Should the amount of time a patient spends exercising be a vital sign? Thanks to efforts of Exercise is Medicine, a program overseen by the American College of Sports Medicine, a growing number of clinicians seem to think so, according to an article in the Wall Street Journal.
Oakland, Calififornia–based Kaiser Permanente is an example of a large health system embracing the approach, in which nurses or medical assistants ask patients how many minutes a week they exercise and enter the data in their electronic medical records along with standard health data.
Next, doctors don't just tell patients they need more exercise, but also discuss with them what activities might work best and what barriers might keep them from starting a new routine. From there, clinicians can refer patients to the appropriate resources, such as behavioral health specialists (to address problems such as anxiety), telephone-based health coaching, physical therapy (to treat or prevent movement-limiting injuries) or low-cost exercise classes.
"What shocked me is how many of my patients do nothing," said Jack Der-Sarkissian, M.D., a Kaiser family doctor who says patients routinely tell him, "nope, I don't exercise and don't do any physical activity." Der-Sarkissian told the newspaper that he brings up physical activity in every visit, regardless of the reason a patient scheduled it.
So far, patients report success and satisfaction with the approach. "Making exercise seem like a vital sign is like reinforcing what we were told as kids to brush our teeth--if you don't do it at night before you go to bed, you feel something is wrong," said Paul Freberg, a 60-year-old patient of Der-Sarkissian who has lowered his doses of blood pressure and cholesterol medications and lost nearly 40 pounds through the program.
"Doctors are a huge motivating force in getting patients to change behavior," concluded Adrian Hutber, vice president of Exercise is Medicine. The group is working with health systems and health plans on pilot programs to include exercise programs and counseling in their coverage, WSJ noted.
To learn more:
- read the article