Start a healthy conversation

It's easy to see how the hardest part of establishing a physician-patient partnership for healthy living habits can be in getting the conversation started.

Patients say they are reluctant to talk with physicians about their diet, exercise habits, smoking or alcohol use because many times they feel the doctor doesn't have time during the usual office visit for a discussion. So they tend to wait for the doctor to start the conversation.

Physicians say they are more than willing to have these conversations, except that they would like some signal from patients that they are going to be willing participants in making themselves healthier so the message doesn't fall on deaf ears. So physicians tend to wait for the patient to take the lead.

To solve this impasse, the AMA has developed the Healthier Life Steps Program. It is an easy way for physicians and patients to break the ice about healthy living. It gives physicians and patients specific tools to learn more about the health effects of diet, exercise, smoking and excessive alcohol use. Both sides can learn how to approach each other on the subjects and how to work together to solve any problems.

The program is centered on materials available at a new AMA Web site (link). The physician-directed content of the site has been up since May 1, with the patient version just now being added. The Healthier Life Steps Program is free to all physicians and patients.

On the physician side, doctors can start by earning CME credit for studying material describing how to use references on healthy lifestyles and behavior changes for their patients, assess patient readiness to change their behavior, counsel patients, and offer action plans to help patients improve their habits.

Physicians can print a self-assessment questionnaire to give to patients. Also available are specific tools such as tip sheets and progress-tracking calendars so patients who are willing to change can keep tabs on their efforts, as well as have reports to give their physicians.

At the site, doctors can print posters encouraging healthy lifestyles, thus sending a signal to their patients that they are there to help with wellness as well as illness.

For patients, the Healthier Life Steps Program offers some of the same tools, such as the questionnaire, so they might bring it to their doctors as a conversation starter.

The patient page also offers links to simple steps for improvement that are given by the best authorities available. On diet and exercise, links go to essential information from organizations such as the Centers for Disease Control and Prevention, the American Dietetic Assn., the American Heart Assn. and the American Cancer Society. There also are links to checklists and healthy recipes from the CDC, the National Heart Lung and Blood Institute, the U.S. Dept. of Agriculture and the U.S. Dept. of Health and Human Services.

Authorities of similar standing are available for background and tools on smoking cessation and reducing risky drinking.

For patients with or without chronic conditions, the site can get conversations going about the best way to live healthy. It also has the depth of information necessary to focus the discussion on individual needs and what the patient can do to stop a bad habit or start a good one.

But an even more basic lesson about healthy living from the site -- and one that applies to both doctor and patient -- is just as important: It's OK to talk about it.