Exercise Prescriptions?

Numerous health and medical organizations recommend getting regular physical activity for a variety of different health reasons — including the American Diabetes Association, which released its latest guidelines on the topic late last month (and which David Spero covered in a recent post). These new guidelines promote the blood glucose–lowering benefits of breaking up prolonged periods of sitting with short, light-intensity activities — preferably for about 3 minutes, every 30 minutes.

But as important as exercise is for managing diabetes — and preventing or managing nearly every health condition imaginable — it’s unlikely that your doctor will give you a detailed prescription for exercise, in contrast to the way that doctors prescribe drugs. So if your doctor wouldn’t simply tell you to go take some antibiotics for a few days to treat an infection — instead, he’d tell you exactly what drug to take and how to take it, and make sure it’s available to you — why don’t doctors treat exercise the same way?

Part of the reason, as a recent article at CNN points out, is that most doctors simply aren’t trained in how to do this. At almost every medical school, courses in exercise are electives, if they even exist at all. Only a handful of schools — including Weill Cornell Medical College, in New York City, and the University of South Carolina School of Medicine Greenville — incorporate training on how to talk to patients about exercise into their regular curriculum.

As the article notes, doctors who are trained in how to talk about exercise learn to focus on how to help patients increase their activity levels in small steps — often viewed as moving from one “stage” of activity, in terms of time and intensity, to the next. This means that if you’re completely sedentary, your doctor doesn’t just tell you to start exercising for 30 minutes every day. Instead, a more promising approach would be for your doctor to discuss what activities that involve movement you might enjoy — such as strolling through the park, clearing brush, or playing lawn games — and how to do them more often.

But on a pessimistic note, the article also mentions that even if a doctor’s prescription carries more weight with patients than general exercise recommendations, most people are unlikely to follow through with a plan for very long unless they have a support system in place to check up on them. Unfortunately, most medical practices currently lack the resources to do anything like this in an effective or widespread way.

What’s your view on doctors prescribing exercise — do you think you’d be more likely to follow an exercise plan if it came from your doctor? Is prescribing exercise, without a structured program or proper follow-up, setting people up for failure? Should all medical schools focus more on the benefits of exercise and other preventive measures, rather than simply treating illness once it develops? Or is this best left to people in other professions? Leave a comment below!