How practices can make time for exercise counseling

Physicians should routinely talk with patients about exercise during appointments, argue researchers and clinicians in a new commentary published in JAMA.

Currently, this conversation happens with only about a third of patients, according to an article from, despite the fact that many chronic diseases can be prevented or improved with physical activity.

"Addressing physical activity in clinical practice may be perceived as challenging given all of the competing priorities, but it can be done, wrote the authors from Brigham and Women's Hospital, Stanford University School of Medicine and the University of Central Florida. "Regarding approaches to the discussion of physical activity during the office visit, consider starting by making physical activity a vital sign."

A nurse or medical assistant (MA) who takes the rest of patients' vital signs, therefore, would initiate the discussion. If patients report that they do exercise regularly, the clinician should document details of their regime in the medical record, the paper recommended. If patients admit that they're not very active, the nurse or MA can talk with them about what activities and goals might be reasonable.

In addition to encouraging patients to self-monitor their activity, perhaps with a mobile app, practices should bring patients for whom they prescribe exercise back for regular follow-up and encourage them to build on their success, the authors urged.

"Physicians and other healthcare professionals are considered trusted sources of health-related information, and they can help patients set priorities to improve their health," paper co-author JoAnn Manson, chief of preventative medicine at Brigham and Women's and a professor of medicine at Harvard Medical School, told "It's a different, maybe, to read in the newspaper that physical activity has been linked to reduced risk of heart disease or of diabetes in a research study than to hear from our own healthcare provider it is important that you make exercise and physical activity a priority in your life to improve your own health."

To learn more:
- read the study
- see the article