Your most powerful Rx

September 2, 2005

It's exercise. But the first step toward an active lifestyle can be hard for your patients. Here's how to help them get started.

My wife thinks I'm an exercise fanatic. Only a nut, she says, would go to Manhattan in July for a race that starts with a swim in the Hudson River, followed by a 40K bike ride, and then a 10K run around Central Park.

I run races like that Ford New York City Triathlon as part of my fitness program. I've experienced firsthand the health benefits of regular exercise, and I'm convinced that we physicians have a responsibility to encourage our patients to be more active. Motivating patients to exercise takes more than handing them a prescription, however. You have to provide the inspiration, education, and practical advice that will get them up and running. Here are some ways I've found that can help patients start on a workout program.

Convince your patients that almost everyone can exercise. If they claim that they're too old or unfit to succeed in an exercise program, tell them this story: A few years ago, the AARP sponsored the first nationwide triathlon event for people over age 50, the Tri-umph! Classic-a 400-meter lake swim, 20K bike race, and 5K run. It was open not only to experienced senior athletes, but to anyone who wanted to improve their fitness. It featured an eight-week training program to help them get up to speed.

The point of the story is that nearly everyone can enhance his level of fitness-and for some people that improvement can be dramatic. Obviously, not all your patients should be doing triathlons. Some have health limitations that prevent them from participating in vigorous activities, but with an appropriate program, everyone can reap the rewards of exercise.

Point out how their lives will improve. Symptom relief is what motivates patients. So tell them that they'll feel better if they exercise, because, in time, they will. The AARP triathletes reported benefits almost immediately: decreased arthritis pain, fewer headaches and backaches, relief of gastrointestinal problems, and a general sense of well-being and accomplishment.

The famous gerontologist Robert N. Butler, MD, said, "If exercise were a drug, it would be the most-prescribed pill in the world." Exercise works better than medication, he says, for preventing diabetes, osteoporosis, and some types of cancer, and has the potential to improve hypertension, headaches, sleep problems, and many other maladies.

Remind patients that exercise can save money. Compared to the expense of tests and drugs, exercise is cheap. Patients who are concerned about healthcare costs need to know that regular exercise sometimes can help reduce the medications they need to control blood pressure or diabetes. For some, it could mean stopping medication entirely.

Help your patients identify workout opportunities. Busy people often complain they have no time for exercise, but there are ways they can build miniworkouts into their everyday pursuits-with no extra time required. Suggest that they combine activities, like working out on a treadmill while they watch TV. Propose that they park at the far end of the lot and walk back to the store, use stairs instead of the elevator, or walk or ride a bike to do errands. Parents can jog around the soccer field while their children have practice, or take their toddlers for long walks in the stroller.

Offer patient handouts with exercise tips. See "Clip and Copy: Exercise tips for your patients". Or direct them to exercise-related Web sites such as http://www.presidentschallenge.org.