WE ALL HATE OUR GPS…IT’S TIME TO CHANGE THE GAME
Hi friends,
I just wanted to update you on something exciting that I’ve been working on. For those of you who don’t know, I’m a GP registrar and have recently trained to become a health and wellness coach. You might be wondering what exactly that is. Well to put it briefly, a health and wellness coach is a professional guide who helps people to envision their ideal level of health, take stock of their current health status, set realistic goals and then hold them accountable to positive behavioural lifestyle changes.
As you probably already know from your own experiences, GPs often have very little time to actually address your medical problems fully and to your satisfaction. It’s problematic. The “one issue per appointment” rule, the cutting you off when you’re just getting to the good stuff, the churning out of relevant (and sometimes irrelevant) information, advice and leaflets for the occasion, just isn’t good enough.
“It doesn’t surprise me that people bad-mouth their GPs”
This time-pressured and prescriptive approach rarely inspires action or behavioural change towards a healthier life. Instead, it often leaves you angry, frustrated, resentful of your GP and sends some down the path of private healthcare. It doesn’t surprise me that people bad-mouth their GPs. I’ve said some pretty damning things about my own to be honest.
There’s a growing awareness and acceptance amongst GPs that factors such as sleep, exercise, stress management and nutrition are major determinants of our health. These elements of health are becoming the cornerstone of modern medicine and as GPs, we try to incorporate these factors into our treatment plans for our patients. But the reality is, that our allotted slither of time (10 minutes!!!) doesn’t always allow for such elaborate and meaningful consultation. Even if we did manage to squeeze in some valuable lifestyle advice, there would be no time to really drive the implementation of advice or support lasting change.
“At this point, I can feel the wrath of the next patient who’s waiting”
Allow me to paint a picture of a typical GP consultation …
Me: Hi Miss A, how can I help you today?
Miss A: Well I’ve had this lower back pain for about 3 months now. It’s getting worse and it’s really beginning to affect my ability to get through my working day.
Me: I see, what do you do for work?
Miss A: I’m a fashion consultant.
Me: Wow, well I hope that’s as glamourous as it sounds! Okay, so can you tell me a bit more about what the pain is like?
Miss A: Yes it usually starts down at the bottom and…
*Miss A goes on to describe the details of the pain*
[3 minutes elapsed]
Me: That sounds really painful! I’m sorry it’s had such a huge impact on you the last few months. Can I ask you just a few more specific questions?
Miss A: Yes sure.
Me: Do you remember having any injury to the back or doing any heavy lifting 3 months ago when this all started? …
*I ask about 10 more specific questions*
[6 minutes elapsed]
Me: Okay from what you’ve told me so far, this sounds more of a muscular problem, than a disc problem or nerve problem. Do you mind if I examine you to get more of an idea?
Miss A: Yes of course.
*Back examination*
[9 minutes elapsed]
Me: From the examination and what you’ve told me, this pain appears to be muscular in origin. Did you have any thoughts on the next best step for you?
Miss A: Yes I was thinking maybe I could be referred to a physiotherapist?
Me: Yes, I think that’s a really good idea - for strengthening those back muscles and advice on posture. We have a physio that works on-site actually, so I can book you in… next week Tuesday at 6 pm?
Miss A: Yes that works. Thank you.
[10minutes elapsed – technically time is up :S]
Me: Did you have any other pressing questions?
Miss A: Yes, do you also mind just taking my blood pressure actually?
Me: Are you worried about it for any particular reason?
Miss A: Erm, well I just want to check it because my parents both have high blood pressure.
Me: Okay, no problem. Let’s take that arm for a spin (yes, I say weird things like this all the time, lol)
[12 minutes elapsed]
*At this point, I can feel the wrath of the next patient who’s waiting*
Me: Your blood pressure is perfect – 120/80.
Miss A: Phew, that’s a relief. Thanks so much.
Me: You’re welcome. Take care and do come back and see me if the back pain is getting worse or if …
*I list the important symptoms to be aware of*
Miss A: Will do, thanks…bye.
Me: Bye!
[13 minutes elapsed]
*And the 2-minute scramble to write up my notes ensues*
What I would have loved to do in that consultation is to:
• talk about potential life stressors
• ask Miss A if she is working from home and if so, what her desk set-up is like
• explore how much core exercise she’s doing, if any at all
• find out if the pain is disturbing her sleep and how that might be affecting daily productivity
• look at nutrition for blood pressure maintenance.
But as you can see, there is simply no extra wiggle room to allow for this. The main focus tends to be on ruling out something serious (which is very important), offering a solution to the symptoms and only addressing underlying causes where possible. It’s no wonder that GPs can’t always get it right. We really do try our best but the system makes it pretty difficult.
Anyway, to wrap up my preamble, my points are these:
People deserve more time to discuss how lifestyle factors are influencing their medical issues or vice versa.
People deserve more guidance and support with implementing positive behaviour change such as stress management, healthy eating, exercise and sleeping habits.
My hope is that as a health and wellness coach I can affect change in this space and I can support and empower people on their journies to optimal health. Later on this year I will be offering one-on-one virtual coaching but for now friends, I’m excited to introduce you to my new Instagram page, where I’ll be sharing information on positive lifestyle change and how to form and sustain healthy habits. And of course, being the geek that I am, research in human psychology and evidence-based lifestyle medicine will be the backbone of it all!
I hope you find it useful and I am always open to hearing your suggestions on how I can add even more value to the platform.
I look forward to seeing you there @healthcoachdoctor.
xo, Dr Winnie