Doctors, Practice What You Preach
The old adage, "Do as I say, not as I do," has never worked terribly well for parents, politicians or physicians. Not surprisingly, patients treated by doctors, nurses and other healthcare providers who are overweight and stressed out--even smoking--may say to themselves that a healthy lifestyle is just too hard--"If they can't do it, how can I?"
To combat this problem, Johns Hopkins medical students recently launched a grassroots campaign to urge fellow medical and nursing students, as well as practicing clinicians, to practice what they should be preaching. They want healthcare professionals to sign The Patient Promise, a personal--and public--commitment "to lead by example and practice healthy lifestyle behaviors comparable to those I would ask of my patient."
To combat this problem, Johns Hopkins medical students recently launched a grassroots campaign to urge fellow medical and nursing students, as well as practicing clinicians, to practice what they should be preaching. They want healthcare professionals to sign The Patient Promise, a personal--and public--commitment "to lead by example and practice healthy lifestyle behaviors comparable to those I would ask of my patient."
Health Professionals Look Inward to Tackle Obesity
Hopkins students recently launched the Patient Promise, a program that aims to ensure health professionals do as they tell patients when it comes to healthy lifestyles. It is one of many similar programs to arise in the industry as health professionals seek to tackle rising obesity rates nationwide by starting with themselves. Research has shown that healthy lifestyle choices on the part of physicians can translate into better care for obese patients. That care is important as the health industry seeks to tackle the rising costs of care, particularly for many chronic conditions that can stem from obesity.
Hopkins students Shiv Gaglani and David Gatz started talking about the idea behind the Patient Promise early this year, realizing that their career choices were taking a toll on their health. "Our own healthy-lifestyle behaviors were going out the window," Gaglani said, given time spent sedentary in classes or studying and busy schedules leaving little room for exercise or healthy cooking. "It's sort of a sacrificial career. By sacrificing our own health, we would become potentially less effective as clinicians because we wouldn't be credible."
The pair got about a dozen students together, including DesRosiers, to draft the Patient Promise, and they launched it in June. Within a few weeks, 300 medical professionals and students across the country had signed it, and the organizers plan to raise that to a few thousand eventually. The organizers are urging signers to form chapters at their own medical institutions to promote accountability to the promise.
Hopkins students Shiv Gaglani and David Gatz started talking about the idea behind the Patient Promise early this year, realizing that their career choices were taking a toll on their health. "Our own healthy-lifestyle behaviors were going out the window," Gaglani said, given time spent sedentary in classes or studying and busy schedules leaving little room for exercise or healthy cooking. "It's sort of a sacrificial career. By sacrificing our own health, we would become potentially less effective as clinicians because we wouldn't be credible."
The pair got about a dozen students together, including DesRosiers, to draft the Patient Promise, and they launched it in June. Within a few weeks, 300 medical professionals and students across the country had signed it, and the organizers plan to raise that to a few thousand eventually. The organizers are urging signers to form chapters at their own medical institutions to promote accountability to the promise.
The Patient Promise: Doctors pledge to lead by example
A study in the January issue of the journal Obesity showed that overweight or obese physicians talked to obese patients about weight management for only 18 percent of available opportunities; in doctors with a healthy BMI, that number rose to 30 percent — still plenty of room for improvement, though. Conversely, other studies show that doctors with healthier habits are more likely to counsel their patients to adopt preventive lifestyle behaviors.
Another Patient Promise goal is to combat weight bias discrimination. “Research suggests that medical students are more likely to view the obese and smokers as lazy or apathetic, which can show up in how they care for such patients down the road,” says Gaglani, who adds that he has witnessed such behavior in clinical settings.
Those pledging the Promise agree to, instead, “…identify and guard myself from potential prejudices against my patient based on unhealthy behaviors, recognizing the often complex origins of these habits.”
Another Patient Promise goal is to combat weight bias discrimination. “Research suggests that medical students are more likely to view the obese and smokers as lazy or apathetic, which can show up in how they care for such patients down the road,” says Gaglani, who adds that he has witnessed such behavior in clinical settings.
Those pledging the Promise agree to, instead, “…identify and guard myself from potential prejudices against my patient based on unhealthy behaviors, recognizing the often complex origins of these habits.”
A Call to 'Heal Thyself'
When it comes to prescribing healthy lifestyles, there’s a strong link between what doctors do themselves and what they tell their patients to do, says Erica Frank, adviser for The Patient Promise, who researches physicians’ personal and clinical health habits. “If we pay more attention to physicians’ health, we’ll have a patient population that is healthier,” the University of British Columbia professor told The Wall Street Journal.
Using the slogan “Hippocrates, not hypocrisy,” students describe The Patient Promise as an extension of the Hippocratic Oath, the credo outlining professional physician conduct. In that spirit and tradition, pledgers commit to practice behaviors similar to those that they request of patients, ranging from getting at least a half-hour of physical activity daily to moderating their intake of alcohol and other potentially harmful substances. The oath also encourages health care professionals to be conscious of potential weight bias—delivering care differently on the basis of body shape and size—which founders of The Patient Promise say has been linked to fewer cancer screenings because of reluctance of providers to perform essential services, such as Pap smears, on obese women.
Using the slogan “Hippocrates, not hypocrisy,” students describe The Patient Promise as an extension of the Hippocratic Oath, the credo outlining professional physician conduct. In that spirit and tradition, pledgers commit to practice behaviors similar to those that they request of patients, ranging from getting at least a half-hour of physical activity daily to moderating their intake of alcohol and other potentially harmful substances. The oath also encourages health care professionals to be conscious of potential weight bias—delivering care differently on the basis of body shape and size—which founders of The Patient Promise say has been linked to fewer cancer screenings because of reluctance of providers to perform essential services, such as Pap smears, on obese women.
Pledging Wellness
Recently, the pledge was signed by Michael C. Hoaglin, clinical director of The Dr. Oz Show, and Joan Duwve, chief medical officer of the Indiana State Department of Health, who left a note on the initiative’s website. “We absolutely must find a way to engage health care providers in the many critical public health battles we are fighting, and losing! Thank you for this simple, but important, tool we can use to work together toward a healthier Indiana—and nation.”
Dr. Oz’s Hoaglin says that he signed because solving America’s challenging chronic disease crisis is within reach.
“The cure for obesity is known. We don’t need to wait to discover any new gene or drug to make a serious dent in this public health issue. Government and guidelines will do little to change the minds of most Americans without our boots on the ground: our nation’s health care professionals,” he says. “Patients need every nudge they can get from those they trust, because I see and experience firsthand how easy it is to fall prey to the standard American diet and a stressful lifestyle.”
Dr. Oz’s Hoaglin says that he signed because solving America’s challenging chronic disease crisis is within reach.
“The cure for obesity is known. We don’t need to wait to discover any new gene or drug to make a serious dent in this public health issue. Government and guidelines will do little to change the minds of most Americans without our boots on the ground: our nation’s health care professionals,” he says. “Patients need every nudge they can get from those they trust, because I see and experience firsthand how easy it is to fall prey to the standard American diet and a stressful lifestyle.”
Op/Ed: Getting doctors to practice what they preach
These findings are the foundation for The Patient Promise, a grass-roots initiative we've launched this month at the Johns Hopkins University School of Medicine and the American Medical Association annual meeting in Chicago. Our goal is simple: to improve the health of patients by improving the health of their health care providers. Clinicians who sign The Patient Promise make a public commitment to adopt health-enhancing behaviors such as physical activity, a balanced diet, harmful substance avoidance and stress management, just as they would — and should — ask of their patients. In the words of physician and Nobel Peace Prize laureateAlbert Schweitzer, "Example is not the main thing in influencing others. It is the only thing." The Patient Promise also urges clinicians to counteract unhelpful and ineffective language and strategies regarding obesity, especially in the health care environment. Unhealthy behaviors and outcomes have more complex origins than stigmatizing explanations like apathy or laziness; such "diagnoses" only alienate patients in need of treatment or preventive care.
Nearly 400 current and future clinicians from 38 institutions across the country have committed to the patient promise, which recently was featured in The Atlantic. Our goal is for at least 1,000 students and health care providers to sign on to the promise by the end of the summer.
Nearly 400 current and future clinicians from 38 institutions across the country have committed to the patient promise, which recently was featured in The Atlantic. Our goal is for at least 1,000 students and health care providers to sign on to the promise by the end of the summer.
Medical professionals challenged to be better role models for their patients
In an era of soft drink bans and restrictions on junk food ads, students at the Johns Hopkins University schools of medicine and nursing are recommending a different approach to aid the more than 170 million Americans who are overweight or obese. By publicly committing to basic tenets of healthy living — regular exercise, eating a balanced diet and managing stress — future nurses and physicians are challenging peers and practicing medical professionals to model healthy behaviors for their patients.
Supporters of the grassroots initiative called The Patient Promise say the initiative is more than an exercise in ethics or idealism — it’s their response to a growing body of evidence that suggests that personal health habits of clinicians may play a powerful role in the health of their patients.
Supporters of the grassroots initiative called The Patient Promise say the initiative is more than an exercise in ethics or idealism — it’s their response to a growing body of evidence that suggests that personal health habits of clinicians may play a powerful role in the health of their patients.
"The Patient Promise", an initiative to improve the health of health care providers
An article published in the January issue of the research Journal obesity was the basis for the Patient Promise initiative started by 2 Johns Hopkins students. The study in Obesity cited research that found that “physicians were more likely to initiate a weight loss conversation with a patient if the physician weighed no more, or less, than the patient.” The John Hopkins students, Shiv Gaglani and David Gatz realized that their career choice in health care was takiing a toll on their health…surely something we can all relate to at times in our health care career. The students are quoted as saying “Our own healthy-lifestyle behaviors were going out the window……given time spent sedentary in classes or studying and busy schedules leaving little room for exercise or healthy cooking. ……it's sort of a sacrificial career. By sacrificing our own health, we would become potentially less effective as clinicians because we wouldn't be credible."
Do As I Do
Nurses and physicians at Johns Hopkins are making a unique promise: to live the healthy lifestyle they recommend to their patients.
“Do as I do,” is the mantra for more than 230 nurses, students, and faculty from The Johns Hopkins Hospital and Johns Hopkins University schools of nursing and medicine who signed the collaborative Patient Promise effort. They are now engaging in regular physical activity, eating a balanced diet, and working alongside patients to adopt positive lifestyle changes. Their oath recognizes that a clinician’s health behavior affects patients’ health behaviors.
“We’re glad to see the enthusiasm behind the initiative,” says Shiv Gaglani, the JHUSOM student who firstintroduced Patient Promise to the Johns Hopkins Doctors and Nurses Alliance (DNA). The initiative has since been adopted by JHUSON students Erika Koff, Lauren McGivern, Hilary Carroll, and Lisa Garrett, who have aligned the ideas with those of the School of Nursing’s own SON Fit Program that promotes healthy work and learning environments.
“Do as I do,” is the mantra for more than 230 nurses, students, and faculty from The Johns Hopkins Hospital and Johns Hopkins University schools of nursing and medicine who signed the collaborative Patient Promise effort. They are now engaging in regular physical activity, eating a balanced diet, and working alongside patients to adopt positive lifestyle changes. Their oath recognizes that a clinician’s health behavior affects patients’ health behaviors.
“We’re glad to see the enthusiasm behind the initiative,” says Shiv Gaglani, the JHUSOM student who firstintroduced Patient Promise to the Johns Hopkins Doctors and Nurses Alliance (DNA). The initiative has since been adopted by JHUSON students Erika Koff, Lauren McGivern, Hilary Carroll, and Lisa Garrett, who have aligned the ideas with those of the School of Nursing’s own SON Fit Program that promotes healthy work and learning environments.
Live What You Say with The Patient Promise
Nurses may not have all the answers for their patients, at least when it comes to conquering personal challenges related to nutrition, fitness and weight. At the ANA Healthy Nurse conference in June, 380 nurses took a short health risk assessment that showed how the nursing population struggles with these issues, too. Seventy percent of those surveyed were in the overweight or obese category; only 35 percent exercise 4-5 times per week, as recommended; and only 40 percent eat the suggested four or more servings of fruits and vegetables a day.
How can nurses make the changes that will improve their health and help their patients do the same? One way, according to the American Nurses Association (ANA) and other clinician advocacy groups, is to become personally accountable and sign The Patient Promise, a commitment made by healthcare providers to pursue the same healthy lifestyle they promote among their patients.
How can nurses make the changes that will improve their health and help their patients do the same? One way, according to the American Nurses Association (ANA) and other clinician advocacy groups, is to become personally accountable and sign The Patient Promise, a commitment made by healthcare providers to pursue the same healthy lifestyle they promote among their patients.
What Happens When Doctors Don’t Take Care of Themselves?
Signers of the Patient Promise pledge to lead by example by exercising regularly, eating balanced and healthful meals, and avoiding harmful substances. The idea was dreamed up by second-year medical student Shiv Gaglani, who was a triathlete and healthy eater — until he started medical school, that is. It took a course on obesity and nutrition to make him realize that he had to pay attention to his own health, along with that of his patients. “We found a good deal of evidence that clinicians who promote their own healthy personal behaviors are more likely to encourage patients to do the same, and have their clinical practice improve,” he told the Gazette.
Since the Promise went live this summer, several medical students have lost 30+ pounds, while others have quit smoking or taken up Zumba.
Since the Promise went live this summer, several medical students have lost 30+ pounds, while others have quit smoking or taken up Zumba.
Opinion: Doctors, practice what you preach
Not surprisingly, patients treated by doctors, nurses and other healthcare providers who are overweight and stressed out—even smoking—may say to themselves that a healthy lifestyle is just too hard—"If they can't do it, how can I?" To combat this problem, John Hopkins medical students recently launched a grassroots campaign to urge fellow medical and nursing students, as well as practicing clinicians, to practice what they should be preaching. They want healthcare professionals to sign The Patient Promise, a personal—and public—commitment "to lead by example and practice healthy lifestyle behaviors comparable to those I would ask of my patient."
Johns Hopkins Medical and Nursing Students Challenge Medical Professionals to Be Better Role Models for Their Patients
A recent report by the Institute on Medicine (IOM) underscores the staggering physical and financial toll of obesity-related chronic disease. The clinician-directed approach of The Patient Promise is one prevention strategy recommended by the IOM to address the epidemic level of Americans who are overweight or obese.
National weight-related trends are reflected among health care providers. According to “Checking Up on the Doctor,” a Health Journal article published in May 2010, 63 percent of male physicians are overweight or obese, compared with about 72 percent of U.S. adults. Similarly, a 2011 article fromThe Journal of Nursing Administration states that 55 percent of nurses are overweight or obese.
The students’ rationale of first addressing the habits of physicians and nurses stems from recent research, including a study from the Johns Hopkins Bloomberg School of Public Health published in the May issue of Obesity. Author Sara Bleich, Ph.D., an assistant professor and an advisor for The Patient Promise, found that overweight or obese physicians were less likely to diagnose and discuss the health risks of obesity with their patients than their normal-weight peers.
National weight-related trends are reflected among health care providers. According to “Checking Up on the Doctor,” a Health Journal article published in May 2010, 63 percent of male physicians are overweight or obese, compared with about 72 percent of U.S. adults. Similarly, a 2011 article fromThe Journal of Nursing Administration states that 55 percent of nurses are overweight or obese.
The students’ rationale of first addressing the habits of physicians and nurses stems from recent research, including a study from the Johns Hopkins Bloomberg School of Public Health published in the May issue of Obesity. Author Sara Bleich, Ph.D., an assistant professor and an advisor for The Patient Promise, found that overweight or obese physicians were less likely to diagnose and discuss the health risks of obesity with their patients than their normal-weight peers.
The medical profession doesn't take good care of its own
In their commentary about how poorly doctors often care for their own health, medical students Shiv Gaglani and David Gates exhort all physicians to practice a healthy lifestyle, exercise, eat right and manage their stress levels ("Physician, heal thyself," June 22). They have signed on to The Patient Promise, an initiative whereby doctors make promise to improve the health of patients by improving their own health.
The last thing the medical profession does is take care of its own well. Most doctors do not get routine physical exams or lab tests. Nurses are slightly better hospital than doctors in this regard, but many are obese, sacrifice sleep during night shifts, eat on the go, choose the wrong foods and keep working even while ill.
I know residents and interns who go to work suffering from the flu or a bad cold. They drink loads of coffee or caffeinated soda to stay awake and then push themselves until they drop. Often their mentors never bother to ask how they are feeling or if they have eaten. When patients are lining up for care and duty calls, doctors in training grab a doughnut or a slice of pizza and keep moving through their numbing routines.
The last thing the medical profession does is take care of its own well. Most doctors do not get routine physical exams or lab tests. Nurses are slightly better hospital than doctors in this regard, but many are obese, sacrifice sleep during night shifts, eat on the go, choose the wrong foods and keep working even while ill.
I know residents and interns who go to work suffering from the flu or a bad cold. They drink loads of coffee or caffeinated soda to stay awake and then push themselves until they drop. Often their mentors never bother to ask how they are feeling or if they have eaten. When patients are lining up for care and duty calls, doctors in training grab a doughnut or a slice of pizza and keep moving through their numbing routines.
