Dr. John Mandrola hosted this week’s Valentine’s Day edition of Grand Rounds, and it’s all from the heart. I especially liked Dr. Elaine Schattner’s article about whether adults need their doctors to tell them to exercise. She looks at the less-than-awesome statistics surrounding this issue (only about a third of adults who saw a doctor in 2010 could recall the doctor saying anything regarding exercise) and the possible reasons why doctors might not be discussing exercise with their patients.
I think we all know that we need to exercise. We all know that it’s good for us. We all know that it helps to maintain a healthy weight and stave off various health conditions. It’s the getting it done part that can be tough. Fitting it into the day, finding the motivation, and sticking with it no matter what – those things aren’t as easy as knowing that we should be exercising. So should our doctors be talking about it more than they are? I would say yes. I think that the more reminders a person has – especially if they come from someone with medical training and a knowledge of the patient’s specific health history – the better. But patients might also get sick of hearing the message. In discussing this post, Dr. John mentioned that a patient once complained to his office manager: “every year I pay Dr Mandrola big dollars to call me fat and out of shape.” Doctors have to walk a fine line between educating, inspiring, and not annoying their patients. It can’t be easy, and it requires different tactics with different patients – not everyone responds the same way to the same sort of stimulus. What may seem inspiring to one patient might come across as an unwanted lecture to the next.
Encouraging people to take responsibility for their health (specifically in terms of what they eat and how much they exercise) could be one of the keys to reducing our out-of-control healthcare spending (and in turn, help to control ever-increasing health insurance premiums). I think that discussions about exercise and nutrition have to become a cornerstone of every preventive care office visit, and hopefully also find a place in visits with specialists. But getting from here to there will take an adjustment of expectations on the part of both patients and their doctors. Kudos to Dr. Schattner for starting the discussion.