Friday, December 19, 2014
Do hospitalists miss opportunities to talk about healthy habits and preventive medicine?
As hospital doctors, we are extremely busy people. Our days whiz by, often without a moment to rest or take a deep breath. We are in “the zone” and rightly completely focused on getting our patients better and in a position when they can hopefully leave the hospital. We have chosen a specialty which is all about secondary level care, one where we know that we are not going to be seeing our patients in the office afterwards. Our encounters and relationships with them may thus seem very brief and to the point. Most of us probably believe in primary prevention too, but feel that it is outside the scope of hospital medicine.
For example, apart from the brief spiel our diabetic and heart failure patients may get about the importance of dietary compliance, how much time do we really spend talking about wellness and preventive medicine with our patients? As a physician with an interest in this area, here I believe is a massive missed opportunity. As you form close relationships with patients and their families over their several day stay, don't underestimate your power as the attending physician to exert influence over what they do when they leave the hospital. Even a passing question such as “Do you eat a lot of vegetables?” Or “Ever thought about getting more exercise?” can really register with a lot of patients, and could help bring about positive changes in their lifestyle habits after you see them. Many patients and families can really open up to you when you bring this up.
Simply thinking that we can “leave it to the primary care physician” to address, is not the right way. With the epidemic of lifestyle related conditions in society, it is the least we can do as doctors. I'm not talking about spending excessive amounts of time emphasizing wellness and preventive medicine during your hectic day, but just give it a bit of thought next time you're seeing patients. I've often been pleasantly surprised by people that I bump into again after their hospital stay who tell me with smiles on their faces that they are eating more fruits or taking longer walks after I suggested it to them (lifestyle changes that, I may add, will probably have higher morbidity percentage benefits than many medications I may have prescribed them). You may be surprised too with where your good common sense doctor advice may lead for your patients.
Suneel Dhand, MD, ACP Member, is a practicing physician in Massachusetts. He has published numerous articles in clinical medicine, covering a wide range of specialty areas including; pulmonology, cardiology, endocrinology, hematology, and infectious disease. He has also authored chapters in the prestigious "5-Minute Clinical Consult" medical textbook. His other clinical interests include quality improvement, hospital safety, hospital utilization, and the use of technology in health care. This post originally appeared at his blog.
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Robert M. Centor, MD, FACP, contributes short essays contemplating medicine and the health care system.
Suneel Dhand, MD, ACP Member
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