Inspiring healthy lives

Rachel Handscombe is a GP partner in Derbyshire. She is an activity enthusiast and is keen to share the benefits of exercise to those she meets.

I wore my 100 parkrun t-shirt to work today. I was curious as to what my patients would say. Rarely a week passes by without some comment about my weight or fitness. I greet my patients in the waiting room and walk the 15 metres or so to my room. I take ‘no wonder you are so fit’ or ‘you must walk miles in a day’ to be a bad prognostic marker. My favourite comment has been ‘you’ll cop it when you reach the menopause!’ So it was a surprise and a bit of a disappointment that no-one really seemed to notice.

My Facebook thread is scattered with posts from Joe Wicks and Rangan Chatterjee – amongst others. There are clips of different strengthening exercises, photos on the beach, adventures in the wild and a general portrayal of wellbeing. Maybe we too, could live satisfied, healthy lives if we followed what they do? Which makes me wonder how much of a role model are we as clinicians at the forefront of primary care? If we ‘advertised well-being’ or showed a little more of how we aim to live healthier lives, would that inspire our patients? Should I respond with more that a shrug and a smile when patients believe that a little walk to and from the waiting room is enough to keep me fit and well?

I love the parkrun practice initiative. My experience is that exercise has vastly improved my health, my confidence, my sense of adventure, my friendships and my general levels of happiness. Did I mention the positive effects it’s had on helping me manage my stress? I’d go so far as to say I am evangelical about a bit of exercise. So it came as no surprise to my colleagues when I bounded into a practice meeting, grinning from ear to ear about the ‘takeover’ parkrun event which I was organising. My excitement levels were soon dampened when the majority of my team freely admitted that 5km – run or walk was really just a little out of their comfort zones.

I wish I’d had the ideas and drive of Paul Sinton-Hewitt – the founder of parkrun. I am astounded by the impact he has had on the wellbeing of our nation(1). He has to be one of the most awesome health heroes of our time. My local parkrun has just celebrated its 10th birthday. There’s an average weekly attendance of 440 runners and over the last 10 years those runners have collaboratively run over a million kilometres. The average number of parkruns done by each runner is 8.9 so there must be something about parkrun that keeps people coming back for more. A staggering intervention but one that still seems so out of reach for many.

As a response to the disappointing turnout for my inaugural takeover parkrun, I have started a local couch to 5km (C25K) running group. There’s a brilliant C25K app that is free and takes participants from being able to run for a minute to being able to run continuously for 30 minutes. It’s a step up to being able to run 5km and after the nine-week course most of my C25K participants have proudly completed their first 5km- at the local parkrun. Hopefully many will now be embraced by the local parkrun community. My hope is that many will continue to run and experience for themselves the health benefits of exercise.

Many patients come to me looking for a ‘magic pill’ to make themselves feel better. Many times, I’ve prescribed medication or referred for operations without really discussing lifestyle. We have 1200 pre-diabetics in our practice. Each year we take their BMI, their BP and their Hbaic. Within a year, 5 to 10% of these patients are likely to be diabetic (3). On turning diabetic we start them on metformin. It’s not surprising that as physicians, we too are looking for a ‘magic pill’ – something that we can give to make a change within the time and financial constraints of our consultations. But ‘lifestyle intervention is the cornerstone of diabetes prevention with evidence of a 40-70% relative risk reduction’ (2).

So what if we did something differently? What if we inspired a new way of living? Instead of measuring decline could we refer our patients into a practice led C25K? Could each practice team take an hour out of their week to run – to improve their own health, but also to inspire and provide an accessible level of exercise and belonging into which patients can be embraced? Joe Wicks has turned his 1.9 million Instagram followers into a fitness empire. Rangan Chatterjee has sold over 200,000 books on living a healthier life. Perhaps it’s time to put on our trainers and role model a healthier way to live?

Now where is that parkrun t-shirt?

 

References

1) Fleming J parkrun: increasing physical activity in primary care. Br J Gen Pract. 2019 Sep 26:69(687):483-484

2) Tabak et al Prediabetes: a high-risk state for diabetes development. The Lancet 2012 June 379 (9833):2279-2290