Keywords: Lifestyle change, weight, diet, activity, alcohol use, smoking, stress reduction, sleep, communication.
Citation: Smith CW, Lester J. Improved lifestyle is the pathway to health. J Participat Med. 2015 Oct 6; 7:e12.
Published: October 6, 2015.
Competing Interests: The authors have declared that no competing interests exist.
I recently participated in a popular radio program about lifestyle change, entitled “Changing Your Life to Improve Your Health.” This stimulating interview and the subsequent discussion reminded me of the importance of emphasizing a healthy lifestyle with patients in my practice. Since lifestyle intervention is futile without patient participation, I invited John Lester, who was interviewed on this program, to join me in this commentary. I wondered how discussion about healthy behaviors stacks up against other health matters on the patient’s agenda. While most patients in my primary care practice are very intently focused on addressing their health issues, many seem to give short shrift to lifestyle issues. For example, they want to know whether the right medications and dosages are being prescribed. Are their cholesterol levels within normal range? Are their immunizations up to date? Are they on schedule for obtaining wellness procedures such as mammograms, pap smears and colonoscopies? All are important, appropriate health matters.
But it is ironic, and can sometimes be frustrating for both patient and provider, to spend so much time and effort obtaining lab tests and adjusting medications and doses when attention isn’t being paid to addressing basic lifestyle issues such as weight, diet, activity, alcohol use, smoking, stress reduction and getting a good night’s sleep. What accounts for this disconnect? Even though the patient may realize the importance of these issues, why does it sometimes seem easier or more natural to dive into the medication list or begin addressing blood pressure or an elevated blood glucose level? And why do the provider and the patient often seem resistant to working on solving the basic issues that are so vital to health? I tossed this question to John and he replied:
“Our current western mindset focuses on fixing problems rather than preventing them. And this mindset is reinforced by endless marketing messages to treat symptoms rather than diseases. Feeling tired? Red Bull gives you wings! Heartburn? Tums to the rescue! Is it any real surprise that this unfortunate state of mind influences patients when it comes to their healthcare decisions? Patients have been programmed into a state of learned helplessness by messages from corporations that relentlessly focus on reinforcing profitable consumer behaviors rather than healthy lives. They are waiting to be told what to do to fix a problem, not how to prevent it.
“The true path to a healthy life begins with a healthy lifestyle, and patients need to be shown this path first and foremost. A big challenge is making those initial changes in one’s lifestyle, and health care professionals have a wonderful opportunity to be there for patients as guides to help make sure those first steps are successful. Give strong support for a patient’s first positive changes in lifestyle, and subsequent changes will happen much more easily.“
Patients must be the drivers of their own health care. This includes monitoring their lab test results, knowing their medication dosages, and talking to other patients with similar conditions. They should also suggest their own ideas to their providers about their treatment or conditions. But, even if all of this is occurring, I believe that participatory medicine is missing an important opportunity if it doesn’t start with a strong commitment by both provider and patient to address lifestyle issues. Participatory medicine must start with prevention. Physicians can help reconnect the patient to this preventive path by keeping this issue front and center in practice, and by support and encouragement for making lifestyle changes. It’s not dramatic or sexy, and it is inexpensive, but it is one of the best ways to make a real difference in the patient’s health status.
And thanks to John for adding the patient’s perspective to this topic and for this great quote: “Talk about healthy eating before talking about eating pills. Discuss exercise before discussing dosages.”
Copyright: © 2015 Charles W. Smith and John Lester. Published here under license by The Journal of Participatory Medicine. Copyright for this article is retained by the authors, with first publication rights granted to the Journal of Participatory Medicine. All journal content, except where otherwise noted, is licensed under a Creative Commons Attribution 3.0 License. By virtue of their appearance in this open-access journal, articles are free to use, with proper attribution, in educational and other non-commercial settings.