HEALTHFat chance: How physicians can help patients lighten their loadThe directions are clear: Eat your fruits and vegetables. Drink water. Exercise regularly. Still the numbers on the scale go up. How can doctors get patients to comply?By Stephanie Stapleton, AMNews staff. Nov. 18, 2002. Why is that doctor wearing a pedometer on his belt? It's simple, said Daniel Van Durme, MD, a Tampa family physician. He wears it as a reminder of a surgeon general's recommendation that people should walk 10,000 steps a day. Even at his busiest, though, when he runs from exam room to exam room, Dr. Van Durme will still end up short and have to finish on the treadmill in the evening. It's a point he often makes to patients. In this context, Dr. Van Durme's pedometer takes on an added purpose -- it becomes a visible teaching tool. It helps him emphasize that exercise goals are doable, but only with deliberate and conscious effort. "Life is complex. No one has a free hour, whether a doctor, a lawyer, a schoolteacher or a janitor," said Dr. Van Durme, associate professor and vice chair of the Dept. of Family Medicine at the University of South Florida College of Medicine, Tampa. But sedentary lifestyles are as much a risk factor as is smoking -- directly related to heart disease, osteoarthritis and a whole range of other illnesses. His message to patients is clear: Failure to get up and move jeopardizes their health. Dr. Van Durme is not alone in struggling to communicate this point. Doctors overwhelmingly report that counseling patients on issues of nutrition and exercise is a source of frustration -- both in terms of patients' reactions and on an even more personal level. Physicians' own best intentions to keep fit sometimes fall prey to medicine's long hours and hectic schedules. For these doctors, finding time to practice what they preach may be difficult, but it is also becoming more imperative as they focus on the obesity epidemic.
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Copyright 2002 American Medical Association. All rights reserved.
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