Dr Michael Dixon is the National Clinical Lead for Social Prescription (NHS England), Medical Advisor to HRH Prince of Wales and Chairman of the College of Medicine in London. In this extended feature with Dr Dixon, we focus on health, wellness and the growth of social prescribing. It has now become national policy (from 1st July) that a link worker will be provided by NHS England to every group of GP practices (Primary Care Network) making social prescribing universally available.
In addition, Dr Dixon shares his vast experience in the medical field, including his own background, career, the role of medicine, thoughts on exercise, diet, yoga, what he’s reading, hopes and aspirations, and even his prescription to live to 100 years! Believing in “patient-centred medicine” and the role of the patient in self healing, his views are as stimulating as they are progressive as he brings to life ideals and values in healthcare that are both contemporary and timeless. Read on for our special in-depth interview with Dr Michael Dixon.
Hello Dr. Dixon,
Welcome to Keep Fit Kingdom and thank you for taking a moment to share your views with us.
Our mission is to help a Billion people reach 100 years of age by year 2100 happily and healthily hence we’re developing the “B2100” programme concept – your thoughts?
Thank you for asking me to share my views. I think “Keep Fit Kingdom” is a noble mission and of course it is not just about reaching 100 years of age it is also about having 100 years of quality life and being healthy in mind, body and spirit. It is something that we can aim for now that it is clear, that there is so much we can do now with our lives to increase our chances of healthy ageing.
Absolutely. So, what made you decide to get into the medical profession, and especially what initially opened your eyes and mind toward Complementary Medicine?
No one had previously been in the medical profession in my family. I was keen to do a job that made a difference though my initial interest was more in the mind than the body. My interest in complementary medicine developed after ten years as a country doctor as I began to realise that there were so many gaps in what we could do for patients using only conventional medicine – e.g. patients with chronic tiredness, frequent infections, irritable bowel, premenstrual syndrome, depression, stress, back pain, neck pain and so many other conditions. It was frustrating to have such a limited range of options for treating conditions that I would see in surgery every day. It made my medicine more effective and colourful and restored my sense of self-worth as a doctor.
On Social Prescribing
I see. You have been championing the cause of social prescribing for many years; can you describe it in a nutshell – and how much easier is it today to roll out new initiatives, pilot projects and short trials personalised for local communities across London and the UK?
Social prescribing is about taking medicine beyond pills and procedures. Patients can be prescribed anything from benefits and housing advice to arts interventions (e.g. singing, dancing, drama and reading groups) to a range of physical interventions (e.g. walk and talks, green and blue gyms, gardening, allotments etc). Social prescribing involves, crucially, a link worker, who can spend time with a patient and understand his/her hopes, challenges, obstacles, beliefs, culture and perspective.
It works because the patient working with the link worker can become more activated in his/her own treatment and health – in many cases someone who is lacking in confidence, self-esteem and motivation can become someone who is confident, enjoys life and plays an active part in his/her own health and that of others. It is now national policy and on 1st July 2019, a link worker will be provided by NHS England to every group of GP practices (primary care network) and thus social prescribing will become universally available.
The Value of Social Prescribing & the Importance of Purpose
Good to know. Our creative approach to social prescribing is flexible and through motivational interviewing helps us understand what makes a referred patient ‘tick’ and focus on what they’re passionate about, their strengths and innate potential. Conceptually, do you think that this method could help prevent illness/disease, depression, use of medication, as well as save GP time, and NHS resources?
Yes it definitely can. We know that it saves on NHS resources as five or six studies from different CCGs (such as Rotherham, Gloucestershire, Croydon and West London) have shown it reduces use of GP services and hospitals by around an average of 20%. It is particularly helpful for patients with mental health problems and leads to less use of medication at a time when it is recognised by most conventional medics that we are over medicalised with too many patients on multiple prescriptions and with antibiotics overused and developing resistance.
Pleased to hear about the positive results so far. So, how much of an influence does having something to look forward to, enjoy doing, or having a purpose and working with others, have on health?
I think it has an enormous influence as much research has shown. If you have a purpose and meaning in life then your outlook, mental well-being and activities mean that you are healthier and live longer. I think that having a meaning in life is possibly the most important thing health wise.
HRH The Prince of Wales’ vision of healthcare
A convincing insight. As the medical advisor to HRH The Prince of Wales – what is his vision for UK healthcare, ultimately?
HRH The Prince of Wales has argued over many years for “the best of both worlds” of conventional and complementary medicine and been an arch advocate of integrated medicine and social prescribing. I think he would like to see each of us able to achieve our potential (these are the tenets behind the Prince’s Trust) and everyone having a chance – in terms of support, motivation and resource – to live as healthy and active and significant a life as possible. He has been a visionary, when it comes to health and much of his thinking, which was once seen as unconventional, is now becoming mainstream.
Changes in the NHS
Certainly it’s something to discuss further. So, what is your vision for social prescribing over the next 5-10 years?
My hope is that clinicians will use it effectively and understand its huge importance in enabling medicine and the health service to be sustainable. I hope that it will see an expansion of the volunteer/voluntary sector at local level, leading to greater social capital, asset-based community development and thus catalyse health creating communities – which make us healthy rather than as at present, make us sick. I hope that it will have proven that it is for the long term and become an intrinsic part of what doctors and the health service and indeed whole communities do in future.
We’re committed to these ideals. If you could change one thing in the NHS right now, what would it be?
I would like to see the NHS become kinder to its patients and those that work within it, with compassion, continuity of care and going the last mile being restored as prime rather than ticking boxes and keeping noses clean. A start might be to change our systems of redress, which have seen doctor and patient pitted against each other with the development of “no win/no fee”.
On the use of medicine
Agree. OK, so how necessary do you believe prescription medications are? Do you think it’s possible to dispense with medicines for the most part? Do you mostly agree with what Dr Rupy, who wrote “The Doctor’s Kitchen” books, suggests: seeing food as your medicine?
Prescription medications have had an enormous impact on quality and length of life for patients with a variety of diseases. Unfortunately, they have been so good that we are now using pills instead of concentrating on a healthy enough lifestyle that will provide more sustainable effects at less expense. When it comes to problems such as depression and stress or infections requiring antibiotics, we should aim to minimise their use by living a lifestyle that will often prevent the problem in the first place and consider non-medical interventions first line when appropriate. Certainly we should see food as medicine and the College of Medicine’s third conference on the 24th October this year will be entitled “Food on Prescription” showing how food can control and prevent a vast range of problems and diseases – indeed it is probably the most significant factor of all, in our health.
We’re working on some ways to introduce this into schools too. Tell us, how far do you think fear and big-pharma marketing conditions people into thinking they must rely on medication?
I think that fear and our medicine-addicted culture are partly to blame but I also think that we are conditioned into looking for the “quick fix” rather than the more sustainable solution that might require greater effort on our own part. The tide is thankfully changing because “a pill for every ill” is sounding increasingly hollow.
Dr Dixon’s Top 3 Tips to live to 100 years
I see. So, based on the number of patients you’ve seen over the years, what are Dr Dixon’s Top 3 tips to live happily and healthily, to a 100-year goal?
First and foremost, have a mission in life. A purpose for getting up in the morning and the visions that you need to achieve. Secondly, ensure that you have enough love and friends around to support you in both good and bad times. Thirdly, keep physically active, eat healthily and think positively.
On the role of yoga
A clear, lifelong prescription. Yoga is very popular nowadays what do you think the role of yoga will be on UK healthcare in the next 5-10 years?
I think yoga is going to have an increasingly high profile as it is not only useful on both the physical and psychological level but brings people together and enables them to play a much more active part in their health and healing.
And do you think that meditation is as important as yoga given the rise of such psychological issues as ADHD, ADD, anxiety and growing stress in general?
Both are important for mind and body and it depends, to some extent, which appeals to a given individual.
Indeed, there’s a tremendous variety available. Some studies indicate that thought could be the medicine of the future, your views? How many years are we away from something like that?
The mind and the body have always been inseparable and it is only wrong-footed scientists and medics that have ignored the extremely powerful effects of the mind in health and healing and, for that matter, disease as well.
We’ve come up with some excellent results in this area. Can you tell us what are a few of your favourite exercises that help you perform at your best?
Flexion and extension exercises for my back, when I get lower back pain especially in consultation and driving. Also a number of yoga positions – particularly for neck pain and my frozen shoulder. I never dreamt that I would ever be able to touch my toes until I started yoga!
On diet & supplements
The seated ‘Forward Fold’ (Paschimottanasana) is indispensable! Moving onto food, what are your views on plant-based diets; vegetarianism & veganism?
We know that plentiful fruit and vegetables are good for health and longevity and I would certainly support those that want to become vegetarians. However we are biologically omnivores and I believe that meat and fish can be part of a healthy diet provided that the food and activity of their sources have also been healthy. Meat has been demonised because of unhealthy farming methods that result from a very distorted market and unreasonable demands on farmers. Sustainable farming requires animals grazing and only they can convert grass into food and fertilizer.
What are your preferred go-to foods that provide you the most energy?
Dark greens (especially purple sprouting broccoli and Swiss chard), new potatoes, just about any fish and all berries.
That’s helpful to know. And, what particular brain-enhancing, nootropic or perhaps Ayurvedic or Chinese (TCM) herb/supplements do you think show the most promise in lieu of conventional prescriptions?
Omega 3 has been shown to be effective – especially in children – we know that many people find Rhodiola helpful. I have to admit to using coffee as a brain enhancer, when under pressure!
Coffee is undergoing a notable resurgence. What’s your best energy-management tip?
Avoid large high fat/high carbohydrate meals.
Favourite film & books in the health field
Brilliant. What film or documentary in the field of health has made an indelible impression on you?
“Cathy Come Home” was a film/documentary in the 1960’s and had a profound influence on me as a teenager. It fuelled my battles against social injustice and my wanting to become a doctor though recognising that there were limits to what any doctor can achieve in this respect.
How interesting. And what books have inspired you most so far in the areas of alternative medicine and health?
They are too numerous to mention! Two books I have just recently been sent and enjoyed are Professor Al Aynsley-Green’s book “The British Betrayal Childhood”, which shows why we need to do much better for our children and adolescents. Sir Al is previously the Children’s Czar and sits on the Scientific Council of the College of Medicine and will be leading initiatives on this. The other book I was recently sent was by Professor Dean Ornish and Anne Ornish “Undo it!” This features Dean Ornish’s extraordinary work in showing how problems such as heart disease, prostatic cancer, ageing and even possibly dementia can be prevented and sometimes reversed by the way you live.
Reflections, hopes & aspirations
Dr Dixon, what are your views on human potential briefly?
It could be almost infinite.
That’s an intriguing prospect. Perhaps this should be discussed more often. What advice would you give to an ambitious, driven medical student about to enter the “real world”? What advice should they ignore?
Never forget your values – if you stop caring then you stop being an effective doctor. Don’t believe those that say you must insulate your feelings from your patient.
What is your proudest accomplishment so far?
To have been a co-creator of social prescription as a national movement and for it now to be national policy and universally available.
Your persistence has paid off. So what goals do you still wish to achieve?
I would like to see social prescription embedded in the health system and shown to be a major catalyst in the development of health-creating communities. I would like to see healing in the divide between conventional and complementary medicine with greater tolerance and respect on both sides. I would like to make better and healthier food more available and more wanted especially by those who need healthy food most. I would like to play a part in reducing the unhappiness of our young people providing them with more hope and the wherewithal to achieve their ambitions.
We hope to contribute to that through our mission and B2100 programme. As we’re about to sign off, Dr Dixon, what are a couple of life quotes or motivational sayings that inspire and motivate you to be and do your best?
“Never, never, never… Never give up!”
“Try to be kind”.
“Upset is optional”.
Thank you. Which progressive thinker and social prescribing champion would you nominate to be interviewed next and why?
Either Sir Sam Everington, who is CCG Chair and has built up the visionary Bromley by Bow Centre or Professor Chris Drinkwater, who set up Newcastle West and was in the vanguard of social prescribing.
Sounds good. And, finally, Dr Dixon, what special message would you like to share with Keep Fit Kingdom readers and those that follow your work in the UK, and around the world, right now?
We must learn to love ourselves and each other more and understand that giving rather than taking is the key to happiness and a longer life.
Thank you Dr Dixon, for your kind participation in this interview and for sharing your valuable insights, experience and wisdom with us.