Stressed out…?There’s a pill for that! Want to control your high blood sugar levels…There’s a pill for that!Can’t sleep…?There’s a pill for that!High blood pressure…?There’s a pill for that!
Stress and lifestyle as a cause of poor food choices and lack of exercise
Healthcare costs and associated costs for communities are growing at unsustainable speeds. Stress, lifestyle and calling in sick to work are major contributing factors. Unfortunately these factors are very difficult to address during the typical short doctor’s appointment. In medical school, doctors are taught to give lifestyle advice, but how effective is this really? Several studies suggest they’re not that effective… [1,2]
- 1. Kaner, E., et al., Effectiveness of screening and brief alcohol intervention in primary care (SIPS trial): pragmatic cluster randomised controlled trial. BMJ, 2013. 346: p. e8501.
- 2. Aittasalo, M., S. Miilunpalo, and J. Suni, The effectiveness of physical activity counseling in a work-site setting. A randomized, controlled trial. Patient Educ Couns, 2004. 55(2): p. 193-202.
If the doctor believes lifestyle advice isn’t being/ won’t be followed, they often provide an option in pill form… To be fair, regularly patients ask for the quick fix as well or eagerly accept the doctor’s offer… Sometimes these pills might be necessary, but in many cases they are certainly not…
Stressed out…? There’s a pill for that!
Want to control your high blood sugar levels…? There’s a pill for that!
Can’t sleep…? There’s a pill for that!
High blood pressure…? There’s a pill for that!
So how should doctors, and the society as a whole, deal with this problem? Perhaps we should try to address root causes, rather than relying on quick fix options. Many would think purely focusing on eating healthy and exercising would be the way to go. However, the danger is we aren’t addressing the root behavioural problem in this way. We’d need to dig deeper, asking ourselves why we aren’t eating healthier or moving more than we ought to. Many times this boils down to being unable to cope with ongoing stressors and having bad lifestyles.
Perhaps we should try to address root causes, rather than relying on quick fix options.
Too little time during a doctor’s visit
Stress and lifestyle are complex issues (perhaps too complex?) to address within a short doctor’s appointment. Ideally the healthcare professional would need more time to explore the underlying problems, to truly listen to the patient, to truly understand why they are living their life in a certain way. Often doctors give advice such as ‘just take it easy’ or ‘take some time off’, however I wonder whether this really would push the patient towards a healthier lifestyle or perhaps even hamper recovery. Work is very important, it provides people social interactions and a sense of purpose, so healthcare professionals should be (at the very least) careful to take that away.
Whenever a cardiologist sees a patient with chest pain, for which no medically objective cause can be found, there’s often no time to dig deeper. Patients are then sent back to the general practitioner (i.e. GP), even though the GP is swamped with their own appointments. These are interesting scenarios we should put more effort into addressing. If there’s too little time to address these complex issues, patients could theoretically get referred to mental healthcare providers, such as psychologists or psychiatrists. However, it’s not unusual that these mental health services have very long waiting times.
Occupational medicine doctors, an untapped resource
A good portion of these stress and lifestyle issues could potentially be addressed by doctors who work as advisers to both the employer and employee on the relationship between work and health, so called “occupational medicine doctors or occupational physician”. In the Netherlands (where I’m currently being trained), the waiting list for occupational physicians is usually much shorter than for mental health services. Hospital specialist, GPs, employers and employees should seriously consider referring to or getting help from occupational physicians, either whilst waiting or instead of visiting the mental health provider. Obviously, consult your (occupational) physician first before opting out from a visit to a mental healthcare provider. Many employees are often unaware that they could pay a visit to their occupational medicine doctors. At least in the Netherlands (I’m not sure how this works in other parts of the world), companies are obliged to provide their employees access to occupational medicine doctors. So don’t hesitate to make use of this often untapped resource.
Many employees are often unaware that they could pay a visit to their occupational medicine doctors.
Stress and lifestyle: complex issues we need to address in and outside the doctor’s office
Again, stress and lifestyle are complex issues to address within a short doctor’s appointment. I’m not touting that a visit to the occupation medicine doctor will solve all problems, however it could be one of the many pieces to solve the puzzle. We ought to think more about solutions in and outside the doctor’s office to address how to deal with stress and a poor lifestyle.
We ought to think more about solutions in and outside the doctor’s office.
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