Physically fit doctors more confident touting healthy habits

How confident physicians are when advising patients to exercise and adopt a healthy diet is tied to the doctors' training and lifestyle habits, a new study shows.

With high obesity rates leading to more cases of chronic disease such as diabetes and coronary heart disease, physicians must appear confident when counseling patients about healthy lifestyles, according to the study in the fall issue of Preventive Cardiology. One in three Americans is obese, defined as having a body mass index of 30 or higher, said the Centers for Disease Control and Prevention.

Researchers surveyed 183 University of Michigan Health System doctors: 102 residents and fellows and 81 attending physicians. Most said they weren't confident they could persuade patients to change their lifestyle habits.

Only about one in 10 trainees and 17.3% of attending physicians were confident about counseling patients on diet and exercise. Physicians who exercised and maintained a healthy weight were generally more comfortable talking with patients about lifestyle.

"Living a healthy lifestyle themselves translates into a more believable message to their patients," Michael Howe, MD, lead author and chief medical resident at the health system, said in a statement.

Attending physicians were more likely to offer healthy lifestyle advice, with 70.4% reporting they advised two-thirds or more of their patients, compared with 36.6% of trainees. Most physicians said they didn't receive adequate training in counseling patients on such issues.

Researchers were surprised by the lack of confidence and relative infrequency of counseling, Dr. Howe said. Studies on smoking cessation efforts have shown that patients respond to counseling by physicians.

"It's all in how the message is delivered. If you really believe what you're preaching, it is definitely a more believable message," he said.

The study found attending physicians were more likely to exercise regularly and eat healthy foods, while trainees eat more fast food. Attending physicians have more time to focus on their health, Dr. Howe said. "The trainees have less training and less time," he said.

Eighty-eight percent of trainees and 48% of attending physicians cited tough work schedules for keeping them from regular exercise, and nearly a quarter of attending physicians also blamed family commitments.

The study recommends that academic medical centers provide adequate training on how to counsel patients and in-hospital opportunities for residents to eat well and exercise (link).

"We're seeing, at least at our institution, a renewed push to support employee health," Dr. Howe said. "That's going to be more and more a trend in health care."