Get a picture in your mind of a family member or friend who is sedentary. When do you think was the last time this person’s doctor gave them advice on their physical activity level? Or better yet, took enough time to map out a physical activity goal and plan with them? Chances are your answer is “never.”

Unfortunately, many primary care physicians do not promote physical activity to their patients beyond the perfunctory, “Get more exercise” admonition. Studies have shown the reasons for this to be lack of:

  • time
  • reimbursement for time spent doing exercise counseling
  • confidence in their ability to provide suitable exercise guidance
  • confidence that patients will change their physical activity habits.

Notice that I didn’t say “lack of belief that exercise is important.” We know from unpublished qualitative research conducted at The Cooper Institute that most health care providers know that physical activity is important and believe that their sedentary patients will benefit from getting more exercise.

Still, there have been only a few studies that have explored whether getting doctors to counsel their patients on physical activity actually leads to increased physical activity and fitness levels. For the most part, the findings have been moderately positive at best. A more recent study may offer some insight on this.

Researchers in Spain recruited over 50 primary care physicians who were then randomized to either a standard care (SC) or counseling intervention (CI) category1. The doctors then recruited over 4,300 patients. The patients of the CI group doctors, received brief physical activity advice or advice plus a 15-minute educational session in which the doctor helped the patient develop a personalized exercise plan.

After six months, the CI group patients significantly increased their physical activity and energy expenditure levels compared to the SC group patients. Patients who were older than 50 seemed to especially benefit from the intervention. And those who received the extra educational session far exceeded the patients in SC group, regardless of age.

So it appears from this study that doctors giving physical activity advice is a good thing and may get some people – especially older people – moving more and burning more calories. Better still is if doctors would help patients come up with a personal plan for increasing their physical activity level. Now, the question is, “Where are doctors going to get the 15 minutes per patient to do the counseling?”

I guess that is what you call health care reform.

 

1 Grandes G, et al. Effectiveness of physical activity advice and prescription by physicians in routine primary care. Archives of Internal Medicine. 2009;169(7):694-701.