Doctors embracing new medicine regime based on physical activity
Patients are coming out of the doctor’s office with prescriptions for physical activity in addition to drugs‚ doctor referrals and follow-up protocols. Doctors are working exercise counselling into office visits and calling exercise a “vital sign” to be measured when they take readings such as pulse and blood pressure.
Rather than just explain the dangers of inactivity‚ they suggest the right amount of exercise‚ and in some cases refer patients to certified trainers who can design regimens for different medical conditions such as asthma and diabetes that might limit certain activities.
The efforts stem from Exercise is Medicine‚ a programme overseen by the American College of Sports Medicine‚ which encourages doctors and other health-care providers to include physical activity when designing treatment for patients.
Although the benefits of exercise in preventing and controlling a number of diseases are well-known‚ studies show doctors don’t always counsel patients on adding more physical activity. About half of Americans report they meet federal guidelines to engage in at least 150 minutes a week of moderate aerobic activity‚ but not everyone owns up to how little exercise they get‚ according to the Centres for Disease Control and Prevention.
A 2011 study published in the American Journal of Preventive Medicine found only about 10% of adults actually met recommended levels‚ though 62% reported they did.
Some large health systems are already seeing the benefits of prescribing exercise. At managed-care giant Kaiser Permanente‚ based in Oakland‚ California‚ as part of its Exercise as a Vital Sign programme‚ nurses or medical assistants ask patients how many minutes a week they exercise and enter the data in their electronic medical records along with other traditional vital signs like blood pressure‚ pulse‚ breathing and temperature.
Doctors then identify patients who may benefit from additional physical activity and discuss what activity is best. They may refer them for telephone health coaching‚ appointments with behavioural specialists and other programmes to promote a healthy lifestyle including yoga‚ tai-chi and Zumba classes for a small fee.
Kaiser also sponsors an exercise app which helps track and encourage movement.
“What shocked me is how many of my patients do nothing‚” says Jack Der-Sarkissian‚ a Kaiser family doctor who says patients routinely tell him: “Nope‚ I don’t exercise and don’t do any physical activity.”
Dr Der-Sarkissian says he incorporates a discussion of activity into every visit no matter what patients are there for. He tries to determine what barriers exist to starting an exercise programme such as anxiety that might be helped by a behavioural-health specialist.
One of Der-Sarkissian’s patients‚ Paul Freberg‚ 60‚ had been a college football player but was so focused on running his manufacturing business that he had no regular exercise regimen‚ had high blood pressure and high cholesterol and was at risk of developing diabetes.
After a warning from his doctor and a proposed regime, he began packing a lunch with fruits and vegetables every day‚ getting up earlier to run four days a week before work‚ and walking on weekends with his wife.
“Making exercise seem like a vital sign is like reinforcing what we were told as kids to brush our teeth – if you don’t do it at night before you go to bed‚ you feel something is wrong. Exercise is such an ingrained part of my life now that if I don’t do it I feel guilty.”
– Wall Street Journal