If the last item isn't part of the usual drill at your doctor's office, a movement is afoot in the USA to change that. One recent national survey indicated only a third of Americans said their doctors asked about or prescribed physical activity.
Kaiser Permanente, one of the nation's largest nonprofit health insurance plans, made a big push a few years ago to get its southern California doctors to ask patients about exercise. Since then, Kaiser has expanded the program across California and to several other states. Now almost 9 million patients are asked about their activity levels at every visit, and some other medical systems are doing it, too.
Here's how it works: during any routine check of vital signs, a nurse or medical assistant asks how many days a week the patient exercises and for how long. The number of minutes per week is posted along with other vitals at the top the medical chart. So it's among the first things the doctor sees.
"All we ask our physicians to do is to make a comment on it, like, 'Hey, good job,' or 'I noticed today that your blood pressure is too high and you're not doing any exercise. There's a connection there. We really need to start you walking 30 minutes a day,'" says Robert Sallis, a Kaiser family doctor. He hatched the vital sign idea as part of a larger initiative by doctors groups.
He says Kaiser doctors generally prescribe exercise first, instead of medication, and for many patients who follow through that's often all it takes.
But it is a challenge to make progress. Some patients may not be aware physical INACTIVITY is riskier than high blood pressure, obesity and other health risks people know they should avoid. A US- government study concluded that people who routinely exercise live longer than others, even if they're overweight.
Carrie Jaworski, a NorthShore family and sports medicine specialist, already asks patients about exercise. She says some of her diabetic patients have been able to cut back on their medicines after getting active.
William Dietz, an obesity expert who retired last year from the Centers for Disease Control and Prevention, says measuring a patient's exercise regardless of method is essential, but that "naming it as a vital sign kind of elevates it." Figuring out how to get people to be more active is the important next step, he says, and could have a big effect in reducing medical costs.
Associated Press, Lindsey Tanner
Activ8rlives says: We think that naming exercise as a vital sign is a great innovation. What this does is make everyone, including the patient's medical team, mindful of the need to be active on a daily basis. This innovation is so simple, does not cost a penny to implement and could make savings from £5bn we spend each year in our NHS treating the consequences of obesity.