What do you think about GP's prescribing you 'a walk'?

[StrawberryMarble]

I just heard this on radio 4, that GP's will be able to prescribe a walk or a bike ride etc. We all know we need to move more & not lead sedentary lives. I don't disagree that we need to get moving & keep our fitness, especially as we get older. But I can see a few people getting upset over this. I think it might be a common prescription with waiting times post covid being so long.

It is about access. 'Access' is affected by all sorts of things, I referenced:

facilities
equipment
time
childcare
mental health to do it in the first place

It is well known that the richer you are, the more you will have these things in place in your life. This is not controversial or new information.

Absolutely this!

Unfortunately many MNers have no idea what it’s like living in the real world for most people.

It’s sometimes not possible to join in these activities or go for walks after work if you’re a single parent working 2 jobs or are full time carers etc.

Something does need to be done as we’re getting unhealthier and relying on medication way too much but having a ‘can do’ attitude is not going to pay the bills.

A few years ago I was suicidal and really needed some help. The GP said I should "go for a daily walk'. I felt so invalidated, and stupid for thinking that I would be able to get any help. It made me wish I hadn't gone at all.

In your shoes I would (and do) join the daily mile as a visitor.

I also need my car during the school day and my only real parking option is the car park. So I arrive early and walk from work and/or go for a walk after work before leaving.

I do join in and so do the staff at the school but I only visit them a couple of times a year and I’m often not there at the times they’re doing it, so it’s not a long term solution.

I also can’t arrive or leave work any earlier or later as I’m a single parent and can’t afford to pay the extra childcare and the one I use doesn’t open any earlier.

But what would these people do if their GP referred them for a course of counselling for trauma or CBT for depression or physiotherapy for a frozen shoulder? What about if they were pregnant and were advised biweekly checkups to monitor the baby’s health? What about if this all involved a bus journey to the most appropriate centre? Would they acknowledge it as necessary treatment for their condition and do as best they could to arrange childcare / get time off work to attend / overcome barriers to accessing the location? Or would they say they
simply couldn’t go because it wasn’t possible to make the time or travel that far?

I think most people would do the former. So if they aren’t prepared to do the same when their GP recommends a social prescription to an exercise class or the gym then the problem seems to be more that they aren’t accepting that exercise as important or necessary for their health or a valuable part of a treatment plan - which is incorrect. Treatment needs to be holistic and successful treatment often involves a level of effort and engagement from the service user.

Or would they say they
simply couldn’t go because it wasn’t possible to make the time or travel that far?

For all those things you would be allowed time off work for it though.
You’re not allowed time off to go for a walk.

In my case I can’t go offsite during my lunch break either.

I’m fortunate that I’m on my feet all day and can get my steps in but I know there’ll be people in similar circumstances as mine who are sat at a desk all day and probably do have many health issues because of it.

I definitely think that exercise, especially walking needs to be increased.
But unfortunately it’s not as simple or easy as your gp just telling you to walk more.

The point of social prescribing is that it is official medical advice. It isn’t just being told to go for a walk - the headline of “GP telling you to go for a walk” is detracting from the actual substance of the report, which includes peer support groups for walking and cycling, and loans of equipment to run or cycle. You would use your recommendation letter from the GP in the same way as one referring you to an outpatient clinic or physiotherapy, to demonstrate to your employer that this was treatment being recommended and request the time off.

It may not work for you as an individual, agreed: you’d presumably also be among the people who couldn’t attend any appointment requiring you to take time off work during the day or do anything which involves finding childcare.

Actually, we have a senior teacher at my school who has a diagnosis of Premenstrual dysphoric disorder (PMDD)

As part of her self care "prescription" regular breaks and walks are recommended so we have arranged her timetable so she can go for a walk during the school day.

Not all employers will, I don't suppose, but if it's prescribed by a doctor and can be submitted to OH, it will surely help patients to get employers on side?

I think that's a really unnecessary dig. Plenty of women have multi-generational caring commitments (elderly parents, young adults with additional needs, dgc they're asked to 'watch'), and come to MN for support and a bit of a chat. On the 'Chat' board.

If it is prescribed by a doctor like any other medical appointment then I think it’s a fantastic thing.

People spend most of their time at work and are often busy during their break times or after work so encouraging exercise in the workplace somehow would definitely benefit many people.

No one will notice what you wear. Coats, football kits, fancy dress,running gear, grey joggers, school kits, bathers, jeans, board shorts all regularly appear at ours. How dare you imply that your service users wouldn't fit in. Are you trying to keep them dependent on you?

In what way is the world more “real” if you have less money?

It’s a very silly claim, everyone’s life is as real as anyone else’s, and the idea that the “real world” is the one inhabited by only the poorest just doesn’t hold up.

Yes, and anyone spending time on here claiming that they can’t fit in any time at all in the week to go for a walk is likely not being honest.

But that was help. He was telling you something to do that could help you. Why were you invalidated by the GP telling you something so simple that could have such an important effect on your mental health?

There's a difference between not fitting in and thinking you won't fit in. I love.love.love parkrun, I think it has done enormous social good and is genuinely more inclusive than almost any other sporting endeavour (football is probably the other and MN loves to hate that!). However, it's still difficult.to turn up for the first time and if you think you don't

Bother, posted too soon.

If you think you don't have the right kit, that's going to be harder, especially if it's because you can't afford it. There's a world of difference between choosing to be oddly dressed and having to go that way.

GP's can and regularly do recommend/ prescribe physical activity as something that will help a whole plethora of health problems. This isn't a new idea at all.

In what way is the world more “real” if you have less money?

It’s a very silly claim, everyone’s life is as real as anyone else’s, and the idea that the “real world” is the one inhabited by only the poorest just doesn’t hold up.

Unless you are new to MN you will regularly see threads suggesting posters do things that the majority of people in the real world (aka offline) aren’t able to do.
E.g. Hire a nanny or cleaner, just move, go part time, become a SAHP etc

It’s not always about having less money but there are several posters who just don’t understand what life is like for the majority of the country.

If someone is a housewife and has all day to exercise, their life is going to be very different to a single parent who works 2 jobs.
If both go to a gp and the gp tells them to just walk more, then that is not helpful to the person who simply does not have the time.

The solutions need to work in the real world which is the life that the majority of people live and not just the most fortunate which is such a small percentage.

Of course if it’s ‘prescribed’ during working hours as PPs have said then that would work for many people as they won’t need to find extra time.

I need a total ankle replacement. I'm glad I don't live somewhere where my GP thinks it would be cured (or even improved) by taking a walk

FGS why would anyone think GP would suggest walking to fix a damage ankle? They don't prescribed blood pressure medication for it either. No one's saying it should be the only thing on offer for every condition.

Well no. And presumably they wouldn’t prescribe you antipsychotics, refer you to a midwife, or
recommend a heart bypass, either.

I’m not sure why people are interpreting “GPs might socially prescribe exercise and physical activities where indicated that these might help the particular condition being treated” as “GPs are going to tell you to go for a walk even if you have no legs” and the like.

Why would a GP do that? Do you think they'd prescribe insulin for high blood pressure?
The reality (and evidence base) is that physical exercise is hugely beneficial for both physical and mental health. So of course GPs should "prescribe" it. Loads of people will see it as them being fobbed off, but that's not a reason for GPs for not following the evidence.

Big pharma have done a stellar job convincing the public that medication is the only effective treatment for mental health problems, while the reality is that the majority of mental ill-health is situational (NOT caused by some inherent "chemical imbalance") and would be improved or resolved by removing external stressors.

I think for the majority now, medication = my problem is real and serious and caused by something out of my control.

If a GP would prescribe people to look after my disabled teenager whilst I am doing the walk that would be great.

AllLopsided
I need a total ankle replacement. I'm glad I don't live somewhere where my GP thinks it would be cured (or even improved) by taking a walk 

Well no. And presumably they wouldn’t prescribe you antipsychotics, refer you to a midwife, or^ recommend a heart bypass, either.

I’m not sure why people are interpreting “GPs might socially prescribe exercise and physical activities where indicated that these might help the particular condition being treated” as “GPs are going to tell you to go for a walk even if you have no legs” and the like.^

Because it will just become a cure all, a sticking plaster. Because it costs nothing and there will probably be incentives for prescribing it. Maybe I'm just cynical because I was fobbed off for years by being told my endometriosis pain was totally normal. The pain that I got a diagnosis for only when I moved abroad? The endometriosis that has put paid to my fertility and caused permanent damage to my organs as a direct result of the GP's lack of action? Yeah that. Forgive me for thinking that suggesting a walk will be applied across the board without even interviewing the patient thoroughly. 'Oh, you're here because you have ankle pain? Here's a prescription for a walk a day! Walking can really help joint pain. Come back to see me in a year. Bye now!' Before I even get to mention my end- stage arthritis and three previous failed surgeries...