Perm Physician July 20, 2023

By Debra Wood

How Physicians Can Be Healthy Role Models for Patients

Physicians play a key role in helping patients develop healthy lifestyles, providing guidance to stop smoking, lose weight, improve their diet or increase their activity levels. The challenge is often reflecting these healthy behaviors in their own life.

Yet doctors serving as healthy role models for their patients is “critical,” said Jo Marie Reilly, MD, MPH, FAAFP, clinical professor of family medicine and director of the Primary Care Initiative at the Keck School of Medicine at the University of Southern California (USC) in Los Angeles.

“Physicians are the first point of contact for patients on their health journey—for things either they ask about and want help with, or don’t know about and need to be pointed out to them,’ she said.

Healthy physicians can influence others

Physicians can provide motivation for people to achieve their health goals. Healthy physicians can help people become healthier.

“It's not only patients who look up to physicians as role models,” said Sue Jacques, a professionalism and civility expert in Canada. “Members of the public do, too. That's why it's vital for doctors to recognize the influence they have. They can share that influence by intentionally demonstrating empathy and consistently exhibiting healthy lifestyle choices and sound decision-making, in both their personal and professional lives.”

On the other hand, if a regularly exercising physician appears dismissive of patients who do not follow the advice or a physician’s exercise regimen, it is unlikely to be helpful, added Thomas L. Schwenk, MD, dean of School of Medicine at the University of Nevada, Reno.

“Self-disclosure has to be used carefully and for specific reasons,” Schwenk said. “It gets to the broader issue, if a physician has to experience everything the patients experience to give proper advice.”

What if a physician is not fit and trim?

Only 2 percent of physicians smoke, according to a 2014 study in the Journal of the American Medical Association, but many physicians, just like their patients, struggle with their weight.

The Medscape Physician Lifestyle & Happiness Report 2018 found 47 percent of physicians were trying to lose weight and only 10 percent exercise daily, with 23 percent exercising four to five times weekly. Nearly one-third of the physicians (32 percent) reported either not exercising at all, or only exercising once per week.

“All physicians and health providers have something with our health we struggle with,” Reilly said. “Those of us most successful are honest about it.”

A reasonable amount of disclosure about their own health challenges and successes could help motivate patients, Reilly reported.

“It’s interesting whether you can give someone advice if you do not follow it,” Schwenk said.

He explained that health promotion is personal and patients often hold physicians offering preventive services to that advice. Jacques added that physicians are viewed as natural leaders in their personal lives and often are held to a higher standard.

“It's critical for medical practitioners to be aware of how closely they're being watched,” Jacques said. “Leading by example through healthy and respectful dietary, fitness, driving, and communication habits is a choice that sets high standards for others to emulate.”

Technology aides and health apps

Fitbits, Apple Watches, pedometers and other electronic tools and health apps can be helpful in achieving health goals. Medical students and physicians are often using the tools, with some medical groups or facilities encouraging more involvement with competitions. These challenges may push participants to take the most steps over a specified period of time, or to achieve other quantifiable goals.

“Everybody likes tools and things they can have with them,” Reilly said. “Those devices have been some of the more motivating things to help patients and ourselves about weight.”

Some favorite health apps among physicians and medical students include:

These apps count food eaten or steps taken, and may include workout suggestions and other features. Some include community support via social media platforms. Yet, as accessible as they are for health providers, the cost of the technology may be a barrier for patients in lower-income settings.

How physicians can make a difference

Reilly recommended using motivational interviewing, identifying a problem and helping patients find ways to start making healthier choices. She suggested initially asking patients if it is OK to talk about their weight, and then setting realistic health goals together.

“I’m most effective in helping a patient change habits, particularly around obesity, when I can give specific advice tailored to them personally,” Reilly said.

Posting information about 5k races and information about staff members’ achievements in such activities can help start a conversation. Handouts written in a level patients can understand also should be available.

Reilly teaches medical students how to be healthy physicians and how to educate their patients on the same topic. While doctors have traditionally been trained to treat diseases, the new emphasis is on learning how to help themselves and their patients avoid illness through healthy habits and preventive measures.

Physicians in training at the Keck School learn about nutrition management, yoga, mindfulness training and setting health goals. Next year, students will learn how to tailor an exercise program to a patient’s abilities, even those in a wheelchair or using a walker.

“I think the next generation of physicians will be different,” Reilly said. “Physician wellness has swept the nation.”

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