Letters, calls & emails: Head off this epidemic of chronic diseases

Dear Editor

Dr Craig Brown writes that GPs need a broader vision for their work, and wonders how long we can keep going personally and professionally in a system blinkered by guidelines and targets (GP, 8 June).

He highlights doctor self-care and the protective power of vocational values; aspects of medicine we currently hear too little about in our training or from our leaders.

So, is it true that we are too preoccupied with the quality framework to reconnect with what brought us into medicine?

By focusing on evidence for drugs, have we missed the mass of evidence highlighting the impact of communication, participation and beliefs on health outcomes?

Or are there signs that medicine is beginning to go beyond the old rhetoric about whole-person care and embrace genuine holism?

I believe there are such signs: the backlash against anti-depressants and the return to talking cures; the growth of patient and community participation; a revaluing of humanities in medicine and medical education; a growing appreciation of how diet, exercise and stress affect health; and demonstrable political will to grasp health inequalities.

And no wonder. Wanless warns that, within a decade, unless practitioners and patients engage with health creation, the NHS will be overwhelmed by long-term, largely preventable diseases.

We can reverse this trend if enough doctors become change agents, instead of just prescribers and data collectors.

The NHS itself is at stake here. We face an epidemic of chronic disease that's the clinical equivalent of global warming. Only by delivering 21st-century holistic care - medicine as if people matter, for patients, practitioners and communities - will the NHS survive.

Professor David Peters, chairman, British Holistic Medical Association, School of Integrated Health, University of Westminster, London.

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