I was catching up with a GP yesterday who has been in general practice for the last 20+ years. He works in one of the practices that I do some work with so we know each other quite well now.
We were discussing medicines and why they have all of a sudden become, by a long way, the most common intervention used by doctors. Is it because we as patients go in expecting to get something and would feel ripped off coming away with nothing, or is it more because doctors are so overrun with patients that they prescribe to match symptom and don't have the chance to actually address the REAL CAUSE of the symptoms - possibly due to the patient wanting it fixed NOW! It is certainly an interesting dynamic.
How would you feel going into the doctor and getting only advice about what you should and should not be eating and about the increased exercise you should be doing and not taking away with you any medicine to 'fix' the thing you went in for?
Even more interesting is whether or not the doctors know or keep up to date about what the best lifestyle change advice is (is it still the food pyramid for nutrition? because that is the advice most often given to everyone that comes into contact with the health system). Then again, is it appropriate to try and help someone change their lifestyle completely in a 15 minute consult every 3 months? Do doctors even have the motivational techniques required to help people make changes? It isn't part of the 5 years at med school that's for sure. Do we really expect that the doctor can fix everything after some patients have abused their bodies for the last 30+ years and think they can return to complete health in a couple of weeks?! Some still see health as a guaranteed right but not realising it is a responsibility - and a personal responsibility at that.
For example, if your blood pressure is quite high one time you were visiting the doctor should you immediately be put on a blood pressure lowering tablet? Should other risk factors be taken into account first? Does the doctor have time to spend with you to identify WHY your blood
pressure might be high - and do they then have time to explain what you
can DO about it yourself?
I'm not trying to say doctors are bad or people are lazy or anything like that. I'm just saying that I find it interesting that we expect an overloaded health system (that is focused on disease) with a flawed model of delivery to keep us healthy?! The sooner we realise health is OUR personal responsibility the better - and the sooner we realise it is more cost effective for the nation to invest in our health from the earliest point possible in preventative techniques the healthier we will all be.
But what will happen to the drug companies and the billions of dollars they make from finding a 'disease' (really just a set of symptoms they can then call a disease), and then matching that with their most recently developed medicine. Well I guess we will have no more need for them!! Especially not for those "chronic conditions".
(I don't even like the term "chronic" because it immediately makes us as the patient believe that you have this for life - AND YOU DON'T HAVE TO!! If you make changes you DO NOT have to be on those medicines forever).
In fact we have been lied to by big pharmaceutical companies trying to scare us into thinking that the risk of something bad happening to us is so much worse if we don't take their medicine.
What they talk about is relative risk instead of absolute risk. What that means is that say there were 100 people and we put them all on a medicine. 5 of these hundred were going to get heart disease anyway. Of those 5, 2 did not get the heart disease as a result of taking medicine but 3 of them still did EVEN though they were taking medicine. This would be a great result for a drug company because they have reduced the risk of getting a heart attack by 40%!!!! ie 2 people of the 5 that were going to get heart disease were 'saved' and 2/5 is 40%. That is known as the relative risk reduction. Can you see the problem here??
What they don't tell you is that the ABSOLUTE risk reduction is actually only 2% as only 2 of those 100 people that took the medicine did not get heart disease as a result of taking medicine!!
Relative risk is how MANY if not ALL drug studies are written up and for obvious reasons. How much of a medicine could you sell by telling people it gave a 2% reduction in risk. I won't even go into this part yet but there is the whole thing of you won't even see that 2% reduction until after 10 years or more of taking the medicine... cRAzy stuff!!
Well I think I've gone on long enough and it wasn't even about what I initially was going to write so I will have to change the post title so it is relevant lol...
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