Physicians and their patients alike know that physical activity is an important component of a healthy lifestyle, but what is less clear is what kind of a role doctors should have in increasing their patients' activity levels.
A new paper by two family physicians from the University of Michigan Health System provides a practical guide for primary care clinicians to help their sedentary patients become more active.
The paper says that physicians play an important role in communicating the benefits of exercise and encouraging physical activity among their patients, even though limited data are available to support a specific approach or to quantify the effect of such counseling.
“We know from experience that there are a number of useful strategies for talking to patients about physical activity in a clinical setting,” says Caroline R. Richardson, M.D., co-author of the paper, which appears in the current issue of the Journal of Clinical Outcomes Management .
“The key step is to help patients assess their current physical activity level and identify those who are both sedentary and willing to consider starting an exercise program,” says Richardson, assistant professor in the Department of Family Medicine at the U-M Medical School and research scientist at the Veterans Affairs Health Services Research and Development at the VA Ann Arbor Healthcare System.
Some helpful techniques include specifically making a connection between the patient's sedentary lifestyle and medical problems he or she is experiencing, providing a written prescription for exercise and following up with patients to make sure they stay on track.
“Sitting still is making people sick. We know that a sedentary lifestyle contributes to chronic diseases and conditions such as diabetes, heart disease, obesity, major depression and even some types of cancer,” says co-author Thomas L. Schwenk, M.D., the George A. Dean, M.D. Family Medicine Chair at U-M.
“Primary care physicians have a responsibility to our patients to help them find ways to become active,” Schwenk says, “and to help them increase their chances of succeeding as they start on the path toward physical activity.”
Other approaches include a patient-centered collaboration with the physician and patient working together to create an exercise plan; empowering patients to take on the responsibility for beginning an exercise program by highlighting his or her skills and expertise; and a counseling technique known as “motivational interviewing,” in which the physician helps patients explore their barriers to behavior change and to find ways to overcome these barriers.
The paper notes that many people perceive barriers to exercise, such as lack of time and convenience. Richardson and Schwenk suggest that physicians can offer the following tips for such patients: