Meet the researcher: Dr Mohammad Razai

Published: 11 September 2020

Dr Mohammad Razai is an academic clinical fellow in primary care at St George’s. His work takes in a broad spectrum of healthcare, focusing on physical activity, primary care guidance and more recently coronavirus.

Practising as both a GP and academic researcher, Dr Razai has a unique perspective on the world of medicine and working during a pandemic. We spoke with him to hear more about his role, and how the current situation is affecting his life at work and at home.

What are your focus areas in research?

I started off working in epidemiology research through a chance trip to Botswana. I spent a few months out there seeing glaucoma patients, working on an exciting project, and from there developed a passion for research.

Since starting at St George’s my focus has been on the interplay between various factors and health. The research project I’m working on is looking at physical activity in postnatal women who had hypertension during pregnancy.

High blood pressure while pregnant can be a risk factor for heart disease, stroke and other problems in later life, but we know exercise can reduce these risks, and simple interventions can make a difference. We’re trying to find out whether very brief advice on physical activity such as brisk walking for 10 minutes by using an app can change behaviour, and if it will encourage more exercise.

The hope is that if it’s shown to work, this could reduce blood pressure and lower the chances of stroke and heart disease in future.

You’ve also produced new research focused on coronavirus. How did this come about?

When coronavirus was picking up speed in the UK, the community was starting to get jittery. I attended a seminar where a colleague of mine was complaining, particularly around the lack of information out there, and especially in primary care. We knew how we should be dealing with people, and Professor Pippa Oakeshott approached us and suggested that we should do something about it.

We started by producing guidance for primary care, which was really well received. It was fascinating to see the number of GPs with similar problems to us at the time, but the guidance was helpful in keeping everyone on track.

Since the initial piece, I’ve now started working more prominently on the mental health side of the pandemic and the effects of lockdown and social isolation. More recently, I’ve also begun to focus on the issues around more vulnerable groups in terms of age and ethnicity.

How has your work changed during the pandemic?

From the clinical side, the loss of a face-to-face connection patients has been really difficult for both clinicians and the patients. I think people appreciate coming in to see a doctor and having a face to face conversation. I have a fear that there might be a drive now to change the way GPs work forever, but we must maintain that in-person relationship-based care with our patients – especially with older adults who don’t have access to technology.  

For research, I’ve been able to work from home a lot during this period. It’s great to be able to do my work from home, but it can also be lonely at times. I think some of us miss the community experience in the institute.

But some things have definitely got better. Without commuting, we have more time to get on with things and meetings online are much quicker than in person.

It’s also created an opportunity for more online learning. I’ve designed and run Futurelearn courses on coronavirus management, with around 30,000 people signed up for the full course. I’m making one on Lyme disease at the moment as well – so it’s not just for coronavirus where people are realising traditional methods are possibly no longer the best way to learn.

What other societal changes have you noticed during the pandemic?

I think there has been a lot more appreciation of different groups. Not just NHS staff, but other essential workers like carers and delivery drivers. I think the extra recognition for these people has been really good and has hopefully made everyone feel more valued.

However, we’ve also noticed that some groups have been at much higher risk during the pandemic. We’ve known for a long time that race and ethnicity have played a part in terms of people getting ill sooner and having more aggressive forms of disease and a lower life expectancy. But during the pandemic, that has become greater still.

In a piece I recently wrote for the BMJ, I wanted to highlight that the NHS and similar organisations have made significant progress in the last decade, but there are still serious problems that exist. Ethnic minority patients are still more likely to have poorer health outcomes than others, and I think it’s quite urgent and quite serious that we deal with this.

What are your hopes for the next two years?

There are lots of recommendations in terms of what needs to be done to reduce health inequalities, and a wealth of evidence that something needs to be done.

In the US, the evidence suggests that the narrowing of the gap between the black and white populations only came about as a result of government commitment and state interventions.

It’s really critical that Government and major organisations like the NHS step up and recognise major problems surrounding race. That’s the first step. The second is to ensure there are programmes in place to make sure these things are dealt with.

I would also hope to see more health interventions in terms of dealing with obesity and lack of physical activity. These are huge risk factors for disease, including coronavirus, and I hope more will be done encourage healthier lifestyles.

What do you get up to when you’re not working?

I have a lot more time to cook now. I’m making a lot of Indian dishes, but rather than using rice, I’m using lentils and beans and cooking things like chicken cholay.

As well as the cooking, I’ve been trying to learn to play the piano. I’ve always loved the instrument, but after reading The Pianist, which is also a fascinating film, it sparked my interest and I bought a piano to have in the house. It’s really useful for habit formation when it’s right in front of you. There’s no need to go and dig something out of somewhere to start playing, you can just get up and play.

I’m also working on a small book that I hope to publish. After seeing lots of people working in the NHS writing about what it means to be human and dealing with grief, pain and suffering, I’ve been writing prose poems.

Working as a healthcare professional and dealing with life and death, there’s a lot of inspiration to take from that, so it would be great to get my writing published.