50 Cents is on the money: modern business kills

Much gnashing of teeth over the new book from rapper 50 Cents in which he draws interesting parallels between modern business practice and his experiences of selling drugs in southside Queens. The musician, real name Curtis James Jackson, told The Times this week that people in the neighbourhood where he grew up wouldn’t rule out killing the competition. 'I now hang out with people who absolutely have those intentions for their competitors but they don’t have the physical act of killing them as part of their strategy. Two different routes, but they want the same outcome.'

The only difference between 50 Cents and most business people is that he admits it. His central idea is not particularly new. Joel Bakan's 2004 book The Corporation shows how the modern public company whose only obligation it to its shareholders is obliged to behave like a psychopath.

What's this got to do with health? Well, psychopathic behaviour is ultimately pretty unhealthy both for the psychopath and his victims. In this case, the victims are not just competitors but also employees. We heard once again yesterday about how dangerous long hours are to the men who work them. Earlier this year, research was published showing the damage long hours could do to the brain. According to the International Labour Office, one in five workers around the world - or over 600 million persons - are still working more than 48 hours a week, many merely to make ends meet, a significant majority of them men. (Not having a job can be pretty dangerous too.)

In 2008, work was the theme of Men's Health Week. I suggested on malehealth that work was 'the main cause of men's ill health in the developed world'. Nothing that has happened since has made me change my mind.

When someone is killed as collateral damage in a gangland drugs scrap we're rightly outraged. But where's the concern about men and women working themselves into an early grave? Reduce the regulation of business and you increase the health problems of all those involved in it. The best possible health strategy? Workers rights.

Too many questions for statins to be the answer

We'd all love to find the silver bullet - a pill we could all pop that would make us live longer and/or reduce the risk of serious disease. Drugs companies and alternative practitioners alike sometimes like to imply they've found it. I doubt we ever will.

For a while it looked as if statins, drugs which lower cholesterol, could fit the bill. That all changed a few years ago. Ever since cerivastatin was removed from the US and European markets in 2001 because of a link to rhabdomyolysis, a muscle-wasting disease that can cause kidney failure, statins have been controversial.

New research published today adds to the confusion by suggesting that statins might slightly increase the risk of diabetes. This research while not particularly alarming in itself adds to the impression that we still don't really know how statins work. Given that we also don't really know the relationship between cholesterol and heart disease, there seem to be just one or two too many unknowns to justify giving these drugs to otherwise healthy people.

The danger of diabetes

A good mate of mine was diagnosed with diabetes recently - one of the 300 people diagnosed with the disease every day in the UK. Before you ask, he wasn't remotely overweight and didn't have particularly unhealthy refuelling habits. Yes, diabetes really can hit anyone.

There are 2.6 million people in the UK with the disease. Seven million of us also have prediabetes. This means we have blood sugar problems - not severe enough to be called diabetes but still, say Diabetes UK today, potentially dangerous to the heart. That means 1 in 7 of us are directly affected and we all must know someone. You'd think with something this common we'd all know the signs and symptoms but we don't. Ask people what diabetes is and they'll usually say 'something to do with sugar'. We all need to do better than that.

Why? Because we all know about sportsmen like Steve Redgrave and Gary Mabbutt, who became world-beaters despite their diabetes, we assume that the disease must be relatively trivial. It isn't. Diabetes can be controlled very well but it needs to be diagnosed first. Undiagnosed diabetes can kill - as Lee discovered in this month's feature on malehealth. If you think diabetes is anything but serious, read it.

Online GP consultations CAN work

Last night I checked out the new online surgery that I wrote about on Monday. I've had a few health problems recently so it was legitimate but, of course, as a journalist, I couldn't help throwing a couple of curve balls too.

To recap on how it works, it could hardly be easier: you just log on using a nickname if you like and talk to a doctor live online in a private chat room. My verdict is that this sort of consultation can be useful - up to a point.

The downsides first. It's far more time consuming than a real GP's appointment. We spent half an hour on something that would have taken 10 minutes face to face and had all sorts of fun trying to agree over the units we were talking about for some recent blood tests.

At times I got the impression the doc wasn't reading my comments properly which led me to ask if he was talking to other patients at the same time. He assured me that he wasn't. That being so I can only assume he wasn't seeing my inputs properly or in real time. The technology probably needs tweaking and there's a good case for a little IT training for doctors - and I suppose, patients - in using it.

But the positives made up for this, I think. I was far more comfortable in this environment. The doctor-patient relationship felt far more equal. There are no pedestals online or intimidating white coats or ties. I was able to ask what was really on my mind and the doc was able to clarify a few things. The limitation of this - the reason I say online consultations are only useful up to a point - is the same problem as we had on malehealth with our Ask The Doctor feature. Ultimately, the best advice, the only advice a doctor can give over the internet in all confidence, is: you should go and see your own GP about this.

Of course, a good online consultation beforehand can ensure you're better prepared, less intimidated and don't waste anybody's time (a common reason for not using the doctor according to research out today). All good reasons for developing the use of online medicine I think.

The curve ball? This particular online surgery is funded by Pfizer, the drug company whose extensive portfolio includes Viagra. It's a legitimate concern that a doctor's surgery funded by a drug company might result in the over-enthusiastic promotion of their products. I'm delighted to say this didn't happen. At the risk of mixing my baseball and cricket metaphors, the doc played my questions with a straight bat. He gave very good advice about what erection problems might mean and the tests used to find out without once mentioning the sponsor's product.

This particular surgery is open till Friday 9 October. There are also two similar online facilities being run by the European Men's Health Forum, one for questions on sexual health, the other on prostate health. Again, I've written about this EMHF service before. Why not give one - or all - of them a try and let us know what you think.

New GP's surgery online - for one week only

For my 100th post to this blog, I'm writing with some very good news. Well, some good news tempered with a little reality.

An online GPs surgery has opened. Rather than go to the GP, you can log on and talk to a GP in real-time. We know that a) men are reluctant to go to the GP and b) they like to use the internet, so this is a service I've been wanting to announce ever since I became editor of malehealth.

So what's the dose of reality? Well, it will only last for a week and it's being provided by a drug company, Pfizer, rather than the Men's Health Forum. Like the National Obesity Forum and Sexual Dysfunction Association, the MHF is backing the idea. The surgery is staffed by independent GPs, contains links to malehealth and MHF mini-manuals and provides an out of hours service (6pm-11pm) which no GP can match.

In an ideal world, men would go to their GP at the first sign of trouble and, if a site like this were needed, it would be provided by an independent organisation like the MHF. Unfortunately, we don’t live in that world. Coming on the heel of the online consultations provided by European Men's Health Forum on erection problems, premature ejaculation and prostate problems, this new online surgery enhances still further the options available to men with health concerns and that has to be a good thing.