Latest / The Dr Louise Newson Podcast / 288 - I’m an A&E consultant: the changes you can make for a longer, healthier life

Transcript

288 - I’m an A&E consultant: the changes you can make for a longer, healthier life · The Dr Louise Newson Podcast

1:02
So I've been looking forward to this podcast for quite a long
1:05
time and now it's happening. So I've got with me Doctor Rob
1:08
Galloway, who is an A&E consultant, ex stand up
1:12
comedian, someone who's transformed his life and really
1:17
thinking about medicine in a different way to maybe when he
1:20
qualified. And I certainly think about
1:23
medicine. I think about my training, I
1:25
think about so many things I didn't do right as a junior
1:29
doctor that I didn't think about because I didn't know.
1:31
And I've spoken about some of this on my podcast before, but
1:35
I'm 54 and I'm really committed to improving health of as many
1:40
people as possible in as many different ways as possible.
1:43
And this podcast is one of those ways.
1:45
So I'm very excited, Rob, to introduce you to my guest today.
1:49
Thank you very much for having me.
1:50
Goodbye to me. So can you just give a very
1:52
potted history, like who you are and what you do and what you're
1:55
doing now? So I'm Professor Rob Galloway,
1:58
I'm an A&E consultant, Graham Brighton and a worker at
2:00
Brighton Sussex Medical School. I've been a doctor since 2001
2:03
essentially as my third choice career.
2:05
I did a couple of awful stints and stand up comedian fail
2:08
completely. So I also want to be a
2:09
footballer but I was rubbish. So basically, the two things I
2:11
wanted to do, I couldn't do. So I went into medicine.
2:14
But I got attracted to A&E because for a number of reasons.
2:18
One, I like the excitement. Anyone who knows me knows I've
2:20
probably got undiagnosed ADHD, which I probably think is a
2:24
superpower rather than an I'll, and I get bored incredibly
2:27
easily. But also I had some altruistic
2:30
view that I wanted to help the most vulnerable in society and
2:33
it is the most vulnerable in society.
2:36
And so I trained an A&E consultant, also trained an
2:38
intensive care consultant and spent 13 years as a consultant
2:42
working full time for the last 24 years.
2:45
And it's made me reflect. The last few years has made me
2:47
reflect so that at the beginning of my career I was quite
2:49
academic. I've written a couple of
2:50
textbooks on critical appraisal and how to assess the evidence
2:54
of certain things. I'd also had a little foray into
2:57
other things. So I'd written a book about what
2:59
it's like working in A&E called In Stitches, The Highs and Lows
3:02
of Life as an A&E Doctor. And I wrote that under pseudonym
3:05
Dr. Nick Edwards because I didn't want to get sacked at the
3:06
time. And I also work as the medical
3:09
advisor for Brighton Football Club and I'm very interested in
3:12
patient safety, sort of have an article every couple of weeks
3:14
with Daily Mail and I run patient safety courses.
3:16
I've always had this eclectic career, but over the years I've
3:21
concentrated on two things, the clinical work, patient safety
3:24
and also workforce. So I've set up different systems
3:26
for workforce, for the gene doctors, but all of it was to
3:29
create staff and create systems that we could look after
3:31
patients when they became unwell.
3:34
So if someone fell over, I could know how to block their broken
3:37
hip if they're the pain, referring to orthopedic doctors,
3:40
if they were having a diabetic crisis, how to treat that.
3:44
And I, in all honesty, during my late 20s and 30s, I worked
3:48
incredibly hard to get lots and lots and lots of qualifications.
3:52
I've got lots of letters after my name, probably to the
3:54
detriment of my well-being, in all honesty.
3:57
And so I've got a lot more letters than friends and I was
4:00
probably not top of the game. That's a pleasingly advocate,
4:03
but I knew how to look after very unwell people when I worked
4:05
at a trauma centre and I was providing good care.
4:09
But the last few years I've gone through a transition in my life.
4:12
I went through a difficult time. Eight years ago, my dad, or
4:15
seven years ago, my dad died. I went through a divorce.
4:17
I was quite down, I was on antidepressants, I was
4:20
overweight, I was unhealthy. And it was going through that
4:24
time I also realised that actually what good was I doing
4:27
at work? Because however much effort we
4:30
put in to keep the NHS going, the more and more because I was
4:33
managing the workforce, the more and more staff I put into the
4:35
systems, the more and more medicines we prescribed.
4:39
The health wasn't getting any better, the weights were getting
4:41
worse, and I work in any I can see.
4:45
The current westernized system has utterly failed.
4:49
I'm about to do a late shift tomorrow and then a set of night
4:52
shifts. The last time I was at work,
4:53
there's 36 people in a corridor. There's not 36 people just
4:57
waiting to be seen. This is 36 people in a corridor
4:59
for hours and hours and hours who've been seen by doctors have
5:02
had treatments started, but they're waiting to go to bed.
5:05
The demands are just way greater than what we call society.
5:09
And if you look for the first time in society, life expected
5:14
is going down. But it's not just life
5:15
expectancy, it's health span it's getting.
5:19
And it made me realise that actually everything I've been
5:21
doing has possibly been wrong and I've possibly wasted the
5:24
last 24 years and it made me reflect and that's the journey
5:27
I've been going on. And it's so interesting because
5:29
we're very reactive in medicine. And I think when I was doing A&E
5:33
many, many years ago, I enjoyed it.
5:35
But I not like you. I don't like the uncontrolled
5:39
nature of someone coming in really sick.
5:41
And I like to be really common in control.
5:43
So I found that quite difficult. But I love being a medic means
5:48
that you are exposed to all sorts of people from all sorts
5:52
of life, which I think is such a privilege and I still do now.
5:55
I love working in areas of deputy.
5:57
I've been doing a lot of work in prisons recently and I just love
6:01
it. I think it's, there's so much we
6:03
can give back. But medicine, as I used to know,
6:07
it's very reactive. It's like playing ping pong.
6:09
You're just firing, firing, firing, and you're treating the
6:12
condition. And then more and more over the
6:15
years, partly because I've got older, but my knowledge has
6:18
really improved about inflammatory diseases, how we
6:21
reduce inflammation in the body. And I know you're really
6:24
interested in it too. I didn't know that clinical
6:28
depression, osteoporosis are inflammatory diseases.
6:33
And I also didn't know that we are less healthy as we age.
6:37
And this whole lifespan versus health span is so different,
6:41
especially actually for women. Most of us as women spend the
6:45
last 10 years of our life in ill health.
6:49
And even as a doctor, as a GP, I used to visit nursing homes,
6:54
care homes, sheltered accommodation every single time
6:58
I visited. And it was 90% of the times.
7:02
Women. Did I ever once think about
7:05
their hormones? Never.
7:07
I would love to go back in time because all those Utis, urinary
7:11
tract infections, didn't even think about giving them even
7:15
just a bit of local hormone that we know there's evidence reduces
7:19
urinary tract infections. But then, you know, people with
7:22
total body pain, people with confusion, people with
7:25
palpitations, didn't even think about hormones.
7:28
But we're not trained to do that, are we?
7:30
No, I think we've got a a medical model, which is very
7:33
much pharmaceutical. There is a treatment, there is a
7:37
drug you can prescribe, and this is the protocols we're given.
7:40
Similar to you, I opposite to you.
7:42
I love the chaos, the not knowing what's going on.
7:45
I couldn't do your job because I I just can't stand just doing,
7:49
you know, single issue. I mean, I like the chaos of
7:53
someone who's had a heart attack when someone comes with a trauma
7:55
and then someone's trying to stab me.
7:57
That something gets me excited at work.
7:59
But the thing which you know that that after a while you
8:02
think, okay, are we doing the right thing by always treating
8:05
patients? Are we doing the right thing by
8:07
saying right, this is what you need.
8:08
But actually, should we stand back and be more of what I call
8:11
a risk addition? Are we actually doing the right
8:15
thing for the patient by organizing another CT scan?
8:18
Or should we step back and say, are we doing too much medicine?
8:20
Are we giving another antidepressant, anti
8:23
hypertensive anticholesterol drug?
8:25
Is there other things we should be doing?
8:27
But crucially, what I've realized from all my experience
8:30
is actually so much of what I see is preventable and the
8:34
amount of money we're pumping into hospital, it's in the wrong
8:38
place. If there's one thing I could
8:40
prescribe, and to everybody, it will be exercise, because
8:44
exercise is antidepressant. The evidence for exercise is, I
8:50
would say, better than for circling, for mild depression,
8:52
not for severe depression, but for mild depression like I had.
8:54
So I was put on circling because I think I had a response to
8:58
misery. A normal response to misery
9:01
rather than severe depression. But exercise is such a good
9:05
thing. But what's ridiculous?
9:06
I went to the GP asking for circling.
9:09
Well, you didn't. Know just fixing that medical
9:11
model but things like exercise so good for depression, for
9:14
reduction of cancer, for reduction of diabetes, for
9:16
Alzheimer's. We forget how important that is.
9:20
Then there's diet and I've lost about 10 kilos by just looking
9:24
at what I eat. I used to eat just dreadful
9:26
food. I used to think nothing of
9:29
having a, you know, a Mars bar packet of crisps during my lunch
9:32
break, you know, at work. The hospitals are such an
9:35
unhealthy environment, cannot eat healthy food because the
9:39
most of the vending machines just sell variations of awful
9:43
ultra processed food. The way you manage health has to
9:45
be done from the very beginning. Every department in the country,
9:49
every politician needs to look at bad different areas and how
9:52
we can promote health. I took my kids to the leisure
9:55
centre the other day to go swimming.
9:57
I try to get some food. The only food at a leisure
10:00
center was awful, ultra processed food.
10:03
And this is the bastions of health leisure centers.
10:05
And I couldn't feed them healthily.
10:06
So to have, you know, we've got to do everything to promote good
10:11
health and prevention because we are facing this rise and rise
10:15
and rise in cost of ill health. Society can't afford it.
10:20
We've got one life. We need to not waste it by
10:22
getting ill. And that's why when people need
10:24
to invest in their own health, rather than just accepting
10:27
illness, we need to invest in our own health.
10:29
And do you really need to go to another work meeting?
10:33
Do you really need to send that other e-mail?
10:34
Or would you be better off at 6:00 in the morning going for a
10:37
run? And that's the last thing I've
10:38
started to tell myself. I think you're absolutely right,
10:41
and I've certainly become more selfish as I've got older.
10:44
I can't time in my week to do yoga, I make my own lunch
10:47
because otherwise I can't get it when I'm here because I'm too
10:50
busy and then I could eat something.
10:52
But I'm lucky and not lucky that I get quite bad migraines.
10:55
So if I don't eat healthily it will trigger a migraine.
10:58
So I've always got that to tell me.
11:00
But a lot of people haven't. They can just eat what they like
11:02
when they like, but it catches up.
11:04
But also part of our training is not looking holistically, it's
11:07
looking at which drug for which treatment.
11:09
And I know obviously all I do is hormones, but they affect every
11:13
single organ in in the body. So today I've seen a patient
11:17
who's been given antidepressants by the psychiatrist.
11:20
She's been given blood pressure treatment and treatment for her
11:23
fast heartbeat from the cardiologist.
11:25
She's been given painkillers because she's been diagnosed
11:28
with fibromyalgia. They're talking about statins
11:31
because her cholesterol's up. But she's also 48 and her
11:34
periods have nearly stopped and she's perimenopausal.
11:38
So in medicine, we did get taught.
11:40
I know I did treat the underlying cause, but no one is
11:44
looking looking at the common denominator and medicines become
11:47
more siloed, hasn't it with time.
11:49
And it's also become what as well as the hormones, what else
11:51
is underlying for all those things?
11:53
Is it a beast? I don't know your patient
11:55
obviously, but is there an the diet there is a beast you know,
11:58
as well as the hormones. Is there something that if?
12:00
It's definitely together, absolutely.
12:03
And often when people's hormones are balanced, they're like, do
12:05
you know what, doctor? I'm getting up in the morning,
12:07
I'm going for a run. I'm going for a little, you
12:10
know, Oh, I'm going outside because most of us are inside
12:13
The whole time I'm going outside, I'm talking to my
12:15
friends. I'm having a cup of herbal tea
12:18
rather than some, I don't know, busy drink.
12:21
And it's they're all these little things.
12:23
Which also society's become too medicalised.
12:26
Everyone's scared of going outside in the sun, you get skin
12:28
cancer. But actually sunlight is so good
12:31
in preventing depression and preventing inflammation.
12:33
All these things we need to think about that we've just
12:36
become forgotten. Forgotten.
12:38
And when I look look back at, you know, the medical model I
12:41
was taught until about 5 years ago, I would teach in all
12:44
honesty was based on drugs and operations are the solution.
12:49
I can't remember any nutrition training I had.
12:51
Nutrition training I had was incorrect because it talked
12:53
about the dangers of fats rather than the dangers of ultra
12:56
processed food and too many carbs and sugars and crisps and
13:00
that something. But I remember as a junior
13:02
doctorate medical student, we were taking out constantly by
13:04
drug reps So I would get my good meals by going to restaurants
13:08
with a drug Rep. And so that subliminal, I'd sit
13:11
there for 10 minutes and think, oh, I'm not going to listen to
13:13
them, but actually that subliminal message and I'll
13:15
tell. Them No, you do because I'm a
13:16
bit older than you and I remember when Omeprazole came
13:20
out, which is a PPI, proton pumping inhibitor and it was
13:23
game changing and we went to Granada Studios because I was in
13:26
Manchester and I've never been before because we were students
13:29
actually and any doing any trips was a big thing.
13:32
We didn't really go to those sorts of trips.
13:35
So we went to Granada Studios, a whole tour.
13:37
We felt really privileged because we weren't even doctors,
13:40
we were medical students and I remember having such a great
13:44
time, but it was still drip fed. Drip fed.
13:46
Acid is bad, acid is bad, can't have acid in your stomach.
13:49
This is really good. And we were like oh, wait till
13:51
we start prescribing. These sound really interesting,
13:54
and now we're trying to get people off some of these drugs.
13:57
You know, don't get me wrong, they have a role, but they're
14:00
not something we should be just giving to everybody.
14:03
And they have significant, there are risks for them.
14:05
And what we don't teach in medicine is to think about
14:08
number needs to treat, how many patients, ones in front of us
14:11
like with the same condition, do I need to treat to save one
14:14
life? And then what are the harms of
14:16
that? So you've got people who've got
14:18
a slightly higher rate of cholesterol, you may need to
14:21
treat hundreds of people like that person in front of you with
14:23
statins to save one stroke or one heart attack over 10 years.
14:29
But the side effects of those medications are massive.
14:32
And then when we think about, we also have far too quick to
14:36
organize diagnostic tests sometimes.
14:38
So we don't think about number need to investigate how many
14:41
patients in front of me with this condition do I need to
14:44
investigate to save a life. So a really good example is
14:48
we've got any person from a nursing home who comes in with a
14:51
full and it's standard protocol that, you know, if they bang
14:55
their head, they've got some bruises, got some confusion,
14:57
we'll get a CT head, which is fine.
15:00
But actually how many CT heads do you need to save life?
15:02
Because most of these patients wouldn't go for an operation
15:05
anyway. We are greeting our own
15:08
anxieties and our own risk of being sued and that's, yeah, one
15:12
of the problems. We've got defensive medicine.
15:14
Rather than being risk additions, we've become too
15:16
protocolised and we've not thought about the bigger picture
15:19
and thought about the person. We think about illness, not
15:22
people. Yeah, I think that's so true.
15:24
And so many times I'll say to patients I will only do a blood
15:28
test or a scan if it's going to change my management.
15:31
You are more than just a number. And sometimes it can be quite
15:35
hard for them to understand that.
15:38
But once they realise that obviously then if they don't get
15:41
better, we will consider if they need a scan or a test or a
15:45
referral or something else. But it is also this multi
15:48
pronged approach that I think so much in medicine, we think we'll
15:52
give a treatment and then see if it works.
15:54
But actually we'll give a treatment, but also we'll talk
15:56
to you about your lifestyle. And actually I did a Instagram
16:00
Live the other day just about exercise.
16:02
And I'm not an exercise specialist.
16:04
I am honestly not incredibly fit, but I do yoga regularly for
16:09
my mental health, my physical health as well.
16:12
And I was just talking generally about moving, not always
16:15
exercise, just doing something. And somebody then messaged me
16:18
the next day and say don't use them because I listened to your
16:21
chat. I got up at six and went for a
16:23
walk. Thank you so much.
16:25
And I'm like, yes, come on, that's brilliant, isn't it?
16:28
I don't think you don't need exercise specialists to
16:30
necessarily about exercise, just need to do something you enjoy.
16:33
If you enjoy playing tennis, play tennis you enjoy.
16:35
For going for run, go for run, just make sure you get out and
16:38
exercise. The other thing is people forget
16:40
is how important weights are. And it's not just aerobic
16:44
running and cycling. It's actually physical, you
16:47
know, lifting weights and that's, you know, if you want to
16:50
lose weight, it's about diet and it's about improving your
16:52
muscle. You won't be able to run
16:54
yourself out of into a diet. It's about building up the
16:57
muscle because that increase your metabolic rate and that
16:59
makes it easy to lose weight. Plus it's the diet and so it's
17:02
the weights as well as the aerobic exercise which is so
17:05
important. And one of the things I really
17:08
worry about is frailty. I've spoken about before this
17:12
osteosarcopenia, so loss of bone mass, muscle mass and just
17:17
general, firstly, more likely to trip over the carpet, more
17:21
likely to have a break, you know, more than I.
17:24
But all these factors that especially elderly women are
17:28
coming into hospital with. The number of ladies I see Who
17:32
postmen are causal, their bones are brittle and they fall over,
17:36
they break the hips. Now it is such an awful
17:40
condition because it's not necessarily the hip breaking
17:42
which is the problem, it's the sign of how unwell they are and
17:45
there are things you can do to prevent it.
17:47
Now I am on vitamin D and K2, which is a tablet I take every
17:52
single day just to improve my bone density.
17:55
And because I've got into this, I got a DEXA scan to look at my
17:58
bone mass and my mass, and I'm in the top 95% of the population
18:02
of my age group for bone. And it's not that that's too
18:05
high, probably 50% is too low because that's what the average
18:08
person is. But I don't want to break my hip
18:10
when I'm older because I know what a death sentence that
18:12
means. And so it's about making sure
18:15
your vitamin D levels are high enough.
18:18
I don't know any harms if you take the standard amount,
18:21
virtually no harms. Obviously if you overlay and
18:23
take too much there as vitamin D toxicity.
18:24
But if you just take the standard amount in the vitamins
18:27
not cause any harms, then exercise that makes a mass
18:30
difference and then where you know you're the exponent in
18:32
terms of the hormones. That's not my area at all, but I
18:35
do know that one of the is such a danger that someone breaks the
18:39
hip tragedy. Yeah, but we've known actually
18:42
since 1941, someone, Professor Albright, first noticed that
18:47
hormones are very good at building bone.
18:49
And so one of the first indications for HRT actually was
18:53
for osteoporosis, both treatment and prevention.
18:56
But then since the bisphosphonates and other drugs
18:58
have come on, they've obviously a lot more expensive.
19:02
Lots of drug companies make them, and so that's been pushed
19:05
out and pushed out. And they of course have a role.
19:08
But actually again, treat the underlying 'cause if they're
19:11
postmenopausal, the low estrogen has contributed to their
19:14
thinning of the bone, then give back the estrogen to help build
19:18
the bone. But we found out last year with
19:21
a number of fractures that fragility fractures in women,
19:25
only 0.15% of those women were prescribed HRT.
19:31
That is nothing, is it Rob? Yeah.
19:33
And even before we become perimenopausal, you can do all
19:37
the other things like with the vitamin D way before you get
19:40
there to do everything you can. And this, that's just, you know,
19:43
bone fracture is just an example of all the things we can start
19:45
doing to try and to improve our health span because ultimately
19:50
that's the only way that the health service should go is in
19:53
try and improve health span. And, you know, we've got to have
19:56
that mind flip. We've got to have that mind
19:58
flip. Otherwise the health service
19:59
won't be there for us when we really need it for some awful
20:02
accident or illness that isn't preventable.
20:04
We need to get rid of as much preventable unwellness as
20:07
possible. So a really good example is type
20:09
D diabetes. It's such a killer.
20:11
It causes strokes, heart attacks, cataracts, you know,
20:14
blindness, everything. But actually, instead of just
20:16
treating with more and more medications, you can diet your
20:19
way. Out of type 2 diabetes, not type
20:22
1, not when you need the insulin injections if you're young, but
20:25
an obesity related type 2 diabetes.
20:28
Basically go on a virtually no carb diet.
20:32
That is not harmful at all. Do it with a dietician.
20:35
You completely change your body's relationship with insulin
20:39
and you stop becoming diabetic, and you can add years and years
20:42
and years of quality life to yourself by just lifestyle
20:45
changes, and then combine those lifestyle changes with the
20:48
treatments you need and people's health can be utterly
20:52
transformed. And it's interesting to say,
20:54
before I left general practice, I had a few patients who finally
20:58
started listening because it's hard to make changes.
21:00
It really is to Lowestoft when you've had certain food choices
21:05
ingrained in you. But they did start.
21:07
And I had a few men actually who were transformed, but it meant
21:11
they came off their antihypertensive, they came off
21:14
their statins, they reduced their type 2 diabetes
21:18
medication, they stopped their antidepressants, and they felt
21:22
so well as well. But that's not great for big
21:25
pharma though, is it? Well, there's is this sort of
21:28
thing about the money. When I look at some of the
21:31
turnovers of these big pharmaceutical companies, the
21:34
turnover for some of these drug companies is actually in
21:37
billions, not millions, isn't it?
21:39
It's not good for profits if people stop being diabetic
21:42
because they'll need a lot less of all those medications.
21:45
And actually we should be investing our money in longevity
21:48
clinics, in well-being clinics. You know, I had a meeting today
21:52
with the place for the well-being pharmacy in home.
21:54
It's a private pharmacy where they're starting to do a lot of
21:58
well-being checks, longevity clinics, exercise performance
22:02
tests, and they've got a great set up to look at how to improve
22:06
your longevity, improve your health span.
22:09
And actually some of that investment was moved that way
22:12
rather than to treatment. The impact could have been
22:15
massive. And I can signpost anybody wants
22:17
to e-mail me, it's Dr. robgalloway@gmail.com and I can
22:21
signpost you to the pharmacy. You do this type of things, but
22:23
it's just so much good which can come from it.
22:27
Yeah, absolutely. No ones ever too young to start
22:30
making changes. But the other side is no ones
22:32
too old. I think there are quite a few
22:34
people who think, well, I've always been like this, it's
22:36
really difficult. And certainly I've had some
22:39
great responses to people in their 70s or 80s who have made
22:42
very simple changes to their lifestyle, usually by a
22:46
combination of changing their diet, maybe not having as many
22:50
biscuits with a cup of tea in the afternoon, but also just
22:53
walking up the stairs rather than using the lift.
22:55
Or walking to the bus stop or the next bus stop rather than
22:58
the first one nearest to their house.
22:59
And those little things really can be transformational to
23:02
future House, can't they Rob? I completely agree.
23:04
So I'm involved in a chemical healthy for longer.
23:07
It's about trying to move physical exercise into carers
23:12
and when carers go to patients homes and also into nursing
23:15
homes, residential homes, instead of just making the
23:17
patient a cup of tea, get them to actually do 15 minutes of
23:20
exercise. And so this small Sarsoc company
23:23
called Healthy for Longer. The impact they could have on
23:26
patients is unbelievable. It genuinely is unbelievable
23:30
because we've made a series of exercise videos and the carers
23:34
are trained into becoming health personal trainers.
23:36
It's all evidence based things and I've advised them what
23:39
exercise to do and they get these patients who normally
23:42
sedentary don't move. They're getting weaker and
23:44
weaker to start lifting weights, start doing simple exercises,
23:47
and then actually the number of falls goes down, the mental
23:50
well-being goes up, and it's that type of attitude.
23:52
That's where the money needs to be in.
23:54
That's where the investment needs to be in.
23:56
That's where you know, you do that.
23:57
Then for a year, you won't necessarily need to send them
24:00
from the home into a nursing home.
24:02
You won't need that dependent care.
24:04
We create that different attitude.
24:07
It can make a big such a big difference.
24:10
So how are we going to do this? Is anyone at the forefront of
24:12
this? The problem is it's not sexy.
24:14
What I used to be interested. I still am.
24:16
I'm an only consultant. You know, Mike, a lot of my
24:18
colleagues work in the helicopter emergency stairs.
24:20
They jump out of helicopters, not jump in there and save
24:23
people's lives. You've had a big car accident.
24:24
That's quite sexy. Doing a angiogram when someone's
24:28
having a heart attack is quite sexy.
24:29
Doing CPR, you know, But actually what we're talking
24:33
about, not being rude is pretty dull.
24:36
You're not going to have 24 hours in Louise's clinic as ATV
24:39
program. You're not going to have 24
24:41
hours in longevity. You're not going to have the new
24:43
casualty to be based on someone going through right?
24:47
This is your risk factors. Why don't you take that?
24:49
Why don't you take this? Why don't you stop smoking?
24:51
Why don't you drink less? Why don't you lose weight?
24:53
Why don't you go and speak to Louise about hormones because
24:55
that's quite dull. What we need to do is make it
24:58
interesting, get people excited about it because I'm a older
25:02
father. I've got, I'm 47, I've got five
25:04
kids. My youngest one is 3 months.
25:06
I want her to. I can't cope.
25:08
I'm struggling, I'm actually exhausted.
25:11
But I don't want my baby daughter to have a 65 year old
25:15
dad who then dies from stress and a heart attack.
25:18
I want to live to 100. I want to live to 100 when I'm
25:20
active and well and it's biologically possible.
25:25
We've got a modern society which has got antibiotics and has got
25:28
clean water and that's what used to kill people.
25:32
And you know, there's used to be wars, trauma and infections used
25:35
to kill people. We've got over that.
25:37
Now what kills people is dementia is diabetes,
25:40
cardiovascular and cancer. But a lot of that is preventable
25:44
by lifestyle things. And so actually I think, you
25:48
know, I want to live longer to be able to still provide for my
25:51
family, still work, be interested, do things which
25:53
excite me because I find life exciting.
25:55
I want to live longer, healthier.
25:57
That to me is exciting, is as exciting as what I used to think
26:01
was exciting. And so that's how we do it.
26:03
We get people excited, we get a movement of people interested in
26:06
that holistic way rather than thinking you're quacks who are
26:09
mad to show the evidence behind it.
26:12
And you can only do evidence based medicine.
26:14
Everything we have to do has to be evidence based.
26:17
And a lot of people always talk about you can only do something
26:20
if there's a randomized control studies showing it.
26:23
I always practice best available evidence based medicine.
26:26
Now there's a difference between evidence based medicine and best
26:28
available evidence based medicine.
26:29
So there is no randomized control studies which shows
26:32
smoking is dangerous. It's observational studies.
26:35
We know from observational studies that it's dangerous.
26:39
The people who fund the best, you know what you call the gold
26:42
standard randomized control studies are often pharmacy
26:45
companies or pharmaceuticals, but actually double-blind
26:48
placebo-controlled trials and things like acupuncture.
26:51
There has been some which now show that it can work.
26:54
You know, we can see these difference is of more holistic
26:58
ways of working can make a difference.
27:00
You know, it's going to be hard to show a randomized control
27:03
study in the dangers of ultra processed food because I would
27:05
not want to be in the control group who get ultra processed
27:08
food. But so observational studies
27:10
will have to show the dangers. But we need to make this patient
27:15
centric view sexy rather than that individual treatments and
27:20
the exciting things sexy because then we can really make that
27:23
transformation of what our NHS needs and what we as individuals
27:27
need. I totally agree.
27:28
And some of it doesn't need huge evidence because a lot of it is
27:31
common sense as well, you know, and I think we're forgetting
27:35
common sense. You know, I grew up in the 70s
27:37
and we had St. parties for the Jubilee in 1977 and I was
27:41
looking at some photos recently and there was no one overweight.
27:45
Everyone was lean, everyone was, but our food was very different.
27:49
Everything we did was very different.
27:51
So we have to just go back to basics as well and think about
27:55
what we're eating, what we're drinking, how we're moving, and
27:59
that will make a huge difference.
28:01
So there's a lot we're going to do even if we do all this, Rob,
28:04
you will still have a job. People will still have
28:06
accidents. People will still have heart
28:08
attacks as joke. Absolutely.
28:09
And I want to be there for unpreventful things because at
28:12
the moment we are utterly overwhelmed and I can't.
28:15
I'm providing treatment, not care, because care is treatment
28:19
with dignity. I no longer provide dignified
28:22
care because the NHS in all honesty, is failing the medical
28:27
model that we've grown up with, that I've talked, that I has
28:31
been part of my psyche has failed.
28:33
And it's only the last few years when I've gone through my own
28:35
transition of, you know, I was unwell with Crohn's and
28:38
depression. My Crohn's is so much better
28:40
now. I've changed my diet, but you
28:41
know, I still get anxious. But my upset about things was to
28:45
appeal by 5K run every day. You know, I've gone through my
28:48
own journey in how I've transformed my health and I
28:51
think I'm, you know, I'm stressed because I've got five
28:54
kids and I do night still, but I'm still maintaining a vaguely
28:57
healthy balance because I've really looked at myself.
29:01
I want to look at the whole population, the people I treat.
29:04
And the current model has failed, is failing.
29:07
And we can't just tweak the status quo.
29:10
We are on an absolute health crisis.
29:13
And what we mustn't do is waste a good crisis.
29:15
We've got to use this crisis to transform the health of our
29:18
population. And it's once in a generation
29:21
opportunity at the moment. So right, and such a wonderful
29:24
way to end. But before we end, I always ask
29:27
for three take home tips and these are going to be quite easy
29:30
actually, but three things that we can all do because I know
29:34
however healthy we are, we can always do better.
29:36
So three things that we can all do that will help keep us
29:40
healthier for longer. Rob.
29:42
I think #1 is think about what you want to be like in 20 years
29:47
time, 30 years time with your grandchildren.
29:49
Do you want to lift up your kids and fly them around?
29:53
Do you want to be able to lift up a suitcase and go on holiday
29:56
with them? If the answer is yes, then you
29:59
need to invest in your health. Like you invest in shares, you
30:04
can invest in your health. So can you run 100M with your
30:07
kids? Can you pick up their suitcase
30:09
and take them on holiday? Can you lift them over your
30:11
shoulder and fly them in the air?
30:13
Are you going to be there for that?
30:15
Your grandchildren's 18th birthday.
30:17
Once you realize what your answer is, then everybody knows
30:21
the answers. Because I could say number one,
30:24
stop smoking #2 do some exercise #3 eat healthy.
30:27
You know that. So that being my #1 tip, think
30:29
about where you want to be #2 make things easy to live
30:35
healthily. So I have a chocolate addiction.
30:38
I am utterly obsessed. I love chocolate.
30:40
And the first thing is I just try never to buy it now in the
30:45
house. But the third thing is I say to
30:47
my kids, if you ever see me eating chocolate, I can
30:50
guarantee you I will give you £15.
30:52
I don't like losing money and I have a fine system.
30:55
So if they catch me to eating chocolate or crisps or awful
30:59
fizzy drinks, you know I'll pay that fine.
31:01
So make it create an environment where it is easy to live
31:07
healthy. So make habits.
31:08
So get up in the morning first thing to do.
31:11
Have some water go from before you do anything or get up.
31:14
Just make it into a habit because if you're outside of a
31:18
habit, you won't do it. So number one, have an aim #2
31:22
have a habit. And just trying to think of #3
31:26
you didn't give me any warning for this, so I hadn't really
31:28
thought of the third one. Come back to me, do something
31:30
like. I'll think of the third thing.
31:31
Well, I think, I think #3 is empower yourself with
31:35
information, actually, yeah. And make choices that are right
31:38
for you. Yeah, I think the days are
31:40
saying you can't do it, you can because even though things
31:44
aren't hard, it is very hard. You know ultra processed food is
31:47
cheaper. It is probably sometimes cheaper
31:50
to drive than to buy a new bicycle and cycle, but there are
31:53
things we can do, and so we need to realize where we want to go.
31:58
We need to make those habits easy, and we need to believe
32:01
that we can make a difference, because actually, we can.
32:04
Perfect. Very good.
32:06
So thank you so much for your time.
32:08
I know you're going off to do more work, but I'm really
32:10
appreciate you cramming in this space so we can educate and make
32:15
people think differently about their health and disease
32:17
prevention as well. So thanks so much for your time
32:19
today. Pleasure, Thanks for having me.
32:25
You can find out more about Newson Health Group by visiting
32:29
www.newsonhealth.co.uk and you can download the free Balance
32:35
app on the App Store or Google. Play.