities, a new set of immediately implementable, safe tools which they can start using on the Monday after the course. The idea is to enhance their toolkit to reduce prescribing costs and pressure on the crumbling NHS, but also to give them increased job satisfaction (less ‘compassion’ fatigue perhaps) and useful skills for personal use too.
Michael Ash BSc (Hons) RNT introduces Personalised Lifestyle Medicine
A bottom-up revolution
The course is a major initiative and represents a very welcome critical shift in how medicine might be done within the NHS in years to come. Over 1000 GPs have already been trained and what’s more remarkable, is that the demand is being driven by the doctors themselves, and the course is sanctioned by the Royal College of General Practitioners (RCGP). It’s a bottom-up revolution in much the same way that medical students, craving expert nutritional and lifestyle information and finding their medical education severely lacking, created Nutritank to do it for themselves.
Dr Rangan Chatterjee BSc (Hons) MRCP MRCGP expands on how Prescribing Lifestyle Medicine can help doctors and their patients
Light at the end of the NHS tunnel
For those of you doubting as to how on earth doctors can be introduced to lifestyle medicine and skilled up sufficiently in one day, think again. This course has been masterfully structured by experts who also understand how an NHS GP’s day shapes up. From the practical ‘symptom web’, the structure provided by Dr Chatterjee’s ‘four pillars’, through to identifying the ‘how, what and when’ and finally co-creating with the patient a lifestyle prescription the patient can take with them — the entire day is based on providing appropriate, science-based, clinically-validated interventions through the use of simple, yet powerful, tried-and-tested tools. And the whole system has been designed in a way that makes it possible for it to be delivered (or at least initiated) in the space of a 10-minute consultation!
The detailed case studies, plethora of research papers, humorous anecdotes, clinical pearls and decades of experience between the educators makes this an exciting, pacey day. No boring education here. It’s edge of your seat stuff and we didn’t appear to be alone in our experience if the animated post-conference dialogue was anything to go by.
Dr Ayan Panja MRCGP on the benefits of the Prescribing Lifestyle Medicine course
Dr Panja, with his years of experience both as a GP and a health educator being omnipresent, brought a series of cases to life. The case studies he discussed were all real, and reflected the typical pattern of challenging patients many GPs are exposed to, often without any ability to handle them. They simply don’t fit well with NICE guidelines – and they often present with multiple conditions, some of which are often missed. Right up there are complications arising from loss of integrity of the gut epithelium, that can trigger systemic inflammation and then an array of conditions and autoimmune diseases.
As Dr Panja and the other speakers made clear more than once, the principle of primum non nocere (Latin for First do no harm), is integral to the Hippocratic Oath to which all modern doctors swear allegiance. With persistent evidence of over-treatment or lack of effectiveness of certain pharmaceuticals in commonly encountered conditions, there has never been a more important time for lifestyle medicine.
The final note – the role play between Dr Chatterjee (GP) and Dr Panja (patient) had to be seen to be believed. It would have done well as a comedy skit at the Edinburgh Fringe! They did a ‘bad’ consultation followed by a ‘good’ one, the latter taking on board the tools to which doctors had been introduced during the course of the day.
So, if you’re a doctor, medical student or a clinician from another discipline, or know someone who might benefit, please do share this article and the links below with them. This first day is just the beginning and the team have ensured that there is a great deal of support available after completion and becoming part of the Prescribing Lifestyle Medicine community.
We can’t recommend this course highly enough and look forward to seeing how Prescribing Lifestyle Medicine develops as the demand grows.
For other similar and functional medicine courses for health professionals see, Clinical Education, an independent, not for profit, organisation that brings a range of educational experiences to healthcare professionals.