DHSc, CSCS, EP-C, Exercise is Medicine Credential Level II, FNS Department of Fitness and Wellness, College of Education and Health Professions, Park University, 92W Vaughn Ave, Gilbert, AZ 85233, USAUnited States
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As healthcare costs continue to rise worldwide, as well as cases of overweight and obese individuals, a pedagogical shift must be made towards a greater use of preventative care and exercise as treatment methods for disease management and prevention. The physical benefits of exercise are not disputed, but costs, proper exercise prescription, and program compliance remain barriers to widespread adoption of exercise as treatment for disease management and improving quality of life. Regular weekly exercise not only improves quality of life in overweight and obese individuals1 and individuals with cardiorespiratory illness or disease,2 but will also save on healthcare costs. Research has indicated seniors (age <65-years) who regularly participate in an organized exercise program spend on average $1186-2144 less than their less active or sedentary peers.3 However, the Centers for Disease Control (CDC)4 noted that only 22.9% of Americans achieved the weekly exercise recommendations of strength training two times per week, and at least 150-minutes of moderate-to-vigorous cardiovascular activity weekly.
Keywords: cardiorespiratory; primary care physician (PCP)
Open Journal PUBLISHERS Opinion Why are Patients Reluctant to View Exercise as a Treatment Plan?
* Mike Swoboda, DHSc, CSCS, EP-C, Exercise is Medicine Credential Level II, FNS* Department of Fitness and Wellness, College of Education and Health Professions, Park University, 92W Vaughn Ave, Gilbert, AZ 85233, USA * *Corresponding author Mike Swoboda, DHSc, CSCS, EP-C, Exercise is Medicine Credential Level II, FNS Assistant Professor, Department of Fitness and Wellness, College of Education and Health Professions, Park University, 92W Vaughn Avee, Gilbert, AZ85233, USA; Tel. 480-923-0028 x3028; E-mail: mswoboda@park.edu Article information th th st Received: Decmber 17 , 2019; Accepted: December 27 , 2019; Published: December 31 , 2019 Cite this article Swoboda M. Why are patients reluctant to view exercise as a treatment plan? Obes Res Open J. 2019; 6(2): 35-36. doi: 10.17140/OROJ-6-140 s healthcare costs continue to rise worldwide, as well as cases cise prescription is simply telling patients to “exercise more,” and of overweight and obese individuals, a pedagogical shift must are unable to differentiate between exercise and physical activity.6 A be made towards a greater use of preventative care and exercise as This extends into discontinuation of exercise as part of an on- treatment methods for disease management and prevention. The going disease management treatment plan, such as in the case of physical benefits of exercise are not disputed, but costs, proper osteoarthritis. When exercise is prescribed as part of an ongoing exercise prescription, and program compliance remain barriers to maintenance plan (as opposed to a short-term solution), noncom- widespread adoption of exercise as treatment for disease manage- pliance and complete discontinuation of exercise programs be- ment and improving quality of life. Regular weekly exercise not comes inevitable for the majority of participants.7 only improves quality of life in overweight and obese individu- 1 2 als1 and individuals with cardiorespiratory illness or disease,2 but There is no simple solution to this problem, but steps can will also save on healthcare costs. Research has indicated seniors be put in place to start to curb the acceptance of using exercise as a (age <65-years) who regularly participate in an organized exercise long-term preventative treatment method by at-risk patients. Phy- program spend on average $1186-2144 less than their less active sicians without an in-house exercise specialist should partner with or sedentary peers.3 However, the Centers for Disease Control organizations, universities, or individuals within the community to (CDC)4 noted that only 22.9% of Americans achieved the week- provide access to adequate exercise prescription to their patients. ly exercise recommendations of strength training two times per Allowing a fitness professional to provide an exercise program to week, and at least 150-minutes of moderate-to-vigorous cardiovas- a patient that fits their ability level and access to services, overall cular activity weekly.
understanding of how to exercise will increase. Without direction, or by simply telling a patient to exercise without specific instruc- With mounting positive evidence that regular exercise tors, sedentary behaviors will continue to rise. Changing patient’s should be a part of all people’s lives, why is there a lack of exercise perceptions to adopting exercise as a treatment plan will ultimately by individuals worldwide? This answer appears to be twofold, and be the more trying issue. A paradigm shift of viewing exercise as the main determining interaction is between the patient and their something temporary to recover from injury or to be a short-term primary care physician (PCP).
treatment needs to change to a lifelong endeavor. PCPs who are able to convey the value of exercise as a type of medicine, rather One such issue is a general expectation of patients to be than something that should just be part of a patient’s life without treated with medication by their PCP for their chief complaints a specific reason, will ultimately have the most success with long- of illness or chronic condition. While nations are starting to adopt term patient compliance. Although intrinsic motivation is the most policies to reduce the prescription of excessive medications and powerful form of motivation to elicit behavior change, it may be medical testing, many patients still demand medications for treat- necessary for healthcare providers and employers to use extrinsic ment, even when they are not indicated.5 motivators to begin the process of behavior change. This could potentially include financial incentives and discounts on healthcare Still, the bigger issue exists in PCPs who are not able to costs when a patient stays compliant with an exercise program. properly prescribe exercise. Many PCPs believe that proper exer- Incorporating the exercise professional into the healthcare sys- cc Copyright 2019 by Swoboda M. This is an open-access article distributed under Creative Commons Attribution 4.0 International License (CC BY 4.0), which allows to copy, redistribute, remix, transform, and reproduce in any medium or format, even commercially, provided the original work is properly cited. Obes Res Open J. 2019; 6(2): 35-36. doi: 10.17140/OROJ-6-140 tem by allowing insurance reimbursements and billing is one of 4. Blackwell DL, Clarke, TC. State Variation in Meeting the 2008 the biggest hurdles to achieving this goal. Ultimately, there must Federal Guidelines for both aerobic and muscle-strengthening ac- be a ubiquitous acceptance of exercise being part of the field of tivities through leisure-time physical activity among adults aged 18- healthcare and medicine for the long-term reversal of obesity and 64: United States, 2010-2015. Natl Health Stat Report. 2018; (112): obesity-related illnesses.