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Friday 4 December 2015

BBC's Dr Chatterjee: My baby’s illness changed the way I work

When his son was just six months old, Dr Rangan Chatterjee was  devastated to discover the baby had a life-threatening condition. ''He had a fit caused by low levels of calcium – a hypo-calcaemic convulsion – because of a vitamin D deficiency, and needed intravenous calcium as well as high-dose vitamin D to save him. My wife and I were terribly shocked,’’ he says.

The near tragedy forced him to confront an uncomfortable truth. Fourteen years of medical training had not equipped him to detect a preventable condition in his own child. The episode changed his whole view of medicine and how he practised it.

Five years later, Dr Chatterjee, 38, is the star of the new BBC One series Doctor in The House, which sees the GP live with three different families in their own homes for a month at a time. He scrutinises them at work, at play, shopping for food and cooking, eating and sleeping.

Some are struggling with common problems – type 2 diabetes, menopause, stress and back pain – but the GP from Oldham is not there to prescribe drugs; his treatment is based on lifestyle interventions, and the effects are impressive. Dr Chatterjee grew up in a medical family – his late father, Dr Tarun Chatterjee, was a consultant in genito-urinary medicine at Manchester Royal Infirmary – and he studied at the University of Edinburgh Medical School, graduating in 2001 with an additional degree in immunology.

A career in renal medicine was his intention, but after initial medical rotations in Scotland, he returned to Manchester in 2003 to help look after his father, who was seriously ill with lupus and kidney failure. ''By that time I had done all the crazy emergency room shifts, and sat some of my exams, but I was becoming very frustrated at how super-specialist medicine was. I felt the role of generalist was undervalued.

As a doctor, I wasn’t really seeing the whole person.’’ He moved to general practice and found his beliefs put to the test at once: ''On my first day I saw a young woman with depression. My guidance suggested that I should prescribe anti-depressants, but I felt that this was wrong. She needed to talk.’’ He saw the patient twice a week and let her talk while he simply listened.  “And we got her better. I haven’t forgotten the value of that human connection.

“Studies suggest you can’t teach a good bedside manner. But if you can connect with patients, build a rapport with them, you get better outcomes.” Not that Dr Chatterjee doesn’t value mainstream medicine or drugs in context. “Acute medicine gave me 15 extra years with my father, as well as saving my son. But I believe GPs need to learn more about a functional medicine approach, as well as nutritional science. We don’t get taught this stuff at medical school and we don’t know how to engage people in behavioural change.”

His own “odyssey” of training proved to be a useful calling card when he auditioned last year for the BBC documentary series which explores “what would happen if a GP had more time with their patients?” That question “really resonated with me,” Dr Chatterjee says. Three months – and an intense interview process – later, Dr Chatterjee was in front of the cameras; filming  took nearly four months.

While he feels confident performing on screen – in his spare time he plays in a band – he says practising medicine in someone’s home was “odd”.  “You don’t really have the security of a surgery. It was uncomfortable at times. It can be hard to deliver difficult information to people you have become friendly with.’’ It sounds like a throwback to the traditional idea of the family doctor; the one who knew every member of the family. More Dr Finlay than Dr House?  ''Absolutely. Like most GPs, I love getting to know patients, but I don’t love the way we have to practise. The consultation is inadequate for the complexity of problems we see. And we don’t really have the tools to help the lifestyle-driven chronic problems.”

He adds: “The main reason I did the show is that I am passionate about public health. Good health isn’t as hard as we think it is. I always tell patients that most healthcare takes place in the home. It is based around what you put on a plate and how you use your feet.’’

The viewing public seems to agree with his approach. “I know that some people are sceptical of TV doctors but there has been so much positive feedback I’m really grateful for, including lots from doctors who say that they are delighted to see positive lifestyle medicine in action.”

Some viewers – mostly female – are also delighted to see a new doctor on screen who is tall (6ft 6in), handsome and sporty; he is already being dubbed by some the new “Dr McDreamy”, after the handsome character played by Patrick Dempsey in the TV hospital drama Grey’s Anatomy.

He laughs with not a little embarrassment when we discuss his potential new appointment as Chief Medical Heart-throb to the Nation. ''I don’t think I looked up to TV doctors as a kid, but do I remember that we used to watch Casualty on Saturday nights when I was at medical school.’’

Becoming well-known has had its moments already, not least on Twitter. “Ah, the social media side. That has been a learning experience for me – good and bad. People will take a pop at you – because they can. I wasn’t entirely prepared for being in the public eye.”

He laughs, “I caught the first episode with my wife, and I had to keep getting up from the sofa, saying 'I can’t watch this’. It was too strange seeing myself.”  Dr McDreamy’s growing legion of fans may beg to differ. But as long as they’re learning a few practical ways to avoid ill-health, he isn’t going to complain. ''I hope viewers will see the power of incremental change.  I really want to inspire people  to be healthier.’’

Doctor in the House continues on BBC One next Thursday here

10 things Dr Chatterjee learnt from his TV practice 

1 People are confused – there’s so much conflicting ''health’’ information out there; it makes lifestyle change difficult.

2 Chronic stress is a huge problem.

3 Acute and chronic care need completely different approaches.

4 The 10-minute consultation is inadequate for most problems that GPs see these days.

5 Lots of people still believe in “low fat’’ foods – not knowing they are loaded with added sugar.

6 There’s too much focus on family history – genetics loads the gun, but environment pulls the trigger.

7 Sleep – lack of it – is a big issue.

8 As a nation, we are overfed but under-nourished.

9 We have lost the ability to switch off – we are ''on’’ from the moment we wake up, and this is a big driver of the problems that doctors see.

10 Lifestyle changes don’t have to be huge but they do need to be consistent. For instance, I recommend that people should meditate daily, even if it is just for three minutes.



Linda said...

Interesting story! I plan to share it on Google Plus.

Cranberry Morning said...

That was a fascinating post! True here to, overfed and under nourished. Plus, doctors have very little time to spend with patients, and the huge bureaucracy that is health care becomes overburdened with paperwork, yet inadequate transfer of patient information from one doctor to another. Although all our medical information is now digital, it doesn't mean that the pertinent information is going to get to the doctor who is actually seeing the patient now. Big chunks of it seem to go missing, and we end up with two different diagnoses from two different specialists within two hours, both seeing the same patient. It's very frustrating.

Anonymous said...

This is still true of so many. Lots of people still believe in “low fat’’ foods – not knowing they are loaded with added sugar.

DeniseinVA said...

Fascinating concept this show. Having a doctor in the house for three months I would find very strange. I hope they get this show over here as I would like to see it.