AMA Healthier Life Steps™ - The Health of Doctors Matters

The American Medical Association recently published two toolkits: AMA Healthier Life Steps™, for physicians to counsel patients, and Physician’s Health, a guide for physicians to pay attention to their own health, with a tool for them to use in consult with their own primary care physician. Together, the toolkits are intended to encourage a greater physician-patient alliance for health.

The guides address four key health behaviors: healthy eating, physical activity, tobacco use, and excessive use of alcohol. The physician's section includes action plans, health screening and milestones, as well as progress tracking calendars.

The first tool kit was developed by the Healthy Lifestyles Team at the AMA. The second toolkit: AMA Healthier Life Steps™ - A Physician's Guide to Personal Health, was developed as a collaborative effort between the Healthy Lifestyles Team and the Office of Physician Health and Healthcare Disparities. Dr. Sonja Boone, M.D., Director of Physician Health and Health Care Disparities, presented them both at a recent stakeholder meeting for Building a Healthier Chicago. Afterwards, I caught up with with her to ask what inspired the projects.

We discussed the importance of wellness, the benefit of doctors modeling good personal health behaviors, and the pressures doctors experience, which can challenge their ability to care for patients. Among the research, Dr. Boone cited two studies that influenced the development of the toolkit:

Studies: Physical Activity by Philip Le Bel and Erica Frank

2007-2008 World Medical Association study on the decline of physician satisfaction, as the business of medicine has overshadowed patient care.

“To acknowledge, physicians are under extraordinary pressure, beginning with med school,” said Dr. Boone. "We’ve come to realize that—even with regard to treating patients—it's important for physicians to take time for themselves, their families & friends. It’s important to note that the development of this resource is not in response to physicians who have unhealthy behaviors or habits. Rather, the intent is to promote an understanding of the health needs and wellness of  physicians, which can help them to serve as better role models and counsel patients on healthy behaviors," she added.

As patients, we’re anxious about our own health and don’t always realize that our doctors can become  overwhelmed by the pressure and responsibility of a challenging care environment. Of course the doctor’s health isn’t the patient’s responsibility—but healthy physicians are better able to provide good care.

Dr. Boone: “Let’s look at a few reasons why the health of physicians is so important. If you think of it as a matter of public health, we are facing a shortage of physicians, especially primary care doctors. We need our physicians to be healthy so they can continue treating patients."

She then added, "Quality of life is a leading question for physicians. They need coping skills to be able to handle the stressors and the uncertainty of the profession. We’re encouraged by studies that physicians live one to two years longer than average. However, we have concerns about the fact that there is also a higher evidence of age-matched depression and suicide among doctors."

“We also feel strongly that doctors can have an impact on patient wellness through living by example."

I then asked, so what’s the best approach to developing a guide that encourages self-care, broadens patient care perspectives and provides support for coping with demanding care environments?

“The toolkit is also designed to educate doctors. The USDA guidelines are a good example. Physicians may not keep up to date on the USDA guidelines. But the USDA guide has been revised to be much easier to read. We want physicians to keep that information top-of-mind and easy to locate as a resource, and to be actively aware of the USDA dietary guidelines in treatment of patients."

Looking ahead, phase two of the AMA Healthier Life Steps Toolkit™ - A Physician's Guide to Personal Health will focus on mental health and burnout, with action items and solutions. This is in response to a number of trends, and the following are a few that affect physicians.

“The last 20 years have seen a great deal of change in the medical field, driven to a great extent by managed care and now health care reform. These changes have affected people’s interest in going into medicine, and have led to a decline in med school applications."

With all the changes and challenges in health care, it’s easy to imagine how the social perception and status of a career in medicine might be diminished. For pre-med students as well as practicing doctors, I asked, has the pride of being a physician been affected?

“The perception of prestige in the practice of medicine has arguably been affected. However, for me it has always been an honor to be a physician and to earn and hold the trust of my patients. I think nearly every doctor would share this sentiment,” concluded Dr. Boone.

However change unfolds in the health care system, the health of doctors matters a great deal. The affordable care act has been relegated to providing health care insurance coverage to more people, but the doctor/patient relationship is an important part of actually providing better care. Helping physicians to be healthy themselves makes the physician’s prescription more credible. It also helps shift the care model, from costly treatment to the cost-saving advantages of prevention and wellness.