Do Adults Need Physicians to Tell Them to Exercise?

According to a new CDC report, only 1 in 3 doctors advise their adult patients to exercise. The survey-​​based findings are limited, in part, because they rely on people’s rec­ol­lection of whether they’d visited a physician in the pre­vious year and what they were told. Nonetheless, the study revealed some clear trends:

1. In 2010, 32.4% of adults who’d seen a health care pro­fes­sional were advised to begin or con­tinue with exercise or other physical activity. That fraction’s up sig­nif­i­cantly from 2000, when a slim 22.6% of patients recalled their doctors telling them to get a move on.

2. Among folks over 85 years, nearly 29% say they were told to exercise. That number’s nearly doubled since 2000, when only 15.3% of elderly patients reportedly received this kind of advice.

3. Adults with dia­betes were told to increase their activity more often than those with high blood pressure, car­dio­vas­cular disease and cancer. Com­pared with healthy weight adults, obese people were twice as likely to have been told to exercise by a physician or other health professional.

An under­lying message is that doctors should be prodding their patients to exercise. From the report:

Research points to the ben­efits of physical activity for reducing the risk of chronic health con­di­tions (1–4). Engaging in regular physical activity can reduce med­ication depen­dence, help maintain func­tional inde­pen­dence, and improve the quality of life for older adults (5,6). Physi­cians and other health pro­fes­sionals can be influ­ential sources of health infor­mation, and exercise coun­seling by primary care physi­cians has been shown to increase patients’ par­tic­i­pation in physical activity (6–9).

There was dis­cussion about this yes­terday on Twitter, stemming in part from a USA Today article on the report. And here’s the essence of the short-​​form debate:

Some sug­gested that doctors don’t tell patients to exercise because they, them­selves, are over­weight. Or it’s because they don’t feel com­fortable rec­om­mending for others what they don’t do them­selves. While this might explain some physi­cians’ behavior or dis­comfort with the topic, it can’t explain that of the majority.

So why don’t more doctors pre­scribe exercise for their patients?

Reasons I wonder about include a lack of time for “non-​​essential” com­mu­ni­cation, espe­cially in clinics. In spe­cialists’ offices, the omission of exercise could have to do with the visit’s purpose. A gas­troen­terol­ogist or internist who eval­uates a patient for a problem like diarrhea, say, might not think to ask about exercise. For some doctors it might be, prob­lem­at­i­cally, an attitude issue — that they just don’t care that much, or think it would be a waste of time to discuss the matter of exercise.

Whatever the reasons are that most doctors don’t bring up the issue, one might ask this: Why do adults need doctors to tell them about the health ben­efits of regular exercise? After all, it’s common knowledge – the kind of thing taught in ele­mentary school, like nutrition should be — that regular exercise is good for most people. As we age, being out of con­dition makes every task in life, like walking a few blocks, harder.

In an ideal world, we’d have most adults exer­cising reg­u­larly, and doctors who’d occa­sionally intervene and counsel patients about what they shouldn’t do because of a par­ticular medical con­dition, like arthritis or heart limitation. I guess we’re not there yet -

All for this week,

ES

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