4: Role of Physician's Health and the Physician's Personal Health Flashcards
Section 4, ABLM 4th Ed.
Scientific data supporting that physicians who practice healthy lifestyle are more likely to offer counselling and patient outcomes.
Physician’s personal health behaviours.
2009 survey of californian physicians: number 763
severe to moderate stress: 53%
no or occasional exercise 35%
6 or few hours of sleep 34%
never or occasionally ate breakfast 27%
sedative/tranquilizer use 13%
depression 7%
Marijuana use 4%
2012 survey 53% of primary care physicians were obese.
in 2013 36% of canadian 4th year medical students surveyed didnt meet PA guidelines
in 2013 article overweight resident physicians under acknowledged their overweight status and their under- acknowledgement increased by training year.
other studies have found physicians are practising healthy behaviours therefore arguing against unhealthy doctors’
in 2000 study in men, mortality outcome suggest that physicians live longer than same race professionals and non professional in the US population.
in 2015 study: physicians and medical students engage in more PA than the general US adult population.
Physician’s personal health and attitudes impact patient care
A. in Life style medicine 3rd edition 2019 by J Rippe. Erica Franks says
1. providers need to focus on their own health.
2.healthy doctors are more likely to produce healthy patients.
B. meta-analysis of 24 studies high correlation between physician’s PA habits and counselling frequency odds of counselling 1.4-5.7 times higher among the exercising physicians.
C. Cross sectional study on 1349 internists
Male internists: with smoking, alcohol, seat belt use, and PA were positively associated with counselling for each health behaviour except alcohol use.
Female: with PA positively associated with counselling patients about exercise and alcohol use.
D. physician who exercise( aerobic and strength) are more likely to counsel patients on exercise than who dont
E.physician attempting to chase their own poor habits counsel more
F. training primary care physician in behavioural counselling and providing them with tools and resources helps in their practice of weight related care.
G. in 2014 study physician and medical student with normal BMI felt confident about counselling their patients about PA.
H. non smoking physician emphasize the risk of smoking.
I physician more likely to record diagnosis of obesity and initiate a conversation if they perceived patient weight to be more than their own.
J. female physician’s personal health practices, counsel of behaviour change at least once a year= if they ate less fat counsel on cholesterol, if ate five fruit and veg per day they counsel more on nutrition, if consumed veg diet counsel on weight loss and nutrition.
K. poor physician health habits impact counselling they provide to their patients.
L. The American Medical association code of medical ethics’’ physician health and wellness’’ physicians have responsibility to maintain their health and wellness for safety and effectiveness of the medical care they provide.
M. Physicians are high risk of burn out: which is syndrome of high emotional exhaustion, high depersonalization and a low sense of personal accomplishment from work.
2019 consensus study by national medical academy NAM report US 35-45% on nurses and physicians have substantial symptoms of burnout. medical students 45-60%.
suboptimal care for patient may be one of the unintended consequences of physician burnout.
NAM suggests interventions to prevent and reduce burnout need to be both individual based and organisationally focused strategies.
wellness programs for health providers.
PA opportunities inside and outside office: gym on site, local gym discounts.
implement wellness culture in office with breaks for PA and healthy foods.
provide healthy meals inside and outside office dont serve or provide unhealthy food at office events.
install standing workstations or treadmill desks especially for those who primarily work on the computer.
consider using technology to assist in tracking activities such as phone applications or pedometers.
engage colleagues in health challenges and competitions.
involve in local community changes ‘’ walk with Doc’’
supporting and incorporating wellness programs in the office helps promote the practices and set an example for patients.
personal readiness assessment and develop action plan.
- Readiness for personal action plan for providers. similar to patient. stage of change SMART goals confidence scale and importance scale etc.
- reassess progress, confidence and importance of making change.
- celebrate success, brainstorm ways to overcome barriers and to help specific actions.
how to conduct effective health advocacy on behalf of life style medicine directly with patients and their families as well as policy makers and decision makers.
Mobilising physicians for community level changes.
1. advocacy
2. community advocacy for public health needs.
3. goals of acquiring advocacy skills.
4. provider in advocate role
5. ways one can begin to advocate.
a. be a resource by supplying information and educational material, set an example by being a life style medicine champion in one’s social and medical network, offer expertise to elected officials, local decision makers and community organisations, reach out through one’s network both online and in person.
plan or host an event. speak at a community meeting or with the media.
6. advocacy check list.: a. define the problem and desired solution or policy intervention. ( E;g access to healthy food, walking paths, safe places to be PA, neighbourhood design)
b. understand one’s audience stakeholders, who might help or hinder to achieve goals. ideal time to approach the stakeholders.
c. determine strategy tactics and timeline: decision maker meet individually or in group, legal or regulatory guidelines to consider, develop strategies to overcome resistance who might oppose.
d. evaluate outcomes: metrics need to be tracked to determines whether and when then implemented change has worked, predetermine what a successful intervention will look like.
Examples of life style medicine advocacy.
- Blue Zone project. its a community led collaboration north America.
blue zone five geographical location in the world where world’s heathiest people live ( oinawa in japan, sardinia italy, Nicoya peninsula costa rica, Ikaria Greece, Loma Linda california
communities with 9 common characteristics: - they move naturally in their day to day life
- feel a sense of purpose
3.eat mainly a plant based diet
4.stop eating after becoming 80% full
5.relax - downshift
- put family first
8.find the right tribe to engage with
9.belong to something greater than yourself. - Robert Wood Johnson foundation. ‘’ creating a culture of health’’ community leaders and medical providers collaborate in these cities to bring about better health.
3.Dean ornish’s plant based cardica rehab program.
4.Plan4health intiative by the american public health association and american planning association.
5.project for public spaces new york connection between place and health.
6.the urban land institute network community designs and place acitivation.
7.main street america: 4 points economic vitality, design, promotion and organisation.
8.creative placemaking by national endownment of arts: incorporating the art to transform communties. - national complete street coalition : to design and construct streets that are safe and accessible to all members of the community.
- Physician’s personal health behaviours.
2009 survey of californian physicians: number 763 which one is incorrect:
A. severe to moderate stress: 53%
B. no or occasional exercise 55%
C. 6 or few hours of sleep 34%
D. never or occasionally ate breakfast 27%
B 35%
- Which of the following statement is incorrect:
A. non smoking physician emphasize the risk of smoking.
B. physician more likely to record diagnosis of obesity and initiate a conversation if they perceived patient weight to be more than their own.
C. female physician’s personal health practices, counsel of behaviour change at least once a year= if they ate less fat counsel on cholesterol, if ate five fruit and veg per day they counsel more on nutrition, if consumed veg diet counsel on weight loss and nutrition.
D. poor physician health habits impact counselling they provide to their patients.
E. The American Medical association code of medical ethics’’ physician health and wellness’’ physicians have responsibility to maintain their health and wellness for safety and effectiveness of the medical care they provide.
F. Physicians are high risk of burn out: which is syndrome of high emotional exhaustion, high depersonalization and a low sense of personal accomplishment from work.
G 2019 consensus study by national medical academy NAM report US 45%-60%% on nurses and physicians have substantial symptoms of burnout. medical students 35-45%.
G.
45-60% medical students
35-45% nurses and physicians
- The following involve advocacy check list except:
A. define the problem and desired solution or policy intervention. ( E;g access to healthy food, walking paths, safe places to be PA, neighbourhood design)
B. understanding one’s audience stakeholders is not important, who might help or hinder to achieve goals, ideal time to approach the stakeholders.
C. determine strategy tactics and timeline: decision maker meet individually or in group, legal or regulatory guidelines to consider, develop strategies to overcome resistance who might oppose.
D. evaluate outcomes: metrics need to be tracked to determines whether and when then implemented change has worked, predetermine what a successful intervention will look like.
B. understanding one’s audience is important.
- The following are Examples of life style medicine advocacy except.
A. Blue Zone project
B. Robert Wood Johnson foundation. ‘’ creating a culture of health’’ community leaders and medical providers collaborate in these cities to bring about better health.
C. Dean Martin’s plant based cardiac rehab program.
D. Plan4health intiative by the american public health association and american planning association.
E .project for public spaces new york connection between place and health.
G. Red Zone project
C and G
C: Dean Ornish
G: no such project apart from Blue zone
5. The following are blue zones: five geographical locations in the world where world's heathiest people live true of false A. Oinawa in japan, B. Sardinia Italy, C. Nicoya peninsula costa Rica, D. Ikaria Greece, E Loma Linda California
True
- The blue Zone communities with 9 common characteristics which one is not correct:
A. they move naturally (PA) in their day to day life
B. feel a sense of purpose
C. eat mainly a plant based diet
D. stop eating after becoming 50% full
E. relax
F. downshift ( downsizing house, give away belongings you dont need)
G. put family first
H. find the right tribe to engage with
I. belong to something greater than yourself.
D. 80%
