Submitted to: Teaching and Learning in Medicine
Publication Type: Peer reviewed journal
Publication Acceptance Date: 1/1/2005
Publication Date: 1/1/2005
Citation: Rogers, L.Q., Gutin, B., Humphries, M.C., Lemmon, C.R., Waller, J.L., Baranowski, T., Saunders, R. 2005. A physician fitness program: Enhancing the physician as an "exercise" role model for patients. Teaching and Learning in Medicine. 17(1):27-35. Interpretive Summary: Physicians should be counseling patients to increase their levels of physical activity. Physicians should be better counselors, if they, themselves, are physically active, but most are not. This manuscript reports on a program to increase physical activity among 48 Medicine residents in one medical school. The intervention took 3 months and included behavioral counseling, identifying facilities in which PA could be done on and off campus, group conferences on time management, scheduled physically active social events (e.g. softball game with families), exercise prescriptions and personal exercise goal setting. No increases were detected in resident energy expenditure or cardiovascular fitness. However, residents reported greater confidence in being able to counsel their patients to be more physically active. Other interventions need to be tested to increase resident physical activity, and test its effect on their actual counseling behavior.
Technical Abstract: Physically active physicians are more apt to counsel patients about exercise. The purpose of this study was to determine the effect of a physician fitness program on resident physician cardiovascular fitness, physical activity behavior/stage of change, and physical activity counseling behavior/attitudes. A prospective, intervention study with measurements at baseline (before intervention), 3 months (immediately after intervention), and 6 months (3 months after intervention) evaluated a multifaceted exercise program for 48 internal medicine residents. Resident physician cardiovascular fitness, energy expenditure, physical activity stage of change, knowledge, attitudes, and counseling behavior were measured. Resident physician fitness significantly declined over time (baseline VO(2)-170 = 29.1 ml/kg/min, first follow-up VO(2)-170 = 27.3 ml/kg/min, and second follow-up VO(2)-170 = 26.2 ml/kg/min; p = .001). Although there was no change in overall energy expenditure, the number of resident physicians in the precontemplation or contemplation stage of change significantly declined with a corresponding increase in the number in a "higher" stage of change at first (p = .0034) and second follow-up (p = .024). There was a nonsignificant increase in self-reported patient counseling. Resident physician counseling confidence and perceived success significantly improved at first follow-up only (p = .01 and p = .03, respectively). Although resident physician fitness and energy expenditure did not improve after intervention, a significant improvement in resident physician physical activity stage of change and attitudes toward patient counseling was noted. Randomized controlled trials are needed to confirm whether these changes are attributable to the intervention.