I've been a doctor for 25 years - this is where the system fails

1. RCDr. Rangan Chatterjee0:00

   I've spent years inside a system that, in theory, is supposed to help people heal. But far too often, I have seen it fail. I have literally seen thousands of patients struggle over the years, convinced that they were broken because the pills weren't working, when the truth is they were never the problem. In many cases, it was the system. So today, I want to share with you what I wish someone had told me when I first became a doctor. Now, you come out of medical school believing that you have been given all the tools that you need to help people heal, but that's not quite fully true. We're given a lot of helpful tools, for sure, which can help some people. But the reality is that these days, eighty to ninety percent of what we see in medicine is in some way driven by our collective modern lifestyles. Now, when I say that, I'm not putting blame on people. I understand that modern life is tough. At the same time, we need to recognize that these collective modern lifestyles are making us sick in a variety of different ways. Now, the key thing that I want to explain to you is that at medical school, we're not really taught about how lifestyle causes these issues, nor are we given much training in order to help people change their lifestyles. We are basically taught to diagnose disease and to treat the symptoms of that disease with drugs, which of course can be really, really helpful for some individuals, but not for everyone. It can help some things, but it doesn't help everything. The reality is that when you come in and see a doctor with whatever problem you're having, it's very likely that your condition or your symptoms are going to get medicalized. As the saying goes, if all you have is a hammer, everything looks like a nail. We are trained in a disease model. That's what we're trained to look at. The diagnosis of disease is completely different from the creation of health, which is one of the reasons why so many patients these days are overly medicated, and those medications that they are taking often aren't working very well. In a lot of cases, they're certainly not getting to the root cause of the problem. Now, the number of prescriptions issued by family doctors has literally exploded in the last twenty years, with millions now taking a cocktail of six or more different pills. And the reality is, is that a lot of the studies we have to assess whether a medication works or not is only done when you're taking that one medication. So if you're on two or three or four or five or six pills or even more, the studies haven't really been done to say that that's safe or that those medications won't interact with each other. So this is a massive problem, and I'm not blaming individual doctors. I get it. I know how we're trained. I know what the system almost requires you to do. But as a patient, I think you need to understand what's really going on. Your doctor is trying to help you, but your doctor's trying to help you probably based upon a model that they learnt at medical school, which is ultimately a disease-based model. I think it's really important for us all to understand that your depression is not a deficiency of Prozac, your Type II diabetes is not a deficiency of metformin, your weight gain is not a deficiency of Ozempic. Now, that does not mean that those things can never have any use. I'm not saying that. I'm all for informed consent, but too often we are not giving patients another option. We're telling them that, "You have Type II diabetes, therefore we need to start you on medication." Instead of saying, "Well, Type II diabetes started in your body maybe five or even ten years ago, and it's been building. And yes, we've diagnosed it today, but the process started a long time ago. Would you like me to help you understand what are the factors in your life that might have been contributing? Because if we can change them, it's possible to turn that ship around." That's the approach I've always taken with my patients, and that's the approach I think most patients want. They want to be given an option. Now, I respect every single patient to do what they believe is right for them. If you're given an option as a patient and you go, "I don't want to do the lifestyle change. Not interested. Give me the pill," I'm okay with that as long as we as a profession have properly explained both options for you. But I can tell you that is not happening in the vast majority of cases, number one, because of the training that we get, and number two, because of the modern healthcare system. Here in the UK, it is not uncommon for a patient to only get ten minutes with their doctor, so of course it tends to be much easier to write a prescription than it is to spend time trying to understand someone's lifestyle. So I do understand that.But the reality is we are in a healthcare crisis in many countries around the world, and we're not going to medicate our way out of it. There has to be another way. Now, to really illustrate this, I want to briefly talk about depression. Now, I'm not sure if you know this or not, but here in the UK, 20% of the UK adult population are currently taking antidepressants. Now, I think that is a shocking statistic. One in five of UK adults are taking antidepressants. What does that say about the state of the modern world? What does it say about the way we treat or medicate the problems that are often happening as a consequence of the way in which we live? You know, antidepressants are now among the most commonly prescribed drugs in England, almost doubling from thirty-six million prescriptions in 2008 to over seventy million just a decade later. And according to one study of patients on antidepressants, 38% of people taking them report negative side effects. Now, this is a really serious issue. First of all, if you look at the evidence as to whether these antidepressants work or not, the evidence is pretty shaky, honestly. There's not a convincing case that there really is a chemical imbalance in depression that gets fixed by taking these drugs. I know this is a controversial perspective, but even if you think that there is evidence to support that there is a chemical imbalance and that these drugs aim to fix that, do you honestly believe that it's reasonable for 20% of the UK adult population to be taking antidepressants? Because I don't. In fact, I'll be completely honest with you and say I've never really liked labeling any of my patients with depression. If it feels like you've forgotten how to feel joy, like you're surviving and not really living, I've created a free guide to help you. Because happiness isn't something you chase, it's something you train your brain to feel. My new guide is called The Happiness Prescription, 5 Daily Rituals That Rewire Your Brain for Joy. These are the exact rituals I've used with many of my patients to help them feel alive again, even in the middle of stress, fatigue, or loss. To get your free guide right now, click the first link in the description box below or scan the QR code on screen. If a patient comes in and they have a variety of different symptoms, low mood, difficulty in getting pleasure from the things that they used to get pleasure in, they're struggling with motivation, they're getting up early in the morning. These are symptoms that are suggestive of a diagnosis of depression. But I think you have to be very, very careful before you label someone, because labels can, in some cases, become disempowering. People will often go and believe that, "Oh, you know, of course, this is the way I am because I've got depression. You know, I knew I was gonna get depression. My dad had depression." Of course, I understand that sometimes labels can be helpful. A label can help someone get access to services that they wouldn't otherwise have access to without that label. But I think it's really important to understand that labels are not neutral. Once you have that label, you may find that you get disempowered, and you stop trying to make the changes that can often be really, really helpful. So I personally have shied away from making a diagnosis of depression, even though that's what the world around me has often wanted me to do, or the system, I should say. What I've often done is talk to people about what they can do in their lives that potentially might make a difference. Now, the thing with depression is this. You could literally come across ten different people who have all got a diagnosis of depression, but they may have ten different reasons for that. They're not all the same. Each one needs to be looked at individually. We need to figure out, well, what is going on in this person that might be contributing? And in my experience, there is almost always a way that you can help people without the use of medication. The key is try to understand the individual. What's actually going on? Maybe they've left their home environment for a work opportunity. So they've left their family, they've left their friends, and on paper, they've got a great job, but they're lonely because they've got no one around them. So in some ways, their low mood is completely understandable. It's a natural response to the state of their life. Perhaps they're in a job that they can't stand, and they have no way of changing that at the moment. There's no purpose there. There's no passion. But that's the job they currently have to do in order to meet the bills. Well, again, their low mood and their discomfort with their life may well be an accurate reflection of what's going on in their life. Maybe someone is stuck inside all day. They don't get out. They're living in a high-rise in the middle of an urban city. They're eating junk food all the time. They're not moving their body. They're spending a lot of time on screens.Well, maybe the low mood and indifference they have to life is an accurate reflection of what's going on in their life. And that's the key thing I think about when I have a patient in front of me who I could diagnose with depression. Maybe it's not a disease to treat, but a set of problems we need to understand. You see, there are so many things that we can do to help improve our mood. We have a ton of research showing us that exercise can be very powerful to improve our moods. Even 10 minutes of walking a day has been shown to improve symptoms of depression. We know that being out in nature regularly can also help with symptoms of depression. Some people find cold water swimming or cold water immersion incredibly helpful. Other people don't. And of course, if someone is struggling with their moods, it can be hard for them to have the motivation to engage in so many of these things. But that doesn't mean we're doing them a service by labeling them and putting them on medication. I've been using Bon Charge wellness products for over five years now, from red light therapy to infrared sauna blankets to blue light glasses. Bon Charge make it really easy to get healthy while staying at home. Now, one of my personal favorites is their Demi Red Light Therapy device. I absolutely love it and use it on most days. And I personally have this device on when doing my morning meditation, and I also tend to read in front of it in the evening before I go to bed. And I've noticed some quite significant changes, improved relaxation, enhanced focus, and deeper sleep. Now, there are so many studies out there showing the potential wide-ranging benefits of red light therapy, including better eye health, pain relief, reduced inflammation, enhanced recovery, improved sleep, and even better skin. So if you're looking to take charge of your health at home, I highly recommend you consider adding the Demi Red Light Therapy device into your daily routine. Bon Charge are giving my audience 20% off all of their products on their website. Just scan the QR code on screen or go to boncharge.com/livemore and use the coupon code LIVEMORE to save your 20%. Now, again, I want to reiterate something that's really important. I am not saying that drugs have no place. Of course they do in certain situations. But I believe for many cases, we are massively overusing them. But I can think of, uh, a patient who had to do many different things in order to improve their moods. They used to be on antidepressants, but how did they heal? Because you can heal, and this particular patient I'm thinking about was on and off antidepressants for almost ten years, but he is now thriving. For many years, he's been thriving. He doesn't take any medications at all. And how did he do that? Well, it started off with him making a decision in his brain that the drugs weren't going to fix him. He had to do something different in his life if he wanted to feel different. And he started off by going for a walk in nature every lunchtime. Super small change. Went out for lunch, a little 15, 20 minute walk in nature. Over time, he started to try and eat a little bit better. Then he started to run three or four times a week outside in nature if he could, but not always. Then he started to engage with some breathwork and some cold water immersion. Again, he didn't do all of these things at the same time. It took him time, and each one of these little changes he made started to build momentum. Little by little, his mood started to improve. As he felt better about himself, he would start engaging in more and more things, and over time, that led to him quitting his job and starting a business in something that he was truly passionate about. This is often what needs to happen if we're going to help someone change the way in which they feel. It's not just one thing. It's often a combination of small things that over time really make a massive difference. Now, I've used depression to illustrate my central point, but I can make the same case to you around type two diabetes, anxiety, weight gain, high blood pressure, even hormonal symptoms, because I've seen this over and over again. When you pay attention to your lifestyle, you can have a massive change in all kinds of different conditions, because if you focus on the creation of health, all kinds of downstream symptoms start to go away as a side effect. Now, the way I've done this for many, many years with my patients is with what I call the four pillar approach, which I first wrote about in 2017 in my first book. Okay? Now, in the UK, the book was called The 4 Pillar Plan: How to Relax, Eat, Move, and Sleep Your Way to a Longer, Healthier Life. In many countries around the world, this is the version of the book. In the US and Canada, the book was called How to Make Disease Disappear. Now, these books are still available, so if you want to learn more about my philosophy on how we can use simple lifestyle changes to help a variety of different symptoms, I would really encourage you to check them out. But in essence, in that book, I say that the four key pillars of health are food, movement, sleep, and relaxation.You don't need perfection in any one of those four, but you do need balance between all of them. And why I think these four pillars are so, so crucial is because they're not only the four pillars that have the most impact on our short-term and our long-term health, they're also the four pillars that we actually have a high degree of control over. Now, of course, some of us have got highly stressful lives, and sometimes there's not much we can do about that. But generally speaking, I think most of us can proactively make changes in those four pillars. And since this book came out all over the world a few years ago, I have literally had tens of thousands of messages from people telling me that it's helped them reverse their type 2 diabetes, get rid of their depression, eliminate their hormonal symptoms, reduce their anxiety, et cetera, et cetera, because it's not focused on disease. That's what I said right at the start, didn't I? That's what we're trained to do as doctors, diagnose disease and treat the symptoms of disease with drugs. Whereas my approach is about the creation of health. And what I've learnt over the years is you simply do not know how many of your patients' symptoms are down to lifestyle until you correct their lifestyle. So if you're struggling with a certain part of your life or your health at the moment, I would really encourage you to ask yourself which of these four pillars do you need the most work in? Is it food? Is it movement? Is it sleep? Or is it relaxation? And I would encourage you to make a few small changes in that pillar. You don't need a full life overhaul. You can start with small changes that build up over time. But if you can stay consistent and you pay attention, it is highly likely that within a few days and weeks, you're going to feel like a completely different person. So I hope you found this video useful. Do let me know in the comments below if you have any further questions or topics I can try and cover for you in future videos. And in the meantime, if you do want to check out the book that I was talking about, The 4 Pillar Plan or How to Make Disease Disappear, it's the same book, just different names for different countries. It is available as a paperback, as an e-book, and as an audiobook, which I am narrating. I hope you found this video useful, and if you want to learn more, I'd highly recommend you check out this video now as well. In this video, I'm gonna share with you some of the core life truths that I wish someone had shared with me when I was younger. This is not a shortcut to success. It's a path to freedom.

Episode duration: 21:16