“I’ve had the amazing opportunity over many years now to meet hundreds of talented Doctors that are urban farmers, fantastic cooks, authors of their own self-help books, super-Moms, competitive bass angler or fisherman, avid hikers, pilots, great fathers, beginner tennis players and even competitive, world-class tennis players who play in competitions across Europe and Australia. It might surprise many of you to learn that your next patient doesn’t know that much about you. They also may have a hobby or a skill that you don’t know about which they haven’t tapped into for quite a while. Why don’t you calibrate them this year or encourage them to learn a new skill or even relearn an old hobby. Consider sharing with them in a group setting your own skills and talents. How can you help them achieve a better year, this year? It might be easier than you think and, have you considered the social and mental health benefits?”
By Michael Tetreault, Editor-in-Chief
ATLANTA, GA USA | SummerFall Edition 2020 – Many of us want end this year in particular better than last year.
September seems to be the new January for many. And research is proving this out to be true as well.
Each school year, we start off with really good intentions by making a commitment to improve by the holidays. And it is hope that drives us initially. That hope is a powerful endorphin at the beginning of the fall.
“We’re finding that hope is consistently associated with fewer symptoms of depression. And the good news is that hope is something that can be taught, and can be developed in many of the people who need it,” said Ohio State University researcher Jennifer Cheavens.
CMT’s 2020 Summer Reading List for Concierge Medicine
Inevitably though, we end up not following through. It might surprise many Doctors today that just about every patient wants to learn a new skill or even relearn an old hobby this year. Is it your job to calibrate or recenter your Patient on certain goals at the start of each year? How can you help them achieve some balance and a better quality of life without simply scribbling something else on the prescription pad this year?
The Distracted, Disinterested “Doctor”
The idea of “social prescriptions” or “hobby prescriptions” isn’t new.
Across Europe, provider organizations have adopted the concept of social prescribing, which aims to address lifestyle behaviors and non-clinical needs
A lot of research just in the last year has been conducted about the topic abroad. It’s been discussed in some small circles here in the U.S., mainly among Psychologists and in Psychiatry. But, it’s often forgotten in the daily grind of general practice. We are all moving from one place to another and yes, we rarely find time to focus on new things that require us to learn something new. These unique, quiet and often socially beneficial hobbies have some pretty solid research and evidence supporting their application that I’d like to bring to your attention. Additionally, I want you to consider that it’s often the job of our Doctor to recenter our focus and calibrate our lifestyle when we as the patient simply cannot. There are a lot of ways Doctors can help people do that and one that’s getting some momentum — herein enter the “social prescription.”
Wikipedia defines “Social prescribing” as when health professionals refer patients to support in the community, in order to improve their health and wellbeing. The concept has gained support in the NHS organisations of the United Kingdom as well as in Ireland and the Netherlands.
The Advisory Board here in the U.S. even discusses the topic. This is part of a series about care transformation around the globe, where we look at successful population health managers outside the United States. In this post, we highlight how organizations across Europe and Canada are popularizing the concept of social prescribing. A version of this post previously ran on The Forum.
How Hope Helps You Heal | Wired For Happy
Social prescribing is about expanding the range of options available to GP and patient as they grapple with a problem. Where that problem has its origins in socioeconomic deprivation or long-term psychosocial issues, it is easy for both patient and GP to feel overwhelmed and reluctant to open what could turn out to be a can of worms. Settling for a short-term medical fix may be pragmatic but can easily become a conspiracy of silence which confirms the underlying sense of defeat. Can or should we try to do more during the precious minutes of a GP consultation?
RELATED STORY | British Journal of General Practice | Research
Social prescribing in general practice: adding meaning to medicine
I’m always surprised to learn what other interests Doctors have outside of the office.
I met a Doctor just last weekend who said she absolutely loves tennis but she’s admittedly ‘just terrible at it.’ We both had a good laugh. Another Concierge Doctor we know is an Urban Farmer and raises chickens in Atlanta. And another Concierge Doctor from Missouri we know has a true passion and love of football. He applies his medical expertise to help NFL players — and even to this day works with the NFL team in his city and did I mention he’s even on staff there and can be found on Sunday afternoons on the sidelines with the players!
RELATED STORY | LISTEN | Podcast
(Podcast, 20-min): Fairness in Healthcare … “You’ve married the Hippocratic Oath with the Golden Rule and guess what, Patients’ responded and said ‘YES! I’ve been waiting for you to do this!’”
So I even took up a new hobby over the 2018 holiday break to ease my stress — wood carving. Granted, I’m not very good but it is oddly relaxing. Funny enough, I’m not alone in my whittling and when you visit what we know to be “YouTube University” I find there are entire forums and even dozens of books dedicated to my wood carving pursuit. With the pressures of family, work and the hustle and bustle of having kids, this is one task I can sit down at lunch or even for 20-minutes here and there and become entirely consumed in the endeavor. I wish my Doctor would’ve advised it but I found this one on my own. 🙂 lol.
So when I saw this article by Sheryl Ubelacker at The Canadian Press entitled Doctors pen ‘social prescriptions’ aimed at easing depression, loneliness in patients, I was intrigued at the healthcare application hobbies may have in the exam room, particularly for Concierge Doctors.
“One example from Thunder Bay that really resonates is there’s a long-haul trucker who was experiencing social isolation and he started up a knitting group at the community health centre,” she says, adding that it’s especially satisfying to see a person in need become a volunteer to help others form social connections. A pilot project in which doctors or other practitioners write out a “social prescription” for patients experiencing depression, anxiety or loneliness that affects their sense of well-being is taking place at the Belleville and Quinte West Community Health Centre in Ontario. The concept — prescribing a social activity like taking a yoga class, visiting an art gallery or joining a knitting circle — has proven to be an effective tool in the U.K., where research has shown that not only do patients benefit from a mental-health boost, but many also end up with reduced medications and find less need to visit their doctors.
RELATED STORY | PUBLIC HEALTH RESEARCH | BMJ
Link Worker social prescribing to improve health and well-being for people with long-term conditions: qualitative study of service user perceptions
A first-of-its-kind study has found that “social prescribing” by a trained link worker is an effective way to improve the health and well-being of patients with long-term conditions such as asthma, cardiovascular disease, diabetes, epilepsy, and osteoporosis — which often exacerbate symptoms of depression and/or anxiety. These findings were published online July 16 in the journal BMJ Open.
RELATED STORY | RESEARCH | BMJ | Health Services Research
Social prescribing: less rhetoric and more reality. A systematic review of the evidence — Conclusions: Social prescribing is being widely advocated and implemented but current evidence fails to provide sufficient detail to judge either success or value for money. If social prescribing is to realise its potential, future evaluations must be comparative by design and consider when, by whom, for whom, how well and at what cost.
I love this idea of a a “social prescription” for patients experiencing depression, anxiety or loneliness. It’s a great doorway to an entirely new dialogue with your patients. You may find that many of your patients share the same interest in knitting, crafting, walking or fishing.
“So people come up with their own ideas based on their own talents and skills, but they also have a lens that we don’t see in terms of what the community needs and what our clients need,” she says of the health champions, who included a singing circle in the social activities on offer.
Life is not without its stressors. Going to the Doctor can be stressful enough. A lot of patients admittedly say they don’t want another prescription or to ‘try this …’ for anxiety or depression. They often times want to know that when they lay their head down at night, they’re not the only one in the world that feels this way. Having a social connection with your patients has a lot of health benefits for you and them. Being socially isolated can make us sick in a lot of different ways.
Practical Application and True Stories of This Concept In Healthcare Offices Right Now
- Example #1 – Since the pilot project began in October, Tammy McEvoy has taught classes on wreath-making, and cooked an evening meal for an addiction group meeting at the centre’s Quinte West site in Trenton. Since the pilot project began in October, McEvoy has taught classes on wreath-making, and cooked an evening meal for an addiction group meeting at the centre’s Quinte West site in Trenton. The wreath-making classes brought together 16 participants. “The first one I did, I watched magic happen because they all started helping each other,” says the 52-year-old self-described empty-nester who’s often alone while her husband works long hours. The 18-month pilot project, supported by a $600,000 Ontario Health Ministry grant, is being spearheaded by the Alliance for Healthier Communities, which represents more than 100 primary health-care organizations across the province. The grant allowed the Alliance to trial social prescribing in 10 of the centres, with a goal of evaluating benefits to patients, says Kate Mulligan, director of policy and communications.
- Example #2 – Dr. Michael Monaco, a Physician with a thriving medical practice in Kansas City, MO has a weekly walking group in which he regularly invites, interacts and meets with his Patients. It’s an opportunity for patients to connect with their Doctor in a personal way while sharing memories and good vibes with one another. The social atmosphere of the group is amazing and it has been something Dr. Monaco and his patients look forward to and have been attending for years (even in the snow).
- Example #3 – Dr. Ellie Campbell of Campbell Family Medicine has created a variety of opportunities for her patients to interact with her outside of the exam room. From educational grocery store aisle meet-ups where patients to “Walk With A Doc” in the park in and around her community and more.
- Example #4 – Local Delaware Concierge Physician Dr. Uday Jani and chef/restaurateur Matt Haley teamed up to present their next installment of the Doc & Chef, a patient education series which focuses on healthy, simple ways to prepare nutritious food. The free cooking demonstration and educational seminars take place at Fish On in the Villages of Five Points in Lewes, DE.
- Example #5 – The UK government wants to formalise doctors’ referral of patients for community activities and is setting up an academy to advance the practice. “Dance lessons for the lonely on NHS,” led the Daily Mail in October. “GPs should prescribe hobbies like ballroom dancing, gardenin
g and art classes to millions of people, because it is often better than drugs,” said the Telegraph. Source: Social prescribing: coffee mornings, singing groups, and dance lessons on the NHS
- Example #6 – Michigan Hospitalist tells us he started a Monday Evening Bicycling/Cycling Group
- Example #7 – During the COVID-19 Pandemic, many people started attending online/virtual webinars with art instructors from around the world. These three to four hour virtual events start with a blank canvas and allow the instructor to teach participants how to paint step by step. Doctors who have an interest in painting could lead these courses in-person or virtually to a small group of interested patients.
- Example #8 –Doctors from Colorado to Georgia have interests in outdoor activities which they have invited small groups of Patients to join them in For example, going on a small, non-difficult hiking excursion. Another idea might be inviting a small group of patients who like to fish and enter into a fishing tournament together as a team.
So as you consider the research, read the studies and explore this topic of “social prescribing” on your own and possibly for your practice, I’ll leave you with this thought …
“What would it look like today if my Doctor gave 1% more effort today than yesterday? Often, that’s all it takes. But towards what activity? How well do his/her patients really know him/her? Is there something (e.g. hobby, activity, etc) I have as the Doctor that I can share in organized small group settings with my Patients? What people look for when they visit and talk about their life with their Doctor is that they help the patient look for progress, not perfection. It’s why small, fast wins are important. Focusing on small wins, small activities, hobbies for example, will lead to greater achievements. Focusing on small achievements that will lead to bigger ones.” ~Michael Tetreault, Editor
Maybe you have a hobby or have been thinking about sharing a talent or skill you have with your patients or even creating a small group setting among your patients like some of the ones described above that can bring your patients together? Maybe you have an idea? Share it here or write to us and let us know what you’ve been doing. You can email us at firstname.lastname@example.org.