Is your doctor fit?

This topic has long been of interest to me. I see many physician colleagues who are markedly overweight, obese, morbidly obese, etc. and just cringe at how their messages about weight loss, fitness, etc. must go over with their patients. If you are obese and your doctor (who is also obese) tells you to lose weight, how do you feel about that? First, you say to yourself, “This doctor is a hypocrite.” Second, you say, “OK, how do I do that?” but really doubt that you will receive an answer that is workable or reliable.

Basically, you would not [and perhaps should not] have confidence in the fitness advice you get from a doctor who is out-of-shape. No matter what kind of all-star advice your overweight doctor gives you, you will always question its validity. You will wonder if he/she has ever tried it him/herself; you will wonder why it should be so important for you to get fit when your doctor looks like a couch potato.

Granted, medical training is no walk-in-the-park; medical school and residency consist of long hours and innumerable stressors, enough to drive anyone to engage in stress-eating. To me, however, there is no excuse to hold onto that lousy lifestyle after residency.

I gained about 20 pounds during med school and residency, finally turning things around near the end of my 2nd year of residency when I simply made smarter choices in the cafeteria and was able to drop 10 pounds over the next year. That was when I first started tracking my weight on a near-daily basis. Nothing beats smart eating. Since I have continued to get in shape through diet and exercise, I have noticed that patients of mine are much more willing to hear what I have to say about getting in shape. It’s not that I was ever obese, but I would have been classified as overweight at my worst point, and I know I didn’t look like a reliable beacon of fitness information.

People should want to see their physicians “walk the talk” and rightfully so. When I am in the role of patient, I refuse to go to a physician who is not physically fit. I’m not wasting my time or money on half-baked advice. I want someone who knows what it’s like to maintain an exercise regimen, not someone who relies on the virtues of pharmacology to maintain “health”.

Let me pose this scenario: say you develop hypertension (high blood pressure) and you make an appointment with a physician to discuss how to manage it. Dr. A is obese, inactive (watches TV in his free time) – picture that protruding abdomen pushing through the white coat. Dr. B is lean and physically active, works out 3-4 days/week. How likely do you think it is that Dr. A (who probably requires a BP medication) even knows the degree of impact that exercise can have on one’s blood pressure? Dr. B knows – Dr. B has never been on a blood pressure medication and has seen his BP drop significantly due to regular exercise. How much effort do you think Dr. A puts into encouraging lifestyle changes to control hypertension? Not as much as Dr. B, because Dr. A has never seen that effect firsthand. Dr. A only knows the wonder of medications. If I have the choice, I will be going to Dr. B.  I don’t want to be stuck on a medication for something I can manage with lifestyle changes alone.

I have seen that bias in action time and time again.  Do yourself a favor and pick a physician who can see his/her toes.  Would you pick a financial planner who lives paycheck to paycheck or has no retirement savings?  Sure, plenty of people stick with their overweight doctor because they know they won’t get grief about their weight.  Just remember, sometimes your health is all you’ve got.

Here’s an intriguing article from the Minnesota Medical Association magazine, referencing a New York Times article.
Do athlete-doctors make the best doctors for athletes?
MINNEAPOLIS, January 3, 2008—A New York Times article asks whether physicians who are also athletes make the best doctors for other athletes.

One source in the story is University of Minnesota professor of family medicine (and MMA member) William R o b e r t s, M.D., who when he is not doctoring is likely to be running, skiing or sailing.

The article asks whether athletes fare better when their physicians are also athletes.

Roberts told the reporter that, because of his own athletic history, active people sought him out to such an extent that his practice morphed gradually into one made up mostly of athletes.

“They know I like physical activity and I am willing to try to find ways to keep them active,” said, Roberts, a former president of the American College of Sports Medicine.

He told the Times that he recently saw a patient with atrial fibrillation, a heart disorder. The man said other doctors had told him to stop exercising, so he had come to Roberts hoping to hear a different message.

A different message is what he got. Roberts told the man that he could exercise to his heart’s content — just as long as the heart rate stayed within an acceptable range, and as long as he had no chest pain or shortness of breath.

Also quoted was Ronald Davis, M.D., president of the American Medical Association. A doctor who is physically active, Davis told the Times, “is more likely to provide advice on exercise that will be meaningful to patients.”

The best indication of whether athletes should seek athlete-doctors is that the athlete-doctors themselves have athlete-doctors, the article said.

W i l l i a m R o b e r t s said he chose a doctor who is an athlete, and so did his wife, a skier. His own doctor (and fellow MMA member) is D a v i d T h o r s o n, M.D. [ahem, athletic???], a skier who had been Roberts’ partner in private practice.

“I recruited him in the early 1990s after we raced against each other in sailboats,” Roberts said. He has been T h o r s o n ’ s patient ever since.

Depends on your definition of fitness, I guess.  Well, you get the point.

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