Dear Sir
In many medical schools, students undergo an integrated basic sciences/ clinical course from Year 1.
Interestingly, despite the years of training at both an undergraduate and postgraduate level, it is clear that many of us rarely practice the strategy of prevention being better than cure. From a hospital perspective, junior doctors, for example, can easily treat an exacerbation of COPD or an episode of decompensated liver disease, but rarely do they spend time discussing the grave implications of smoking or continued alcohol misuse. Similarly, many patients are often admitted following repeated drug overdoses, but once over the withdrawal phase patients are often waved farewell with words to the effect of, ‘We can’t force you to stop doing what you are doing, the decision rests with you.’ The same can also be said for those heavily obese patients with their associated complications of hypertension and diabetes. I wonder how much time is actually spent encouraging individuals to lose weight when they are admitted with a systolic of 200 mm Hg or excessively high blood sugars?
Now I am sure all medically trained individuals have a more than adequate understanding of the importance of public health, but it is something that is rarely touched upon during medical school and even practiced later on in postgraduate training. Maybe as doctors we shy away from areas we may view as ‘soft medicine’. Or is it due to the fact that as a result of limited training, we do not feel confident in engaging with our patients at length about its importance.