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JHH 6.3 Nov 09 Layout JOURNAL OF holistic healthcare Contents ISSN 1743-9493 Editorial . 2 Published by Update . 3 British Holistic Medical Association Being holistic West Barn, Chewton Keynsham The new focus of the BHMA . 4 BRISTOL BS31 2SR Email: [email protected] William House www.bhma.org Food as medicine: the anti-inflammatory diet . 8 Andrew T Weil Reg. Charity No. 289459 The change journey . 13 Editor-in-chief Chris Johnstone David Peters [email protected] Reflections on motherhood as a G P: Empathy in action! . 16 Gillian Myers Editorial Board Dr William House (Chair), Connecting citizens and services in new and Professor David Peters, meaningful relationships to transform healthcare . 20 Peter Donebauer, Dr Thuli Alyson McGregor Whitehouse, Dr Antonia Wrigley Closing the compassion gap in health and social care . 25 Editor Andy Bradley Edwina Rowling [email protected] Medicine as if people matter – integration rather than breakdown . 29 Advertising Rates Michael Dixon 1/4 page £130; 1/2 page £210; full page £400; loose inserts £140. The Lambeth GP Food Co-op: Rates are exclusive of origination An emerging model of community co-operation . 32 where applicable. To advertise Ed Rosen email [email protected] A conversation with David Reilly Products and services offered by Director of The WEL Project . 35 advertisers in these pages are not David Reilly and David Peters necessarily endorsed by the BHMA. A meaningful encounter . 40 Design Justin Haroun [email protected] Neural networking, confabulation and subtle information . 43 Printing William Bloom Spinnaker Press The juggler – being wise in the modern NHS . 46 William House William House . 50 Research . 51 Reviews . 52 Unless otherwise stated, material is copyright BHMA and reproduction for educational, non-profit purposes is welcomed. However we do ask that you credit the journal. With this exception n o part of this publication may be reproduced in any form or by any other means – graphically, electronically, or mechanically, including photocopying, recording, taping or informa tion storage and retrieval systems – without the prior written permission from the British Holistic Medical Association. Every effort is made to ensure the accuracy of material published in the Journal of Holistic Healthcare . However, the publishers will not be liable for any inaccuracies. The Volume 13 G Issue 1 G Spring 2016 views expressed by contributors are not necessarily those of the editor or publisher. 1 David Peters Editorial Editor If we want whole person care, let’s start their careers outside the NHS as a result of the treat doctors as whole people government’s decision to impose a new junior contract. With the NHS getting ever busier it makes no sense to Too often it’s assumed – at least tacitly – that doctors are force junior doctors into longer hours for little more pay. different. Perhaps we need to believe they are inured to If the Secretary of State has bought into the delusion that the pain, embarrassment and distress they encounter; that doctors can take anything that's thrown at them, he needs they can rise above the suffering they meet every day, and to be told that this is far from the truth. For in fact keep doing it without losing warmth and empathy. This is doctors’ mental health is worse than the general a big ask, but if we expect doctors to walk this emotional population’s and their risk of suicide far higher. Though tightrope, what will they need to help them do it? Time? the mental health of new medical students is much the Yes certainly; time enough with patients to listen, reflect same as in the general population, sadly by their second and make good decisions. What else though: emotional year medics are psychologically worse off than the rest of support, a comfortable enough home life, an optimistic us, and the overall decline continues year on year. and collaborative temperament? Well, all of the above, plus We know that as doctors get more stressed, the quality – and this is crucial – a sense of being valued. Because of care they provide deteriorates, yet half of practicing being valued is a big issue for doctors. doctors say they feel burned out – unable to empathise with patients, potentially error-prone, and often with life Doctors’ resilience – a question of balance problems outside work. At a time when many older doctors are retiring early, why is the government hell bent • overloaded • job-related gratifications on making our new doctors feel even more undervalued • lack control from positive patient and taken for granted, and less likely to stay in medicine? • work is no longer rewarding interactions The British Medical Association says many GP surgeries, • a breakdown in the • leisure-time activities; struggling to fill staff vacancies are already at ‘breaking time-out work-community point’. This situation is set to get worse, especially in • feeling unfairly treated • self-demarcation; limitation of working hours; time primary care: 69% of GP trainees are women and in • dealing with conflicting England there are now more female than male GPs. Yet an values management • continuous professional official report admits this contract will have an ‘indirect DRAINERS development Maslach, Schaufeli, Leiter 2001 adverse effect on women’.* This is particularly bad news • acceptance of professional as female doctors are already twice as prone to depression and personal boundaries as their male colleagues – and even more so if they have • a focus on positive aspects children (Hsu and Marshall, 1987), and four times more of work likely than their female patients to take their own lives. • personal reflexivity With the popularity of general practice as a chosen DRIVERS Zwack J, Schweitzer J 2013 medical career in serious decline, a perfect storm is surely brewing. There is no time to waste. Something is very Does that mean the medical pay packet ought to be high wrong with the way we educate our young doctors and fail value too? George Bernard Shaw said ‘…every man is the to look after them. Medical schools must take a long hard worse for being poor; and the doctor is a specially look at how they teach, and start creating a more dangerous man when poor’. Poor and, he might have emotionally intelligent curriculum. And, if NHS staff are to added, tired. Though our target-driven NHS has come maintain their amazing resilience in the face of austerity up with some perverse incentives, at least NHS doctors’ and ever-growing demands, we must as its citizen-owners judgements are not distorted by the need to chase press for a more human-scale and holistic NHS. personal profit. Still, no one can say that after five years of *www.bma.org.uk/news-views-analysis/news/2016/april/ demanding training junior doctors are overpaid, especially contract-will-have-adverse-effect-on-women. with five years’ university fees to settle up. A first year Hsu K, Marshall V (1987). Prevalence of depression and distress in a junior doctor’s basic salary is only £22,636 – about the large sample of Canadian residents, interns, and fellows. American same as a new school teacher’s. No wonder, fearing that Journal of Psychiatry 144 pp 1561–1566. the new contract will cut their pay by up to 40%, and force Maslach C, Schaufeli WB, Leiter MP (2001) Job burnout. Annual them to work more antisocial shifts, they are up in arms. Review of Psychology 52 pp 397–422. And for medical students in England the future looks Zwack J, Schweitzer J (2013) If every fifth physician is affected by bleak. A 2016 BMA survey (15,247 students) found that burnout, what about the other four? Resilience strategies of 74% of those responding said they were more likely to experienced physicians. Acad Med 88 pp 382–389. 2 © Journal of holistic healthcare G Volume 13 Issue 1 Spring 2016 UPDATE Food. The forgotten medicine Earth saw ‘explosive’ annual growth in carbon dioxide in 2015 A unique meeting co-organised by former BHMA trustee Dr Catherine Zollman for the College of Medicine and The Earth saw its largest annual spike in atmospheric supported by the BHMA will take place on 9 June 2016 at carbon dioxide concentrations on record in 2015, the Royal Society of Medicine. Amazingly, this is the first according to new data released by the National Oceanic conference in the UK on health and food and headlining and Atmospheric Administration (NOAA). The increase is the event will be Dr Andrew Weil who is making a rare significant because it demonstrates the continued march appearance in the UK. The conference will include a very toward higher levels of global warming pollutants in the healthy lunch and cooking demonstrations, along with a atmosphere. Those increasingly higher levels are helping bit of physical activity and laughter to keep the circulation to destabilise parts of Antarctica and Greenland, raise sea going facilitated by Dr Phil Hammond (aka Trust Me I’m levels around the world, and cause more frequent and a Doctor – next stop the Edinburgh Fringe) and all those intense heat waves in many regions. It is a sobering attending are invited to a VIP drinks reception at the end. milestone too, since countries are working more diligently Book your place asap as they are selling like hot than ever to cut emissions of planet-warming greenhouse (wholemeal, low sugar) cakes. gases, but the atmosphere is not yet seeing the results. www.collegeofmedicine.org.uk/events/#!event/2016/6/8/food-8211- According to NOAA, carbon dioxide measurements taken the-forgotten-medicine at the Mauna Loa Observatory in Hawaii show that carbon dioxide concentrations jumped by 3.05 parts per million Lifestyle medicine workshop for GPs (ppm) during 2015, the largest year-to-year increase in 56 years of research.
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