I had an interesting question this week about how I manage my time being a GP and incorporating my nutrition ideas and training. The best answer is juggling! At the moment I juggle my time between my NHS GP practice in Wandsworth and studying at the College of Naturopathic Medicine in London. I have one day a week of Nutrition clinics or lectures and these are long days. Living in London certainly makes it easier as I can travel into the centre of town pretty easily. Some of my classmates come from a long way away. I also have children so that adds to the juggling. CNM are quite good in that you can swap lectures days around in advance and they give you a few options to catch up.
The lecture days at CNM are long but incredibly interesting. Most of the lecturers are practising nutritionists with years of experience so they will provide practical support and information and the classes are very lively and full of questions. We have amazing lecturers from nutritionists who specialise in cancer, heart health and all sorts of other topics. We sometimes get practitioners of functional medicine and herbal medicine too and I have learnt so much about these disciplines. Many of the ideas can be used in holistic lifestyle plans for clients.
“My classmates are an eclectic mix of people. We have other doctors, pharmacists, people from the world of business and HR in the city, yoga gurus, nutrition bloggers, chefs, fitness specialists, chiropracters, therapists as well as others who have given up jobs to change career paths or combine this new interest with a busy family life at home too.”
This provides you with fresh perspectives on health that you can discuss over lunch. Working in the NHS can become a bit one sided. It is this aspect of studying at CNM that I really enjoy. You get to hear different personal stories and viewpoints and open your mind to new ideas. One thing about everyone on the course is that they are all pretty motivated and passionate so the environment is very positive and is upbeat.
In terms of bringing my nutritional skills into my role as an NHS GP, the biggest constraint at work is pressure of time. We have to see so many patients in one day who have 10 minutes of time allocated to them. Once these appointments are finished I usually have the same amount of work in NHS administration to do.
I can apply some of the things I learn into the consultations. For example, I am much more mindful of medication reviews and looking at lifestyle measures to optimise health other than drugs. Of course, being a doctor means I am trained to know when drugs are essential but I can also see when patients seem to be over medicated. This is useful to do especially when patients have had adverse reactions and side effects of drugs. I think that it is great that there are now some initiatives to get pharmacists working to support GPs because drug side effects and interactions are very important to recognise. We have just signed up to join a pilot in Wandsworth to do this at my surgery.
Often just bringing the idea of looking at food choices for health into the consultation for a patient to think about is a first and positive step. A lot of patients ask me what they can do for themselves. I think it is great that patients are reading more about nutrition but sometimes the information can be overwhelming. If you do an Internet search for a weight loss diet for example you can be faced with ten different conflicting choices. People get information overload.
Being able to get an individualised plan is so important but this takes time. Since the mapping of the genome in 2003 more and more information is being gathered about individual differences in responses to diet and lifestyle. It is absolutely fascinating. Unfortunately this is still cutting edge stuff and not generally available on the NHS. I think we will see more of this in the future and I think that is really exciting. In some branches of medicine this is being used to look at use of medication, for example cancer drugs or aspirin and the same can be true for lifestyle choices. It will help people make choices and see results more effectively.
“I think medicine has changed so much and the NHS designed in 1948, as great as it is, is not designed for today’s information and lifestyle. The general way we are exposed to food choices is huge and sadly some of these choices are not nutritionally balanced put your health at more risk.”
Bodies work as a whole and more and more doctors are so specialised now that a person’s symptoms don’t get joined up. GPs are still the generalists who are best placed to see the whole picture. The main issue is that they don’t have enough time to do so. Most GPs I know are caring, interested, academic and forward thinking. They would be interested in nutrition too but right now they are probably too overwhelmed to do so. Having holistic lifestyle coaches who understand nutrition and health and who can work in family GP practices would be so fantastic. We need to support GPs and help them practice medicine as it should be done.
Maybe we need to start by giving doctors their own individual nutrition and lifestyle plan to optimise their own health. Now that would be a step in the right direction?