FAQ: How can primary care physicians help patients successfully make lifestyle changes?

Frequently asked questions for the primary care community, excerpted from a conversation between a leading primary care physician and a world-renowned beta cell researcher. (2:20)


Dr. Leahy: I learned some years ago in my clinic that I am not good at predicting who are the patients who will be most successful with diet and exercise.  It really comes back to reinforce itself for me almost very frequently. 

I’ll see a patient -- they’ll often be there with their spouse -- I’ll talk to them for several minutes and they have lots and lots of questions, specific questions about diet changes and activity and what works and what doesn’t work and we’ll have this really interactive, interesting conversation and then they come back and nothing has changed as opposed to I have someone who’s not all that interested, not all that educated, not seemingly a patient you think is going to be very productive, they come back often with the statement that my spouse is really into this -- they’re ten pounds lighter and over the next year they’re just the absolute poster child of using effective lifestyle modification. 

So I don’t think we can use one appointment with a patient and make a decision whether this is a good idea or not and I absolutely agree we need to use the professionals -- the dieticians and educators -- who are much better at speaking in language to patients about practical application of these things than I think the average hurried doctor. 

We have available at my institution a cardiac rehab program for patients who obviously have cardiac disease, which is based on effective use of dieticians and also regular exercise and people come actually to the facility and use the gym three times a week under observation.  The thing that’s amazing to me is people really get into it.  It’s like a club for people.  They just really start to adopt healthy lifestyle practices.  And we’re now using that facility for our patients without cardiac disease and it’s really turned out to be a very beneficial program because it’s more than just a doctor saying, “Please go exercise. Please watch your diet. Come back and see me in two months we’ll talk about it.”  I mean there are true goals and guidelines and true sort of milestones along the way that people get positive and negative feedback on and they work with the staff that’s really into it and with other patients that really like it and it’s a fabulous program. 

So I think that’s what we have to think about in our own communities -- sort of find a place where people can work on lifestyle around others who are enthusiastic and really try to put it into practice for their own life.