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Doctors' Health, Well-Being Affect Patient Counseling
Date:10/2/2010

By Serena Gordon
HealthDay Reporter

FRIDAY, Oct. 1 (HealthDay News) -- Doctors who take care of themselves may be more likely to recommend healthy lifestyle habits to their patients than doctors who gobble down fast food a couple of times a week and rarely hit the gym, according to new research.

Additionally, the study found that more experienced doctors and those who felt they'd been well-trained to counsel their patients on lifestyle changes felt more comfortable doing so.

"Physicians who exercised more were more likely to counsel their patients on the importance of exercise," said the study's senior author, Dr. Elizabeth Jackson, an assistant professor of medicine at the University of Michigan Health System in Ann Arbor.

Ironically, the researchers also found that physicians who were overweight were more likely to counsel their patients on the importance of lifestyle changes, probably because they were working on making such changes themselves, the authors theorized.

Results of the study were published online Oct. 1 in the journal Preventive Cardiology.

The study included survey responses from 183 doctors; 102 of the doctors were trainees (residents and fellows) and 81 were attending physicians, meaning they had completed their medical training.

About 21 percent of the trainees were overweight and nearly 6 percent were obese, while 27 percent of the attendings were overweight and over 8 percent were obese. Most of the physicians -- both trainees and attending -- reported having had their blood pressure and cholesterol levels checked during the past year.

Both groups of doctors reported low intake of fruits and vegetables, fast food consumption at least once a week and not getting enough exercise. Attending physicians were far more likely to report exercising four or more days a week.

Seventy percent of attending physicians reported counseling their patients on healthy lifestyle behaviors, while just 37 percent of trainees did so, according to the study.

Physicians also reported that they didn't have a great deal of confidence in their ability to affect change in their patients' lives. Just 11 percent of doctors-in-training, and 17 percent of attending physicians felt they could help their patients change diet-related behaviors.

Part of the problem, said Jackson, may be that doctors "tend to see people who are sick. We don't really see the patients who are going out there and exercising."

Factors that made it more likely that a physician would counsel a patient about the importance of exercise included the physician exercising more than 150 minutes a week or having been trained well in counseling. The researchers also found that overweight doctors were more likely to advise their patients to exercise.

"Every time we see a patient is an opportunity to counsel them for risk factors that kill us, like heart disease and lung cancer. We can educate and empower patients," explained Dr. Jonathan Whiteson, an assistant professor and the medical director of the Cardiac and Pulmonary Wellness and Rehabilitation Program at the NYU Langone Medical Center in New York City.

"But, this article reinforces the idea that we need to do a much better job counseling our patients," he added.

Both Whiteson and Jackson said that better training of doctors might make them feel more effective when it comes to counseling their patients. Whiteson said that role-playing exercises in medical school can be very helpful.

The bottom line, said Jackson, is that "behavior is hard to change. We can't just give you a pill and make you change. But, talking with your patients can help. You may have just seen someone who found a way to make lifestyle changes work, and you can share that with your other patients."

More information

The American Heart Association has lots of advice on healthy living.

SOURCES: Elizabeth Jackson, M.D., assistant professor of medicine, University of Michigan Health System, Ann Arbor, Mich.; Jonathan Whiteson, M.D., assistant professor, department of rehabilitation medicine, and medical director, Cardiac and Pulmonary Wellness and Rehabilitation, NYU Langone Medical Center, New York City; Oct. 1, 2010, Preventive Cardiology, online


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