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ou may know Dr Rangan Chatterjee as the star power of the BBC’s Doctor in the House TV series. He is also one of that rare breed in modern medicine: a doctor with an open heart and mind.
Chatterjee has been examining a deadly sickness in medicine today. Its major symptom is doctors who don’t know enough about nutrition. It is about doctors who can’t – or won’t – acknowledge the real root causes of patients’ ill health. Spoiler alert: it’s not a deficiency of drugs.
Here, Chatterjee looks at why doctors need more education. It begins with understanding that ‘the food you eat can be the safest and most powerful form of medicine or the slowest form of poison’. – Marika Sboros
By Rangan Chatterjee*
I love general practice but I don’t love the way general practice operates at the moment. Many of my patients feel frustrated by the short consultation times.
They feel as though they’re “on the clock” from the minute they walk in. This results in them pre-filtering information that they deem relevant to the consultation, which doesn’t help them or me.
GP satisfaction isn’t any better. A recent study published in the Lancet warns that general practice in England is reaching “saturation point”. Job dissatisfaction and stress among GPs are at their highest levels for over a decade.
I believe that if you have unhappy doctors, you will have unhappy patients.
Do we need longer consultation times? Absolutely. But I believe that there is another key factor in improving patients’ health outcomes and doctor satisfaction: medical education.
A few years into my job as a GP, I realised that I was probably only helping around 25% of the patients walking through my door. Sure, I could give them a drug to “suppress” their symptoms but was I getting to the root cause of the problem? No.
One problem is that in medical school we mostly learn a model of care suitable for acute problems that is primarily pharmaceutical based. However, the health landscape in the UK has changed dramatically over the past few years. Lifestyle choices largely drive the vast majority of chronic problems I see today, such as type 2 diabetes, obesity, gut problems, insomnia and headaches.
Take diabetes. In April 2016, the World Health Organisation (WHO) reported that total diabetes cases had nearly quadrupled to 422 million in 2014 from 108 million in 1980. The condition affects nearly one in 11 adults worldwide – the majority of these are Type 2.
Type 2 diabetes, like many chronic diseases, is potentially preventable and largely driven by our lifestyle and environment. So, why is the UK spending over £20 billion pounds annually on direct and indirect costs of this condition?
We have known what needs to be done for many years now. So why are we unable to stop this avalanche cascading forward with no sign of slowing?
I often chat with my colleagues about this and a recurrent theme pervades: We did not receive enough training in nutrition, lifestyle or behaviour change. Good health occurs outside the doctor’s surgery – not inside.
Click here to read: NOAKES: DOCTORS, DIETITIANS MAKE DIABETES A THREAT TO LIFE?
Fundamentally, chronic problems need a different approach to acute ones. The magic bullet intervention that works for acute illness does not work as well for chronic problems. These often need many small but positive changes that, when implemented together, can have a powerful synergistic effect.
My frustration with the situation led me to seek out individual study in nutrition, lifestyle interventions and movement science. I also learnt a framework of how to put this all together and apply that knowledge in a safe and effective way.
This has reignited my passion for my job and most importantly, my patients are reaping the benefits.
I am delighted to have had the opportunity to showcase the power of a different approach to medicine on the BBC One programme Doctor in the House. For a month at time, I lived alongside three very different families, observing them as they work,ed slept, grocery shopped, exercised and ate.
This gave me the insight I needed to put a range of simple and effective changes into effect.
The success of these changes demonstrated the power of nutrition and lifestyle to improve and even reverse varied conditions such as type 2 diabetes (both new and established), obesity, menopausal symptoms, eczema, and many more . Yes, that’s right, reverse.
Click here to read: DIABETES CAN BE CURED! A DOCTOR’S PERSONAL JOURNEY
I’m also passionate about promoting the value of the expert generalist. In one episode of Doctor in the House, I worked with a five-year-old boy who had three seemingly “different” conditions. He had abdominal pain causing time off school, severe eczema and gastro-oesophageal reflux. When we first met, he was taking three different kinds of medications from three different doctors.
I was the first doctor to put it all together for the parents and explain that the root cause of all three was the same. By addressing this one issue, all three conditions almost fully reversed within a few weeks.
As a society, we have over-emphasised the role of the specialist and undervalued the role of the generalist to tackle chronic disease effectively. We need to move from the era of the super specialist into the era of the super generalist.
I believe that there is a strong case to put nutrition and lifestyle at the heart of medical education. That way, together, we can better serve our patients. It is time to change the trajectory of chronic disease that is making the NHS and many other healthcare systems unsustainable.
The BMJ (British Medical Journal) is currently running a Too Much Medicine campaign, which I fully support. I believe it is time for modern medicine to acknowledge that we have lost our way somewhere – over-diagnosis, over-investigation, over-medicalisation and over-treatment. We need to get back to the root cause.
What we put on our plates and how we use our bodies are the most powerful tools we have. It is time to start using them to take back our health.
- Follow Dr Rangan Chatterjee on Twitter: www.twitter.com/drchatterjeeuk
- Follow Dr Chatterjee on his blog
- This blog first appeared on The Huffington Post and is republished with permission
“… the root cause of all three was the same. By addressing this one issue,…”
What was it?
Likely to be nutrition and lifestyle. I’ll ask Dr Chatterjee and get back to you.
Doctors are well equipped to read up on and study nutrition themselves. The best do and more of them are waking up to that. As far as over-medicating people it has been recently been reported that; An astonishing 64 per cent of drug or medical device side effects are left out of the published reports that clinicians so frequently base decisions on.” This does not even include the epigenetic consequences of our over-medicated lifestyles.
Food may be medicine, but when we eat it and how we eat it is just as important as what we eat. On the Big Banting Breakfast we solidly encourage lifestyle changes which should flow naturally out of the correction to metabolism, bad eating habits, weight loss and improved vitality and clarity of thinking on a keto diet. Even if one does not do ketosis, the elimination of grains and sugar makes tremendous changes to a person’s health.
My opinion is that Doctors should focus more on the benefits of the keto/lchf approach, investigate it with an open mind and put old dogma aside if you have any intellectual honesty or humility. Today scientific papers and journals are easily accessible and any professional should be able to read between the lines, check out the potential conflicts of interest, debate and engage with the arguments and formulate some type of self-experiment. Why do GP’s not attempt their own biohacks if they are afraid of what might happen?
You make a very good point, Jason. Of course, doctors can educate themselves about nutrition and the ones who put patients before profit are doing just that. It helps if they get the right facts at medical school too.
The problem I see is that doctors are told to follow “Evidence-Based Medicine” without realising that half the evidence is missing. There’s a lot hidden in plain sight on PubMed, but first they need to know what to look for. There’s even more that remains “just anecdotes” because no-one will finance studies. I was recently warned again about “cranks on the internet”, a nice way to dismiss the likes of Ron Krauss, Jeff Volek, Stephen Phinney et al. The real cranks (Rory Collins) are NOT on the internet . . .