Doctor puts herring on prescription

An unconventional approach to the treatment of heart disease is being taken by a doctor in Stromness in the Orkney Islands, in Scotland, who is prescribing tubs of marinaded herring for his patients to eat.

The herring is being provided through an NHS funded project that is seeking to turn a local product into a regular treatment. It is also provoking considerable surprise among patients at the Stromness general practice, who are not used to leaving the surgery with something for their evening meal.

The heyday of Orkney's herring industry may be long gone, but a local GP has started prescribing the fish for heart disease (W. H. HOURSTON/ORKNEY LIBRARY PHOTO ARCHIVE)

Although there is evidence that a diet rich in oily fish can prevent heart attacks, the main message that Dr Andrew Trevett is hoping to get across with the initiative is that patients do not have to rely on drugs alone to try to reduce their risk of heart disease.

He hopes that in dispensing the herring, patients will be able to appreciate more fully the benefits that improvements in diet can make to their health.

The herring, which is supplied by a local company, is kept in the practice's refrigerator and given to patients with existing heart problems. They are advised to eat two portions a week and are also encouraged to give up smoking and take more exercise.

Dr Trevett said that the project will run for six months and monitoring will then take place to see if the patients given the herring have made positive lifestyle changes. Anyone who is not partial to herring is advised that sardines, tuna, mackerel, and wild salmon are equally beneficial.

"So far the reaction has been very positive. Most people think it is a bit quirky, but they appear to like it," said Dr Trevett.

Stan Headley, one of the patients prescribed the herring, admitted to being surprised when first offered it. "I actually thought the doctor was joking, but I soon realised he was very serious about the whole thing. The concept of getting it on prescription seemed pretty radical to me - it was the last thing I expected."

Bryan Christie, Edinburgh


studentBMJ 2000;08:175-216 June ISSN 0966-6494