Always interested in health care professionals reservations about patients ability to adhere to lifestyle interventions and not to medication when every day I meet people with diabetes (Types 1 &2) who are struggling with the burden of drug compliance. Taking medication may improve one condition but all too often causes a number of side effects that adversely affect quality of life. Eating less processed food and exercising more regularly have the potential to benefit both physical and mental health. I know which 'treatment' I have more confidence supporting patients to adhere to. Little surprise that the goal of reducing/discontinuing medication is a great motivator in it's own right.
What about including the clinical hours that are lost to the appraisers? In fact how much NHS resource in terms of clinical time and £££ are spent on the whole appraisal and revalidation process every year and where is the evidence that it is improving the quality of care given to patients? Just over 40% of clinicians saying they have changed their practice as a result of appraisal/revalidation does not = improved outcomes but it does mean just under 60% haven't altered their practice despite jumping through the hoops. Value for money .....? Can we have an honest debate on this? Suggest the first step is identifying those with interests in maintaining the status quo and ensuring that their opinions are taken in context.
Great article and support your view 100%. Really interesting looking at traditional diets that are so varied in carb content (Inuit v Japanese) but worked when people lived a 'traditional life'. It all starts to go wrong when the diets become 'modernised' with the introduction of mass produced food and drinks and the concept of grazing. It's not our generation that I worry about as much as the children who are developing diabetes in their early teens, undergoing bariatric surgery to address obesity and have a life expectancy that is less than their parents. This is absolutely the tobacco story of our generation with vested interests playing a key role in defending the status quo. I would rather work to protect my patients than myself.