Should Doctors Prescribe More Than Just Pills?

Treating the symptom not the cause

Modern medicine is symptomatic. This means that when we feel something is off — an ache, a pain — we visit our GP. Our doctor then responds to this in a variety of ways: a referral to a specialist, a blood test, or, more often than not, a prescription for a tablet that will alleviate said symptoms. The tablets might be a course of antibiotics, or a short-term dose of anti-inflammatory painkillers, or your referral to the specialist might manifest itself into a long-term (forever?) prescription of statins or thyroid medication. You’ll feel better, of course you will, because your symptoms will go away. For now at least.

But what about down the line, when your thyroid is increasingly less active or your cholesterol is creeping ever upwards? You’ll try different pills, or up the dose. And it’s ok, because that’s just what we do, right? We trust medicine to make us better. And why shouldn’t we? After all, aren’t doctors there to relieve us of our uncomfortable symptoms?

In a way, yes... But when the root causes of our symptoms are being consistently ignored, we should also use our common sense. The harsh reality is that all medicines do a little harm, we only have to look at the list of possible side effects that accompany even the most common medicine to know that this is the case.

Michael Kirsch outlines it by saying that, “Treating the symptom is not the same as treating the disease.” He goes further and describes something called a ‘Standing Order’, a term we are most likely to associate with money but that has medical implications too: the process by which the symptoms of one medication are treated with another.

These are the issues with symptomatic medicine… The original cause of our symptoms gets overlooked and by continually treating the avalanche of evolving symptoms it’s easy to lose sight of what we were treating in the first place.

So what if there were a different way? Should doctors be able or encouraged — or taught — to prescribe lifestyle changes? What could happen then?

Treating the cause not the symptom

Most of us know, deep down, what it is we need to do to be more healthy. But our modern lifestyles are so hectic that we barely get a chance to consider this as we grab lunch on the go or arrive home, exhausted... after dark... again.

Imagine this. You walk into a doctor’s surgery with a symptom relating to your physical or mental health and you leave toting a green slip. However, on exiting, you bypass the pharmacy and, instead, walk into your local supermarket, park or sports centre. Your prescription isn’t for a pill, it’s for fruit and vegetables, sunlight, exercise, it’s for mindfulness meditation, outdoor swimming or to keep a lifestyle journal for seven days. Your prescription is exploring or treating the cause of your ailment rather than the symptoms.

Lifestyle medicine is systemic rather than symptomatic. This means it takes into account the physical, emotional, environmental and social aspects of illness rather than simply seeing the symptom as stand alone. Its foundations are built on the idea that health is both individual and population-wide. That means that optimising health requires a team approach, one that takes into account both the patient’s circumstances (including their ideas, values, mind-set and social context) and the professionals’ expertise based on clinical research.

But a prescription for lifestyle changes takes time and effort from both the doctor and the patient. Time and effort that you just don’t have or can’t muster. So why bother?

The benefits of lifestyle medicine

Staggering statistics show that 70% of chronic diseases are directly linked to lifestyle habits. The vast majority of these are treated with a cocktail of drugs and all could be prevented with a shift towards better educational, living and working standards for every single member of our society. So we pose the question: is it better to mask the symptoms or prevent the illness in the first place? I’m sure we’d all agree that staving off sickness is better. So why don’t we do that and how do we start?

Embracing lifestyle medicine

The reality is that taking tablets is quicker and easier and who has time to do all the things we should do anyway? Did you see the BBC series, ‘The Doctor Who Gave Up Drugs’? It was enlightening, truly. It documented a doctor, Chris van Tulleken, who attempted to prescribe drug-free treatments and explored our (over) reliance on medications — from Calpol to antidepressants. The thing that struck us? The double whammy of patients’ expectations for a quick fix and the willingness of the medical professionals to acquiesce.

In order for lifestyle medicine to be successful we need a mindset shift, both as individuals and as a society.

• We need a collective shift that looks at systems and not just symptoms
• We need to leave behind fad diets and quick fixes
• We need to be prepared to put in the time and effort to do and eat things that keep us healthy
• We need a society that supports us in doing these things

And this starts with the people at the top: the government, the people who carry the responsibility of setting the work ethics and doling out drugs. Imagine if your prescription cost covered your 5 (or more!) a day. Imagine if, as a result, you could take your prescription into work and it meant that your boss had to limit your working hours to allow for a better work-life balance, which in turn meant you had the time and energy to invest in that exercise class or that meditation course. And what if it wasn’t just you, but everyone?

At the moment this is a bit of a pipe dream. So what can we do, as individuals? Well, the one thing we can control is our own self. We can take stock of our current situation and ask ourselves what medication we take regularly and consider whether we might be taking too much or taking it too often. We can book an appointment with our GP and, rather than going in with an expectation of a traditional prescription and being disappointed when we don’t have a quick fix, we can engage them in a discussion about the medication we’re taking and how we might look to our lifestyle to fix the cause instead. I wonder what they would say...

Additionally, we can all commit to the first step on a path to a more healthy existence by making one small change. Not a new year’s resolution, or even a spring clean, but a personal commitment to a single thing — something realistic. Some ideas:

• 10 minutes of daily mindfulness meditation
• Walk 10,000 steps a day, at least 5 days a week
• Turn off electronics an hour before bed
• Eat a plant-based meal at least once a day
• Do 10 squats before each cup of tea or coffee then reward yourself with said hot drink
  

In conclusion…

To us, it’s a no-brainer. Should doctors only prescribe pills? No. Should they, instead, be prescribing lifestyle medicine that encourages — and makes it easy for — us to eat more healthily and be more active? Yes. Absolutely.

Is this going to happen any time soon? Sadly, it’s unlikely. The answer? Be the change you wish to see in the world: ask the questions; be curious about your body and your health; and make that one tiny lifestyle tweak that might be the key (or at least the start of the key) to treating the cause of preventable symptoms.