After the success of Slow Food, it might be time to prescribe Slow Medicine
It’s that time of year when diets loom large. Many of us carry a few extra pounds from the rich festive fare; it is the beginning of a new year and a natural time for some renewal on the dietary front.
Instead of rushing to the latest celebrity fad diet it might be worth exploring the concept of Slow Food. Founded in Piedmont, Italy, in 1989, the organisation aims to counter the rise of fast food and fast life and the disappearance of local food traditions. Slow Food wants to reverse what it sees as people’s dwindling interest in the food they eat, where it comes from and how it tastes.
As well as developing networks of small-scale producers and cooks, the global Slow Food movement runs taste and food education projects in schools and hospitals. It organises world food events such as Salone del Gusto and Slow Fish where food producers can explain first hand to consumers the quality of “slow food”.
Rather than dieting per se, Slow Food steers you away from last- minute consumption of highly processed food and towards a more thoughtful and planned diet.
The Italians have now come up with the concept of Slow Medicine. In a recent blog the former editor of the British Medical Journal, Richard Smith, described the proceedings of a meeting in Bologna on La Sanità tra Ragione e passione (Health through reason and passion).
It heard that the characteristics of health systems are “complexity, uncertainty, opacity, poor measurement, variability in decision making, asymmetry of information, conflict of interest, and corruption”.
Gianfranco Domenighetti of the Università della Svizzera Italiana said only 11 per cent of 3,000 health interventions had good evidence to support them. It was time, said Domenighetti, to open up the black box of healthcare. We need to encourage a healthy scepticism about the medical market and to help people understand that medicine is far from being an exact science, he said. Data should be published exposing variations in practice, corruption and conflicts of interest.
Measured, respectful care
We should explain that health depends mostly on exogenous factors, not the healthcare system. And people should be given practical tools to promote their autonomy – tools such as access to evidence-based information.
What remedies does Slow Medicine offer? Its manifesto is based on the principles of being measured, respectful and equitable.
On the topic of measured care, it says the dissemination and use of new treatments and new diagnostic procedures are not always accompanied by greater benefits for patients.
“Economic interests, as well as cultural and social pressures, encourage both an excessive use of health services and an expansion of people’s expectations beyond what is realistic, what the health system is able to deliver . . . A measured medicine involves the ability to act with moderation, gradually, and essentially, and uses the resources available appropriately and without waste . . . Slow Medicine recognises that doing more does not mean doing better.
“A respectful medicine is able to acknowledge and take into consideration the values, preferences and orientations of a person in every moment of life . . . Slow Medicine recognises that people’s values, expectations and desires are different and inviolable.” The manifesto says equitable medicine promotes care that is appropriate to the person, and proven to be effective and acceptable both for patients and health professionals. “An equitable medicine opposes inequality and facilitates access to health and social services. It overcomes the fragmentation of care, and encourages the exchange of information and knowledge among professionals. Slow Medicine promotes appropriate and good quality care for all.”
It seems what is needed is for the medical profession to practise medicine in a more transparent manner if current levels of overdiagnosis and overtreatment are to change. “I have little doubt that Slow Medicine – like Slow Food and slow lovemaking – is the best kind of medicine for the 21st century,” Smith concludes. Food for thought?