Does your doctor have time to talk to you about:
Helmets. Sunscreen. Alcohol. Vaping. Smoking. Work place Safety. Safe sex. Substance Use. Domestic Violence. Nutrition education. Prescribing exercise. Screen addiction. Stress management. Social isolation.
Probably not. And because we don’t, nothing is getting better. Nothing is ever going to get better until we do. Let me explain.
It shouldn’t surprise you that doctors aren’t looking for business. (And, for the most part, neither are any other registered, qualified healthcare professionals)
Patients are surprised to learn that wait lists aren’t just public. Many private specialists have long wait lists. One cause is a global shortage of properly qualified healthcare professionals.
The other cause is the ever increasing amount of preventable disease. According to HPAI figures, chronic disease accounts for 40% of admissions and 75% of bed days. Most chronic disease is caused by poor diet, alcohol, physical inactivity, tobacco, obesity.
Prevention of disease works: vaccination, sunscreen, nutrition education, physical activity, stopping smoking, low-risk alcohol use, work-place safety, domestic violence support, early interventions…
My small practice has a wait list. And it is not a marker of success as a modern doctor to have a wait list – it’s only a marker of how broken our healthcare system is that patients have to wait to see you because every other doctor is busy, too.
The majority of the patients scheduled to see me have been referred with established chronic disease, commonly arthritis, obesity, heart disease, and diabetes. (also called “secondary prevention” – so preventative medicine after someone is sick to try to reverse some disease or prevent further problems)
How different would our health service look if at-risk patients had been referred to doctors like me 10 or 15 years ago — before their disease took hold? (also called “primary prevention” – before they are sick) If there were enough GPs to do the preventative medicine that is needed?
A multi-million € industry in “wellness” – from home sensitivity testing to supplements to fasting apps to IV drip bars to unqualified “functional medicine” practitioners – have sprung up in response to this care shortage but cannot replace actual evidence-based prevention when it comes to actual health outcomes.
What should you know about functional medicine?
Functional medicine is practiced by some doctors in Ireland. This is training in an area of medicine that is categorised as “evidence-informed” as opposed to “evidence-based”. However, we are increasingly seeing non-medics (everyone from unqualified “nutritionists” to – in one case – a yoga teacher) now offer functional medicine appointments. The Medical Practioner Act of 2007 protects patients by requiring that a practictioner who practices medicine – that is diagnosis and treatment of disease – being registered (Irish Medical Council). This means that patients know tha there is an independently verified standard of training, continuing professional development, accountability, professional indemnity, and robust complaints process. However, in practice, anyone can now offer a medical appointment if they call it “functional” without actually being any type of registered or healthcare professional – let alone a physician. And if you are not worried about that, you should be.
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