An excerpt from The Connection Cure: The Prescriptive Power of Movement, Nature, Art, Service, and Belonging.
With slicked-back hair, a fancy-buttoned vest, and a politician-like charisma, you wouldn’t guess Dr. Bogdan Chiva Giurca, a doctor for England’s National Health Service (NHS), grew up in a Romanian village, handwashing his clothes because he couldn’t afford laundry. “I got to taste the real social determinants of health without knowing they were called that,” he says. Nor would you guess Bogdan failed to get into medical school twice. But perhaps it was Bogdan’s determination to “look beyond labels” in his own life that helped him do the same with his patients, after he was eventually accepted to medical school in the U.K.
Fate “placed” him with a doctor who believed the same –Mike Dixon, the pioneer of social prescribing — a practice through which health workers prescribe community resources and activities, like art classes and cycling groups, instead of just pills and therapies. It shifts from focusing on “what’s the matter with you” to “what matters to you.”
While working at Dixon’s practice in Devon, Bogdan remembers a “game changer” patient he calls Mrs. Smith. According to her “surface labels,” Mrs. Smith had Parkinson’s, depression, “basically a bunch of diagnoses and a bunch of pills,” Bogdan says. She came to their office weekly. Bogdan was curious about why – what else was happening in her life? But when he asked her attending doctors exactly that, they just shrugged, Bogdan says. “They’d say, ‘Oh we don’t know, we don’t have time, but you’re a medical student, why don’t you go and ask her?”
At first, Bogdan says he “bombarded” her with questions — asking “every single biomedical thing [he] learned in medical school.” But when Mrs. Smith noticed Bogdan’s accent and asked him where he was from, it opened the door for Bogdan to do the same: “I found out she was grieving because her husband passed away. I found out the only time she left her house was for the doctors. I found out she has no friends or relatives. She even laughed and admitted to me, ‘I come here because I quite enjoy seeing you all — it makes me feel looked after.’”
That’s when Bogdan asked Mrs. Smith a version of the perennial social prescribing question: what mattered to her. “What did you used to enjoy before you got sick?” he asked. He soon learned it was salsa dancing. And when Bogdan reported that back to his practice’s health advisor, they wrote Mrs. Smith a different kind of prescription: a salsa club.
The social prescription worked immediately. “She went from being on twelve medications to just two for her Parkinson’s– no more painkillers, no more antidepressants. She went from coming in every week to every four months, [and when she did come in], she was completely bright, looking like a new person,” Bogdan says. She even started bringing a man to her doctor’s appointments. And when Bogdan asked who her new friend was, she proudly told him: it was Jeremy, her salsa dancing partner.
Bogdan says it was his “eureka moment.” He realized his mission wasn’t just to help the Mrs. Smiths, directly; it was to get fellow medical students – and medical schools – so they could help the Mrs. Smiths, by making social prescribing part of their medical school curriculum.
So, Bogdan began campaigning. At one NHS-sponsored social prescribing event in 2017, he remembers standing up to ask the panel a question: “I’m just a medical student, but I have to ask, ‘What about people like me?’ You’ve got thousands of students like us, and in the next few years, we’re going to become your health professionals, and if you’re not teaching us [about social prescribing], you’re playing the short-term game.”
In the meantime, Bogdan started getting medical schools to teach it, anyway. He created a “social prescribing student champion” scheme — contacting every U.K. medical school to nominate one student to become their Bogdan: a learner, a practitioner, a conference-goer, a passionate advocate for social prescribing.
That’s how Bogdan reached Hamaad Khan – who, back then, had been a neuroscience student studying dementia. Instead of finding a chemical dementia cure, Hamaad was interested in what could improve his patients’ quality of life. And when he heard there was a name, theory, and practice for that in social prescribing, he says he had a “visceral” reaction. “I never conceptualized health as being something you created — it was like seeing in color for the first time.”
So, Hamaad joined Bogdan’s growing army of student champions, and got to work: In 2018, for the NHS’ 70th anniversary, they hosted an event as “a way to say thank you” to the link workers, community groups, and practicing doctors who’d broken the rules to start social prescribing before there was cultural permission to do so. In 2019, they hosted another, on the second Thursday in March, now known internationally as “#SocialPrescribingDay.” Social media went nuts. Most of it was praise. But eventually—as social media does —#SocialPrescribingDay saw some pushback: Nurses, social workers, occupational therapists began tweeting, wondering why they were excluded from social prescribing. Bogdan smiled. “I just said, ‘Wonderful, would you like to join us?’” And so, the army grew.
Eventually, they succeeded. Today, true to Bogdan’s original vision, social prescribing is now taught in every single medical school. “It got to the point where medical school deans said, ‘Look, the students are doing it anyway, let’s just put this in the curriculum already,’” he explains. And true to Twitter’s wishes, it’s not just taught for medical students; it’s taught to nurses, social workers, and occupational therapists, too. He calls it the “revolution of the peasants.” And the peasants had won.
In 2023, when I join the U.K.’s fourth #SocialPrescribingDay at the National Academy of Social Prescribing — where Bogdan and Hamaad work, I see the day is far from a peasant’s affair. And later that afternoon, when Hamaad calls up social prescribing student champions to the mainstage, I see that his message is spreading across the health workers of tomorrow, across disciplines. In their scrubs, under spotlights, each of them shares why social prescribing matters to them: Micah praises social prescribing as a way for “patients to take control of their own health journey.” Winton says she saw how social prescribing helped “the father with depression, the teen with anxiety” resume their daily lives. Cara says she “sees firsthand the power of social prescription” in her local community garden — a place she both prescribes to patients and visits herself.
But the standing ovation comes after Hamaad takes the mic and reminds everyone — medical students and senior doctors — what their health care system is really about: “As health creation moves beyond the brick and mortar of our hospitals, our hope is to not just treat ill health, but to prevent it. Our hope for the future is to move beyond sick care. Our hope for the future is a true national health service.”
Julia Hotz is a journalist and author of The Connection Cure: The Prescriptive Power of Movement, Nature, Art, Service, and Belonging.
