Can America’s doctors lead us to better health?

April 27, 2016

Time and again the medical marvels of exercise have been proven. But there’s still not much coaching going on in exam rooms. Only about 9% of doctor office visits include physical activity counseling.

Helen Durkin, JDIt’s hard to miss the fact that the health of our country is struggling. Only about a quarter of American men and a third of American women are at a healthy weight, almost half of all Americans have at least one chronic health condition, and 86% of our healthcare spending goes to treating them.

Yet, we know that four modifiable lifestyle behaviors are behind most chronic diseases: physical inactivity, an unhealthy diet, tobacco use, and the harmful use of alcohol. Study after study has shown that 150 minutes each week of moderate intensity physical activity lowers the risk of heart disease, high blood pressure, stroke, type 2 diabetes, Alzheimer’s disease, depression, and even some cancers.

 

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Time and again the medical marvels of exercise have been proven. But there’s still not much coaching going on in exam rooms. Only about 9% of doctor office visits include physical activity counseling.

It makes you wonder-after all, if exercise is one of the most effective methods for enriching wellness and preventing and managing disease, shouldn’t it be the first line of treatment for patients and not the last?

The underlying reason for this disconnect may lie in how physicians view their role generally and how they are trained and paid. Historically, the focus of the U.S. medical system has been on treating illness. And frankly, doctors tend to view their role as deliverers of the cure-with relatively little time or training spent on prevention or health promotion.

Edward M. Phillips, MD

But with often-avoidable chronic diseases now the leading causes of death and disability in the United States, doctors need to start seeing themselves less as mechanics applying a fix once disease appears, and more as leaders of our country’s wellbeing. It’s time for our healthcare system at large to rethink what it really means to heal.

 

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It’s no longer enough to treat disease and keep symptoms at bay. Our doctors need to lead us to better health. After all, physicians-as well as other primary care providers-are in the ideal position of having our ear when we’re most open to receiving advice about our wellbeing. It’s a fleeting, hard come-by moment of influence. And only doctors have access to it.

So how do we capitalize on that invaluable leadership moment?

Next: What should be done

 

First, doctors need to follow healthy lifestyle habits themselves.

A study published in the Clinical Journal of Sports Medicine found that the more that doctors engage in physical activity, the more likely they are to counsel their patients to do the same.

A study presented in the spring of 2015 at the American College of Sports Medicine’s (ASCM) annual meeting echoed those findings, showing that when doctors do counsel their patients, they tend to recommend activities that are familiar to them-further underscoring the need for medical practitioners to exercise regularly and to participate in different types of physical activity.

Simply, the doctors who participate in vigorous physical activity on a regular basis themselves and who have a healthy body mass index (BMI), are most likely to feel confident about counseling their patients on exercise.

 

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But leading by example is only the start. Leading America to better health involves new ways of communicating and connecting with today’s patients. It requires empathy, understanding the challenges they face, and figuring out what motivates them. It demands making a case for why exercising will not only help their health in the long term, but will make them feel better about themselves, boost their energy, and lift their outlook on life in the short term. Importantly, it will require innovative ways of delivering healthcare, like teaming up with exercise specialists, health clubs, health coaches, behavior specialists, and/or nutritionists.

Doctors cited time constraints as the most potent inhibitor of counseling their patients on exercise, according to the study presented at the ACSM annual meeting. Yet, it only takes seconds to write an exercise prescription. And organizations like Exercise Is Medicine® have many ready-to-use resources that doctors can hand out to patients, free of charge, along with a prescription for exercise. They even offer training and tools to help doctors prescribe exercise in the right “dosage.” This is especially important, as research shows that doctors who provide a written exercise prescription, rather than just verbal communication, see more improvement in their patients’ physical activity levels.

Next: We need doctors to start viewing themselves as leaders

 

Recognizing the leadership role America needs doctors to play, Healthy People 2020-the federal government’s 10-year objectives for improving the health of all Americans-has made increasing the proportion of physician visits that include counseling about exercise a national priority. The U.S. National Physical Activity Plan calls for making physical activity a “vital sign” that all healthcare providers assess and discuss with their patients. The Lifestyle Medicine Education Collaborative (LMEd) is actively advocating for inclusion of exercise in the curriculum for U.S. medical students.

 

Related: Primary care best equipped to improve patient behaviors

 

Luckily, there are great doctors in the medical community who also are great leaders. Take, for example, the innovative thinking of David Sabgir, M.D., a practicing, board-certified cardiologist based in Ohio. After his first year in practice, when his patients began coming back for their annual follow-ups, he realized they weren’t exercising any more than when he’d seen them a year earlier. So what did he do? He invited his patients to join him on a morning walk-and the “Walk with a Doc” movement was born.  

Today, 10 years later, the program is a national movement, with more than 228 Walk Chapters in 40 states and seven countries. Almost 80% of participants say they get more exercise since starting Walk with a Doc and feel more empowered in their interactions with healthcare providers, and 92% say they feel they’re more educated since starting the program, while almost all (97.5%) say they enjoy the refreshing concept of pairing physicians with communities outside the traditional setting.

Indeed, America’s doctors really are in an influential and singular position to lead America to better health. Now we just need them to start viewing themselves as the leaders America needs.