Survey: Doctors Don't Always Follow Their Own Recommendations
Doctors don't always take their own advice: A new survey suggests they weigh treatment options differently depending whether they're deciding for themselves or caring for patients. Sick physicians are more likely to opt for treatment with a higher risk of death but fewer serious side effects, though that's not what they'd recommend for patients. The findings, published Monday in the Archives of Internal Medicine, are based on a survey of 940 primary-care physicians who evaluated hypothetical medical scenarios. Nearly 63 percent of surveyed doctors, for example, would forgo a potentially lifesaving treatment for avian flu to avoid potential side effects, such as permanent paralysis. Only 49 percent, however, would recommend avoiding the treatment to their patients. The findings suggest that patients should play a more active role in their care, the researchers say, adding that instead of making recommendations, doctors should perhaps neutrally present options. "It's a pretty clear message: There's a discrepancy between what doctors recommend to their patients and to themselves," Timothy Quill, author of an editorial published with the survey, told HealthDay. "We need to try to reconcile that and make sure decisions are guided by patient values. Decisions need to be guided by patients' values, not doctors'."
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Your Doctor's Role in Helping You Change Your Health Habits
In an issue of the Annals of Internal Medicine last year, researchers at Kaiser Permanente's Center for Health Research in Portland, Oregon reviewed the latest scientific evidence on how effective medical counseling really is in terms of getting patients to improve their eating and exercise behaviors. Their analysis, which included data from 73 studies, found that counseling does, in fact, help patients make changes that lead to modest improvements in their health. They were able to lose excess weight, increase their activity, and improve their blood pressure and cholesterol levels. While few studies followed patients for more than a year, one long-term study indicated that those with mildly elevated blood pressure who were extensively counseled on switching to a low-sodium diet had a reduced risk of heart attacks and heart failure 10 to 15 years later.
But there's a catch, family physician Kenny Lin writes for U.S. News. The researchers found that in order to achieve these changes, patients needed far more counseling time than doctors or nurses can offer in our current healthcare system. "Low-intensity" counseling—a total of 30 minutes or less, which is typical for most patients—appeared in the study to have no beneficial effect. Only "medium" (totaling up to six hours) and "high" intensity (more than six hours) counseling made a significant difference, and these sessions were typically led by specially trained health educators rather than the patients' own physicians, who may not be as well trained in dispensing specialized nutrition or fitness advice. While study participants got these services for free, those patients in the real world often find that their health insurance will only pay for counseling if they have diabetes or heart disease. [Read more: Your Doctor's Role in Helping You Change Your Health Habits.]
5 Cheap Alternatives to Hiring a Personal Trainer
If you can't afford a personal trainer—or don't want one—there are a number of exercise and nutrition resources available on the Internet. For some, the convenience and social support of surfing for fitness guidance online can make it just as effective as working with a trainer in person, fitness blogger Chelsea Bush writes for U.S. News. Here's a guide for how to use (and not to use) today's top online fitness tools.
1. Social Media. Benefits: Social networks like Facebook and Twitter make it easy to get quick fitness tips and news updates, and connect with peers who can offer support and accountability as you work toward your goals. "People tend to stay with a program if they feel part of a community, and social media is the perfect vehicle for establishing this," says New York-based trainer Robert Brace. You can "check in" at the gym on Foursquare, a smart phone app that posts your whereabouts to your Facebook and Twitter profiles. Or you can tweet pictures of the healthy salad you made for lunch via apps like Flickr and Twitpic. With devices like the Nike+ SportBand, many are logging their running time and distance and broadcasting these from their social media profiles.
The caveat: While social networks can help you stay plugged in to your fitness program, most trainers say these shouldn't be your sole source of support. "The great part about social media is that it reaches the masses," says David Kirsch, a New York-based trainer who fires off daily tips via Twitter and Facebook. But therein also lies the downside, which he acknowledges. Most of what you get from social media is advice for the masses, but to be effective, a fitness routine should be tailored to your body and lifestyle, he says. [Read more: 5 Cheap Alternatives to Hiring a Personal Trainer.]
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