Imagine stepping into the exam room for your regular medical check-up: Your doctor (or an assistant) uses a cuff to check your blood pressure. A thermometer to check your temperature. A stethoscope to listen to your breathing. And then, to check one more vital sign, a simple question: So what are you doing for exercise?
That’s an ideal reality envisioned by a team of researchers and physicians who just issued a “call to action” to colleagues. They urge that exercise counseling become a central component of every medical visit, including by making physical activity a vital sign and prescribing a specific amount of daily exercise to all patients.
We all know that exercise is good for us. But we don’t often consider just how good.
“Physical activity has been shown to reduce the risk of heart disease, stroke, diabetes, certain cancers, osteoporosis, cognitive decline, [hypertension and obesity], and even depression, at minimal cost and with virtually no side effects,” says Dr. JoAnn Manson, chief of the Division of Preventive Medicine at Brigham and Women’s Hospital in Boston. “Can you imagine if there were a pill that could simultaneously have all those benefits? Everyone would be clamoring for it and physicians would be taking it themselves.”
In a “Viewpoint” piece published this week in the Journal of the American Medical Association, Manson and co-authors from the Stanford University School of Medicine and the University of Central Florida offer a new sense of urgency about prescribing exercise to patients.
“A prescription to walk 30 minutes per day could be one of the most important prescriptions a patient could receive.”
“No other single intervention or treatment is associated with such a diverse array of benefits,” they write. Adds Manson: “A prescription to walk 30 minutes per day could be one of the most important prescriptions a patient could receive.”
The overwhelming lack of exercise counseling during medical visits is a missed opportunity to dramatically improve patients’ health, Manson said in an interview. With 506 million primary care visits in the U.S. in 2012 (most for prevention and treatment of preventable chronic health conditions), as few as 34 percent of adults report being counseled about physical activity, the authors write.
They also cite research that shows when doctors and other clinicians emphasize the myriad benefits of exercise to their patients, those patients listen.
“Health care professionals are trusted sources for health related information and they can help patients set priorities to improve their health,” Manson said. “It’s one thing to hear on the news that a study showed physical activity is linked to a reduced risk of heart disease. But it’s another thing to have your own physician or health care provider tell you that it’s an important priority for you to walk 30 minutes a day or increase your activity.”
But, she says, many doctors aren’t having these important conversations with their patients about the value of daily exercise.
“It’s not being done,” she said. “There isn’t really any change in behavior on the part of the health care system, [even while] the burden of chronic disease and health care costs have been escalating. …Only about one-third of patients report that physical activity was discussed during a [medical] visit. Even just having these discussions will demonstrate it’s a priority.” Continue reading