Why are there so many overweight doctors and nurses?
The envy of the world.
In the UK health care is paid out of taxes and is free at the point of need. Something that we in the UK should be very proud of.
I was very pleased to see Simon Stevens, the new NHS CEO’s plans to reduce obesity among National Health Service staff (1) . I am afraid he can do nothing about it. I do recall public outcry when NHS midwife Sherma Turner had weight loss surgery- a lady who was forever telling pregnant women to lose weight (2). She was victim of much public abuse but as a former doctor and now personal trainer I can see how easy it is for her to become obese.
The envy of the world.
In the UK health care is paid out of taxes and is free at the point of need. Something that we in the UK should be very proud of.
I was very pleased to see Simon Stevens, the new NHS CEO’s plans to reduce obesity among National Health Service staff (1) . I am afraid he can do nothing about it. I do recall public outcry when NHS midwife Sherma Turner had weight loss surgery- a lady who was forever telling pregnant women to lose weight (2). She was victim of much public abuse but as a former doctor and now personal trainer I can see how easy it is for her to become obese.
Do as I say not as I do
Many doctors advise their patients to lose weight but all too often it’s do as I say and not as I do. In fact I recall in my student days sitting behind a consultant who was telling a patient to lose weight. In his left hand he had a lit cigarette, on his desk was a pint of beer and he was as overweight as you like. Talk about the pot painting the kettle black!
The NHS CEO is to be congratulated in taking such a stance. The NHS is the UK’s largest employer. However I feel that this is simply rhetoric and if he does anything he’ll face such a backlash he’ll be fired within a week.
NHS staff are first and foremost human being and therefore are just as prone to the stresses that society puts on us all to be obese. However there are some things that make NHS staff more prone to obesity.
Many doctors advise their patients to lose weight but all too often it’s do as I say and not as I do. In fact I recall in my student days sitting behind a consultant who was telling a patient to lose weight. In his left hand he had a lit cigarette, on his desk was a pint of beer and he was as overweight as you like. Talk about the pot painting the kettle black!
The NHS CEO is to be congratulated in taking such a stance. The NHS is the UK’s largest employer. However I feel that this is simply rhetoric and if he does anything he’ll face such a backlash he’ll be fired within a week.
NHS staff are first and foremost human being and therefore are just as prone to the stresses that society puts on us all to be obese. However there are some things that make NHS staff more prone to obesity.
Poverty
The number one cause of obesity is poverty.
Food that is high in fat and low in nutrition is mass produced and cheap.
Food that is high in nutrition and low in fat is hand produced and expensive. Those on lower incomes cannot afford it.
Generally speaking cash poor people tend to be time poor and so they don’t have time to cook fresh food.
Some people out there can only afford to eat one or two meals a day. If that happens then your body thinks nutrition isn’t coming regularly will slow down its metabolism and will store as much fat as it can.
People who are in a rush, often wolf their food down quickly so the brain doesn’t register it, It take 20 minutes for the brain to register that you have eaten. Such people stuff themselves making the problem worse — its worsened if that food is high fat.
With the greatest respect in the world those who are cash poor can be less well educated and so they may not know what is best nutritionally and we apologize if that causes offence.
Lastly those on lower incomes cannot afford expensive gyms and personal trainers.
This is why you will rarely see obesity among the more affluent- it’s a disease of the lower income people. This is the irony- those who need obesity rehabilitation can’t afford it. So many times I’ve had to quote a super obese person the investment of £5,000 over 18 months to rehabilitate them and they’ve said that they cannot afford it.
Disproportionately poor
The first is that NHS professionals are disproportionately affected by the number one cause of obesity- poverty. Obesity is a disease of poverty and not of affluence. Many NHS professionals are trained at universities and when they graduate they are in what I call pseudo poverty. They have a relatively high income but have huge debts. Their take home pay is relatively low and when you take into account the number of hours they put in, tax, national insurance and debt repayments their take home pay is often lower than minimum wage. As a civilised country this shames us.
In 1999 I wrote a paper predicting that by 2010 a student of medicine who had no parental funding would be £100,000 in debt on graduation. I predicted then that non-medical students would be £35,000 in debt on graduation. I predicted then that this would lead to graduates not buying houses and thus leading to a recession in the housing industry leading to a knock on recession in the rest of the economy. I was called a fantasist, a looney, a scaremonger. The UK population knows I proved to be right.
That is one of the reasons why UK junior doctors are going on strike. It will be harder for them to pay off their debts. Although I think their trade union the British Medical Association should be hung drawn and quartered for this.
If the NHS is to combat this among its staff then I would like to see a repeal of the abolition of grants and the introduction of tuition fees. I would like to see the full restoration of grants and the abolition of fees. I was astounded when I read of plans to recruit and train thousands of university graduates to act as doctors’ assistants to reduce their workload. There are 8000 such people ready and waiting to their jobs. They are called medical students! I would suggest that medical students in their clinical years be paid £50 per week to clerk patients in hospital.
It is quite common for me to see NHS professionals who are obese who cannot afford personal training or even gym memberships. Conversely I have met high earning consultants and GPs who are as tight fisted as you can imagine who expect you to go and visit them on a 6 mile return journey and train them for £25! I deliberately do not train people from richer backgrounds because they are too tight fisted.
Stress and disorganisation
The medical profession is inherently stressful and I never cease to be amazed at how disorganised it is. The NHS CEO really needs to look into this. Disorganisation leads to stress and stressed people often comfort eat.
When serial entrepreneur Gerry Robinson went on TV and inspected Rotherham Hospital and openly said that if he ran his business the same way they ran their hospital the receivers would be called in within a week. When I saw that I had a wonderful feeling of “I told you so.”
When I worked in hospital I remember working on two very different wards. The ward from hell- A3- was so disorganised. Within seconds of you coming on duty a nurse would demand a load of jobs needing to be done. Nothing could be prioritised and nothing got done. In fact I remember one Sunday night when I came back the intern on that ward was going to leave the hospital and had packed his bags. He’d done a weekend on call and had been bleeped 30 times by A3 for routine work. I asked him how many times he’d been bleeped by my ward- C1- and he said “none.”
I told him that on my ward we did daily ward rounds- every patient was reviewed daily so we could massively cut down emergencies. When I first started I asked the ward manager to ask the nurses to do their drug rounds and then write down on a list everything that they needed the doctor to do. So long as there was a list I would promise that by 5pm when I finished that the jobs would be done. Lists can get lost and soon we replaced it to a book- two pages for each day. Then each task was diarised. It reached such a stage when I could predict when jobs needed doing and they were done beforehand e.g. if your prescription ran out on a Saturday I’d diarise it for Friday, cross out the original prescription and use the same start date. If I suspected someone was going to be discharged on the consultant ward round I’d diarise the interim discharge (TTO to take out) medication to be made ready by pharmacy.
My piece to resistancewas once when the bed manager came onto my ward. She was stressed. The hospital had reached capacity and was about to go on divert. The local MP had been in touch saying he didn’t want this to happen. She asked me if we’d discharged anybody I said we had eight discharges. She then asked how long it would be before I had done the TTOs. I said that they’d been done the previous day. She hugged me! This system eliminated all routine work being left for on call staff. Indeed I remember that on Saturday 10 November 2001 I was doing a weekend on call-I’d been on leave that week and I got bleeped. It was the C1 ward manager. She urgently needed TTOs. A patient was discharged on Thursday and the ambulance had been booked for Saturday morning at 1130. It was 9am and the TTOs had not been done. I replied with bewilderment. I asked if the other resident doctor hadn’t done them. She said “We were all saying on Friday afternoon”please come back- all is forgiven.”
I did them and on Monday 12th November 2001 she told me that she wanted me on that ward at all times and to never have the other doctor there!
I have yet to see a hospital ward implement that system. However it cut out a considerable amount of stress. In fact I recall teaching a final year medical student who commented that I had my own empire. I never had a problem getting my half hour break every four hours.
This would cut down a lot of stress and stressed people are prone to comfort eating. The new NHS CEO really needs to look into this. However I am confident that there would be great resistance to this. The NHS cannot afford to spend £10 per ward to get such a diary.
Sleep deprivation
NHS staff are disproportionately subject to a leading cause of obesity- sleep deprivation. If you are tired your body’s metabolism slows down. When that happens everything you eat is stored as fat.
I do accept that you can’t shut down hospitals at night but it amazes me that we don’t do more to prevent the high number of night time admissions. My Dad is a former GP and if he had to admit someone but it wasn’t urgent and it could wait till the next morning he’d admit them in the morning on the following working day. Although if that practice was universally implemented it would greatly increase daytime work but it would greatly reduce out of hours work. The other thing that this would do is that if the hospital was informed such a patient was coming in the patient’s notes would be available and in the back of each patient’s notes would be some addressograph labels- these are labels that have the patients full name, address, hospital number and date of birth and let me assure you that such labels save you about 10 minutes work per admission!
No time or too tired to cook fresh food
NHS staff tend to be time poor and after working long hours- in many cases a 12 hour shift the last thing they want to do is to come home and cook. They’ll take anything they can get!
I remember when my Dad was a practising GP — after a long day at work- he’d come home and my adopted grandmother who took my Dad in to live with her- Aunty Griffiths — or my mother would ensure he had a good fresh meal. They’d never let him leave the house in the morning without a good freshly cooked breakfast and always ensured he had a good packed lunch. However they ensured it was always fresh food. Today many parents do not have the time or education to make their families fresh food.
I often think to myself why don’t families ask their grandparents to do what Aunty Griffiths did? What grandparent would refuse? None!
When I was on attachment at one hospital when you were on call meals were brought to you. In fact I remember being on call at one hospital when I was a student. One of the patient’s relatives was so appalled that the junior doctors were so poorly catered for she went home and brought a load of food for us to eat and she wouldn’t take no for an answer!
Missing meals
NHS staff in hospital are often so pushed for time that they often skip lunch. Missing meals is a breeding ground for obesity. If you don’t eat 5 meals a day then your body thinks nutrition isn’t coming regularly and will store everything as fat.
I always advise my clients to have a half hour for each meal. You can’t do that in the NHS- the pace of work is too great and they are too disorganised to do anything about it. Unless of course you were super organised like I was and had an organised ward.
Lack of education
Another factor is delusions of education.
Just because someone has spent a few years at university does not mean that they eat healthily! One thing never ceases to amaze me. I have had a few NHS staff come and train with me and when I look at their nutritional habits I am often dumbfounded. I always ask if they’d recommend their patients would eat like this. They always ask why, I tell them that this nutritional plan will end up putting loads of fat on them and NHS staff are always the worst offenders.
I despair when I look at the school national curriculum and I see that cookery is not compulsory. In fact when I was a medical student we had minimal training on nutrition and in fact I recall many doctors downgrading and denigrating the valuable work of dieticians –sometimes very openly on ward rounds.
Seeking help.
Most NHS staff who are stressed or have a mental health problem are far too afraid to seek help. I was disturbed during my research year to find that two in three medical students interviewed would be too afraid to seek help for a mental health problem for fear of the effect it would have on their career. I also recall many doctors who would look down on an NHS professional who would admit to a mental health problem. I have often wondered how these surgeons would react if it was a family member of even themselves?
Bullying and harassment
The last one really shames society- bullying and harassment. In 2003 a study came out showing that one in three junior doctors had been bullied and several years on when I check the medical literature I find that very little- if anything- has changed. NHS consultants have far too much power over their students and juniors. Many abuse their power. The worst case I ever saw was the case of a female medical student who had been raped by a consultant surgeon. He told her that if she complained he’d ensure she failed all her exams and would never qualify. Nothing ever happened to this consultant.
Indeed I can speak from my own experience that the NHS powers that be will always come down on the side of the perpetrator and never the victim.
In conclusion I applaud Mr. Stevens stance but I think this is simply rhetoric.
Take action
If you want my help then simply go to https://jamesbondhealthandfitness.fitproconnect.com/Consultation/ and I’ll be in touch.
References
(1) NHS Chief Urges hospital staff to join gyms in anti obesity fight.(http://www.theguardian.com/society/2014/oct/18/hospital-staff-urged-to-set-example-obesity-fight)
(2) The 21 stone nursewho lectured patients about obesity loses half her body weight http://www.mirror.co.uk/lifestyle/dieting/21-stone-nurse-who-lectured-3125771
