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77 Overcoming overprescribing: moving from sick-care to health-care with medical education
  1. Hamaad Khan
  1. Anglia Ruskin University, Essex, UK


Overcoming overdiagnosis and overprescribing requires a radical rethinking of medicine: a paradigm shift away from the industrialised model of reactive ‘sick-care’ — where we admit, tend to, and heal the sick; sending patients back out into conditions that caused their illness in the first place — and towards health systems designed with a vision of health creation and disease prevention. As founder of ’Beyond Pills: Hope for the Future’, a student-led campaign, we aim to tackle overprescribing by bettering health education with peer-to-peer teaching.

Change in clinical culture must be led by the future health workforce. Current medical education informs future clinical practice. Future health practitioners are typically taught to view health as a biomedical construct; where health is defined by the functioning of bodily systems. If illness is only seen as biomedical, then the solutions considered by clinicians will only be biomedical too, leading to the overprescribing of drugs. But health exists beyond the membrane of our biology. The way we fall ill is as much about the environment, society, and politics as it is about disease — it’s a biopsychosocial interaction. The future generation of the health workforce must be taught to competently recognise when other interventions can be more beneficial in treating root causes of diseases. The UK APPG on Global Health’s report exploring the future roles of health workers urged that health workers must become agents of change and curators of knowledge who, ‘in addition to their clinical, research, management, or technology roles, can support, facilitate, guide, and influence all those actors outside the health sector [...] who do so much to shape health and wellbeing.’

Overdiagnosis and overprescribing is symptomatic of a hypermedicalised education blind to the possibility of practising medicine beyond medicines, beyond the pills and procedures. By being curators of knowledge with a holistic view of health and illness, future health workers can be agents of change, positively influencing clinical culture and patient expectations towards a more sustainable, effective model of healthcare delivery beyond medicinal treatment.

The ‘Beyond Pills Hope for the Future’’ campaign is led by young health professionals and students, focussing on transforming curricula for health-related subjects, and ensuring its suitability for 21st century demographic needs. Delivering peer-to-peer teaching on holistic, patient-centred, biopsychosocial learning, the campaign aims for the future health workforce to be skilled in establishing sustainable health systems relieved from iatrogenic burdens. 80 students attended the campaign launch in January 2023 and over 115 signatories of support to the campaign aims have been received from students.

We are living in an age with more medicines, more therapies and yet also more illness. As current and future populations live longer and the burden of chronic conditions gets heavier, our response cannot be to mindlessly medicate. It creates more patients, more ill-health, and increases spending on drugs. The future generation presents the opportunity to better understand and communicate medicine-related benefits and harms. This is about redefining perceptions of health amongst current health students, reforming the future health service, and revitalising health for all.

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