GPs urged to tackle problems rather than treat disease
The factors that strongly influence health are outside the hospital system, yet they are rarely given priority
Why is there so little focus on preventing health problems before they hit our creaking hospital system? It would seem like a more common sense approach but the amount of money poured into Ireland’s acute care has long dwarfed what is made available for disease prevention.
Dr Louis Francescutti, president of the Canadian Medical Association and a global campaigner for disease prevention, was in Dublin last week to encourage Irish doctors to lift their eyes from the bedside and look at health more politically.
His theory is that there needs to be a new focus on preventing people from getting ill in the first place, rather than just treating disease.
It all sounded a little thin during an interview on Newstalk where fellow guest and GP Ciara Kelly was exasperated by his habit of saying “well, that’s simple . . .” when asked to suggest solutions to complex health problems.
But the following day he delivered a challenging, well-received lecture, “Getting Rid of the Patient”, to a room full of doctors at the Royal College of Physicians.
The factors with the strongest influence on health lie outside the hospital system, and yet they are rarely given priority.
Healthcare contributes about 25 per cent of your health, with the remaining 75 per cent coming from social and lifestyle factors – did you get a good education, do you have adequate housing, a job you enjoy, enough income to buy good food, a loving family and supportive partner?
To focus on these issues, a much broader “vision” would be needed within the medical community. Speaking to The Irish Times after his lecture, Francescutti conceded that a difficult shift is needed for disease prevention to improve, particularly as medics are already stretched to the limit within the troubled HSE.
“It is hard to move that agenda forward because you have to deal with things like poverty, homelessness and education that lie in the political realm. But it is incredibly important for physicians to get involved at the decision-making level.
“Politicians are looking for the profession to provide solutions. Otherwise changes are not going to happen.”
Half of all the diseases seen in Irish hospitals are the result of just three risk factors – smoking, inactivity and poor nutrition. Despite the massive burden they place on the health system, very little is being done to tackle these issues.
Illness is increasingly behavioural-based and the medical profession, perhaps more comfortable treating infectious disease, is not adapting quickly enough.
“For example, there is little training given to medical students about addressing the causes of the obesity problem swamping Irish hospitals.
“In 2013 we need to ask why we have Generation XXL coming down the line and develop skills to change people’s behaviours,” says Francescutti.