General practitioners who turn parkrun into a prescription risk medicalising a ‘walk in the park’, according to a GP whose opinion article is published today (10 April) in The BMJ.
Glasgow-based GP Margaret McCartney argues that ‘prescribing’ parkrun as part of a social prescribing initiative to promote preventive care is a retrograde step.
Parkrun is an organised, timed, and free 5km run, jog, walk, or wheel on Saturday mornings—in parks, on beaches, or on trails around the world but mainly in the UK, where it originated. Though Parkrun has some paid staff, the work of setting up, timing, and result processing is done by local volunteer teams. About 200,000 people take part every week.
‘This approach [prescribing] doesn’t support patient autonomy or embedding social resources for a community. Instead, it grapples with gatekeeping and – literally – medicalises a walk in the park’ [Margaret McCartney]
Dr McCartney, who is also a senior lecturer the University of St Andrews, is an aficionado herself: ‘I love parkrun and believe that it can make a real difference to public health.’
Power play
But she goes on to challenge the concept of it being prescribed. ‘Prescribing is for drugs that are, in general, deemed too dangerous for the public to have direct access to. Are we really meant to encourage people to consider exercise in the same domain?’
The act of prescribing, Dr McCartney suggests, ‘encapsulates power and command’. ‘I have the authority to prescribe, and you must follow my orders,’ she said. ‘Parkrun, at its origin, was something to recommend or invite interested parties to; it involved word of mouth, personal recommendation, and organic growth.
‘The fact that volunteers are necessary to make it tick means that it’s an enterprise that belongs to no one and to everyone. The atmosphere of cheer is always uplifting.
‘Turning parkrun into a prescription makes it less about pleasure and fun, more like work and compliance,’ Dr McCartney argues. ‘This approach doesn’t support patient autonomy or embedding social resources for a community. Instead, it grapples with gatekeeping and – literally – medicalises a walk in the park.’
Dr McCartney takes issue with those researchers who portray parkrun as a ‘simple, cost effective solution for sustainability, improving wellbeing, reducing loneliness, and disease prevention’.
While some people like it, attend regularly and enjoy all the benefits that come with socialising, fresh air, and friendly venues for exercise, McCartney points out that 43 per cent of people who register for parkrun don’t attend, 22 per cent participate only once, and people who describe themselves as physically inactive are less likely to return.
‘Catnip’ to commercial sponsors
The Royal College of General Practitioners’ approval for ‘prescribing’ parkrun could also be considered ‘catnip’ to commercial sponsors, she notes. For example, the Advertising Standards Authority told Healthspan, a vitamin supplier, to change its health claims after parkrun included one of the company’s adverts in its newsletter.
‘I still go to parkrun. But partnerships risk commercial opportunism, and medicalising exercise is a retrograde step. Resources should belong to the community, not to doctors,’ Dr McCartney concludes.
To access the full version of the article –titled Prescribing parkrun: medicalising a walk in the park doi: 10.1136/bmj.r670 – see: https://www.bmj.com/content/389/bmj.r670
Image: Shutterstock
