Friday, February 29, 2008

We need to educate men in the risks of online buying not bully them

Our online drugs survey suggests that most men would be prepared to buy drugs online in the right circumstances..

Of those surveyed, 38% said they would buy online 'in the right circumstances' and a further 23% said maybe they would. Now, this was a self-selected survey so I wouldn't claim it was highly scientific but at the same time there's no reason to doubt the basic finding. Indeed, one in three of the men in our survey had already bought drugs online.

The most popular online purchase among the 200 men surveyed was drugs to help erections (15% had bought them). The second most popular category was weight-loss drugs with 4%.

Clearly there is a big risk to online buying. But it is also clear - and doctors, drug companies and regulatory authorities need to understand this - that a lot of men are happy with it. Seven out of 10 of men who were buying online said they would recommend what they were buying to a friend. It may be illegal, it may be dangerous but for some men it's better than the alternatives - namely, taking nothing or having to talk to a doctor.

The most popular 'right circumstance' was 'if the doctor (or NICE) was unable or unwilling to prescribe something I felt I needed. Other 'right circumstances' included: recommendation from a reputable site or friend, convenience (to avoid having to go the doctors because they are 'only open in the weekdays') and privacy (to avoid it appearing on my medical records as they are 'now open access to the whole surgery')

Given this willingness to buy online, men need to be informed about how the counterfeit drugs trade really works so they can make their own decisions. This is what we're doing right now on malehealth with features including a tour of an internet drugs factory. Once you know what goes on behind the spam, there's only one decision you can make. But it needs to be a decision based on knowledge. Drug companies and doctors take note: threats about law-breaking or an old-fashioned 'just say no' type approach won't do it.

Tuesday, February 26, 2008

Overprescribed and dangerous - but anti-depressants can help

A review of 47 clinical trails of Prozac and three other anti-depressants has suggested that they are not helping most of the patients for whom they are prescribed. The unpublished trails particularly suggest that the benefits of anti-depressants, in the words of the researchers, fall 'below the accepted criteria for clinical significance’.

Speaking as someone who has taken these drugs, I'm not sure. The real problem is not the drugs but the way they are promoted and prescribed. In the right circumstances anti-depressants can do a job. The trouble is that we're doling them out like sweets - 31 million prescriptions in 2006 alone.

Full story.

Thursday, February 21, 2008

Stop faffing about on trans fats

It's rare we post two stories on the same subject in the same week but we've done it this week with those nasty little fatty acids - trans-fats.

These fats, which are created by turning liquid vegetable fats into solids for use in spreads and other foods, are known to be harmful to the heart and new research suggests they can double your risk of non-aggressive prostate cancer. At the same time, research from the US shows that manufacturers have responded to compulsory labelling of trans fats on food by cutting them completely - many margarine, butters, cookies, cakes and snack foods are trans-fat free. There's an obvious conclusion from this.

So how do you explain the decision of the Food Standards Agency 'that mandatory restrictions are not necessary' in the UK? They say trans-fat consumption is low here. Maybe - but there's no beneficial level of trans fats so even if our levels are already low reducing them further will only help - and possibly quite a lot. The FSA say the real problem in our diet is saturated fat - animal fat. Well, that's not an open and shut case but even if saturateds are the main problem, not solving one problem because there's another one that's more serious seems daft.

Action is quite possible. Denmark has effectively banned trans fats. The EU considered challenging this on anti-competition grounds but dropped the idea. Perhaps it realised the absurdity: in upholding its free trade principles it would be undermining its own health policy. Anyway, the other Nordic countries are considering following suit. Steen Stender of the Danish Nutrition Council has collected trans-fat data from around the world and the UK levels of which the FSA are so proud are really only good by comparison to the USA. Our consumption levels are no better than most in Europe and worse than many.

Trans fat free solutions already exist. Last year the British Retail Consortium announced its intention to remove industrially added trans-fats from all new stocks of own brand products.

Currently there are EU proposals in the table which could tighten up trans fat labelling but they would still be voluntary. Is that really enough? If the USA can insist on labelling without undermining its economy or enraging its fast food fans, why can't the UK?

Wednesday, February 20, 2008

Employers not GPs will reduce work-related illness

Health secretary Alan Johnson has said today that he wants to 'explore what else GPs can do to change our sick note culture into a well note culture'. Once again it's the public servant who is held responsible.

The GP's relationship with his patient is nothing to do with the state or the employer. Already GPs are placed in a difficult position with regard to incapacity benefit assessment and the BMA have rightly called for called for this process to be reformed. The hope has long been that the new incapacity benefit system would place less focus on the GP. But this latest idea appears to go in the opposite direction - extending the GP's policing role to pretty much anyone who is ill.

The BMA's Peter Holden rightly points out that 'confirming that a patient is unwell is very different from making a judgement on whether someone is well enough to do their job.' How is the GP supposed to know what equipment they use, how their office is arranged and about the numerous other factors concerning the job?

It is down to the employer to ensure that workers don't get ill by providing decent, civilised working conditions. Nothing more, nothing less.

This is the way to reduce the 30 million working days lost to work-related ill health and the 6 million lost to workplace injury. Smart employers are already doing that. British Gas and Parcelforce have reduced sickness rates by running advice sessions on back pain and mental health problems. Men are already reluctant to see their doctors. Turning GPs into unpaid sick note monitors for every employer in the country will only make them more reluctant.

Friday, February 15, 2008

Memo to editor: write about something interesting

The new annual circulation figures appear to show the men's magazines locked in terminal decline. Loaded is down 29% year on year, FHM down 15%, Maxim down 40%. It's hard to know whether to mourn the passing of an old friend or rejoice in the fact that the sector's relentless dash down-market doesn't appear to have worked. Even the weekly titles which started off down-market are in freefall - Nuts down 8.5% and Zoo down 12.5%.

The reason is that the 'entertainment' to be found in the average lads mag can now be found online - cheaper, easier to access and done better. Publishers have been so wowed by the web that they've tried to imitate it in print and have lost sight of what's unique and great about magazines. No surprise that the only lads mag to buck the trend is Esquire which has gone up 14%. And this is a mag currently without a website. Yes, they're two different media.

But I think there's a lesson in these ABC figures for any publisher with the brains and the balls to act upon it. Both Men's Health and Men's Fitness are also showing circulation figures slightly up year on year. Now neither of these mags exactly has the editorial style of malehealth and we've certainly been critical of most of the lads mags in the past but we do share the basic interest of Men's Health and Men's Fitness in men's well-being. And, lo and behold, it looks like men do too.

So here's a suggestion for the men's magazines: write about what men are interested in and if that includes health - why not? The world's changing, boys.

Thursday, February 14, 2008

GPs are spinning patients' sympathy away

Doctors are being balloted on which of the government's two options for longer opening hours they dislike least. Option A will see GP's practices richer to the tune of about £12,000 in return for an extra three hours a week. Option B will see the government flogging off out of hours provision to the highest bidder.

Let's hope that in their pique, the doctors still make the right decision. Patients want GP's surgeries open at times that make sense and they want it on the NHS.

The doctors' trade union, the BMA, keep telling us that they've made their own proposals to the government for longer hours. I'm sure they have and I'm sure they're very sensible. But I'd be more convinced about their commitment to them if they didn't also keep claiming that people don't want longer hours and quoting a methodologically suspect survey to prove it.

I don't blame the BMA for spinning against the government - unless he's the only politician on the planet who still in 2008 believes that the free market can solve everything then health secretary Alan Johnson is doing a fair bit of spinning himself with his non-optional 'option B' - but it does worry me that the doctors are spinning on the basis of a piece of research that they either haven't read properly or are hoping we haven't read properly. It shows an indifference to methodology and a preparedness to distort findings which I hope doesn't extend to their reading of medical research.

It also shows a lack of respect for the public. Do the doctors really, sincerely, in their heart of hearts, think that their patients don't want surgeries open occasionally in the evening or on Saturday? If they do, then the substantial pay rises that they've rightly enjoyed over the past couple of years - average GP salaries are now £100,000 plus - have left them them totally divorced from reality.