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Apr 07
The Missing Link in the Health Care System: Agents of Behavior Change

​by Tom Richards, Director of Corporate Engagement, American Council on Exercise

This year, millions of American adults will visit their doctor for a routine check-up. Two out of three will be overweight or obese. At least four out of five will be less active than the recommendations set forth in the Physical Activity Guidelines for Americans.

In most cases, the doctors will easily recognize the need for their patients to make lifestyle changes. But many of the patients will never hear that message. In fact, fewer than half of all primary care physicians routinely provide their patients with guidance on lifestyle behaviors, such as diet, physical activity or weight control.
Other patients, however, may be fortunate enough to have a one-minute conversation with their physicians about the need to make a lifestyle change. Phrases such as "Watch what you're eating," and "Try to get more exercise," will be common. In a small percentage of cases, the conversations may even include specific nutrition guidance and an exercise prescription.

The patients will nod along, distressed but not terribly surprised. They will know that their clothes from a few years back are tighter, and that they don't have as much energy as before. Hearing it from their doctors, however, will bring some necessary focus to the issues. As they leave the office, many of the patients will tell themselves it's time to make a change.

But they will arrive at home, or go back to work, and they will likely be immersed in an environment that supports unhealthy eating and sedentary behaviors. For many, willpower will be no match for the cultural environment. Knowledge and a desire for change will not be enough alone to change. Rather, Americans struggling with weight management and poor fitness need support, guidance and expertise on behavior change.

"The breakthrough medicine of the 21st century is behavior change," says Dr. Eddie Phillips, Founder and Director of the Institute of Lifestyle Medicine. Doctors want to help, of course, but they generally lack the time, training and skills necessary to empower their patients to live a healthier, more active lifestyle. That's slowly changing through the great work of organizations like the Institute of Lifestyle Medicine, but it's unlikely that physicians will ever be the key providers of intensive behavior change counseling. The time demands of the profession are simply too great.

The responsibility of providing the breakthrough medicine of the 21st century must ultimately be borne by other health professionals—well-qualified fitness professionals, health coaches, nurses, registered dietitians, medical assistants, physician assistants and others—who have received the proper training and gained the necessary expertise to create sustainable behavior change. These professionals will be the linchpin of a new health care system that supports people in between trips to the doctor—a system that focuses on healthy behaviors and the prevention and mitigation of chronic disease. And so in the future, millions of Americans will leave their doctor visits not just energized to adopt healthier habits, but fully empowered to do so, thanks to the vital support provided by health and fitness professionals.



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