Doctors: fighting fit or couch potatoes?

Does walking improve diagnosis of skin conditions at varying levels of medical expertise?

The use of walking workstations in educational and work settings has been shown to improve cognitive abilities. At the same time, it has been repeatedly shown that medical residents around the world do not meet exercise guidelines, mainly due to a scarcity of available free time. Our study investigates the boundaries of the previously observed phenomenon of improved cognitive performance with physical activity using materials that represent real life tasks. Participants had different level of expertise and involved second year psychology students, medical students, and family medicine residents. We examined the effect of being physically inactive (i.e., sitting) or active (i.e., walking) while diagnosing multiple complex presentations of four skin conditions. We assumed that being physically active, irrespective of the level of expertise, will bolster diagnostic performance. Our findings show, however, that being physically active does not change the performance level of participants with different levels of medical expertise. Implications for medical education and suggestions for further research will be discussed.

Health behaviors of medical students decline towards residency: how could we maintain and enhance these behaviors throughout their training

BACKGROUND

We examined health behaviors and perceptions among medical students and compared them with the results of a previous survey among residents and senior physicians.

METHODS

This cross-sectional study was performed among second-year medical students (2015-2018) and among physicians (2015) using an online questionnaire. Univariate and multivariate analyses were performed.

RESULTS

Significantly more physicians perceived their health as bad, compared with students. Half of the residents, compared with one-third of senior physicians and one-fifth of students, reported high emotional stress. Residents reported the worst, and students - the best, eating habits. Logistic regression models demonstrated that lower emotional stress, healthy eating habits, adequate sleep, lower body mass index and not having a regular physician, explained good perceived health. Female gender, being a resident, bad perceived health, unhealthy eating habits, less sleep and not having a regular physician, were correlated with high emotional stress.

CONCLUSIONS

The healthy lifestyle of medical students declines towards residency. Given the workload and emotional stress of their chosen profession, it is advised that medical school curriculum provide students with measures to help them to adopt healthier lifestyles, allowing students and physicians to be better role models and the healthcare system to perform better.

Health-related behaviours and perceptions among physicians: results from a cross-sectional study in Israel

OBJECTIVES

Physicians' demanding work conditions may reduce the time and energy required for maintaining healthy lifestyles. This study examined health-related behaviours, perceived health status and emotional stress among physicians, and analysed the effects of personal and work characteristics on these endpoints.

DESIGN

A cross-sectional study using a digital questionnaire.

SETTING AND PARTICIPANTS

All 25 590 physicians who were members of the Israeli Medical Association in 2015 were invited to participate by email. Of 14 694 who opened the e-mail, 4832 (32.9%) responded.

OUTCOME MEASURES

Survey topics included physical activity (PA), nutrition and eating habits, smoking, sleep, perceived health status and emotional stress, body mass index (BMI) and contact with a regular physician, as well as personal and work characteristics. Univariate and multivariate analyses were performed.

RESULTS

Of the 4832 respondents, 21% reported poor or fair health status, 36% felt considerable emotional stress, 57% were overweight or obese (according to BMI≥25 kg/m²), 71% did not meet the recommended PA level, 79% did not meet a composite measure of healthy nutrition, 8% were current smokers, 25% slept 5 hours or less and 57% did not have a regular physician. Residents and hospital physicians reported significantly less healthy lifestyles, lower perceived health status and higher stress levels, compared with senior and community physicians. Multivariate analysis demonstrated that being female (OR=0.74, 95% CI=0.64 to 0.85), younger (0.69, 0.64 to 0.74), having poor nutrition (0.66, 0.55 to 0.78), not meeting PA targets (0.68, 0.57 to 0.82), inadequate sleep (0.54, 0.40 to 0.56) and perceived poor health status (0.48, 0.40 to 0.56) were significantly associated with high stress levels (p<0.001).

CONCLUSIONS

The unfavourable health behaviours reported among Israeli physicians may have negative effects on their health and well-being. An intervention program to help physicians to adopt a healthier lifestyle is urgently needed.

Questionnaire survey assessing the leisure-time physical activity of hospital doctors and awareness of UK physical activity recommendations

Objective

The UK Government Physical Activity Recommendations suggest that adults should aim for 150 min of physical activity each week to maintain health. We assessed the total volume, frequency, intensity and type of exercise taken by hospital doctors in association with their specialty, age and knowledge of the specific components of the recommendations.

Methods

An anonymous paper-based questionnaire was distributed to doctors working in the two largest teaching hospitals in Glasgow. 332 questionnaires were analysed with a response rate of 60.3%.

Results

239 (72%) doctors felt they exercised regularly with 212 (63.9%) meeting the recommended volume of cardiovascular activity, similar to an age and sex-matched cohort of the general Scottish population. Only 78 (23.5%) doctors achieved the recommended muscle-strengthening activities. 108 (35.5%) doctors were aware recommendations for activity existed but only 45 (13.6%) were able to state the recommended duration of activity per week. Doctors who were aware of the recommendations were more likely to personally achieve them (OR 1.802, 95% CI 1.104 to 2.941) although other additional factors may contribute.

Conclusion

Although this was a small study in two hospitals, our results suggest that hospital doctors are as active as the general public in the UK of a similar age. Eight years after implementation, knowledge of specific components of the current physical activity recommendations remains poor. Efforts to improve this prior to graduation, combined with improving confidence and competence in counselling practices and enhancing the opportunities for doctors to exercise, could translate into improved healthcare promotion.

The influence of healthcare workers' occupation on Health Promoting Lifestyle Profile

To compare the adoption of healthy lifestyle behaviors, including: spiritual growth, nutrition, physical activity, interpersonal relations, health responsibility, and stress management, of healthcare workers with workers of other professions. Cross-sectional observational study among a convenience sample of 285 healthcare workers and 137 of other professions. The Health-Promoting Lifestyle Profile-II (HPLP-II), a 52-item measure regarding the six components of healthy lifestyle. Demographic characteristics, education, income, work duration and self-rated health were also collected. Multivariable linear models were specified for each of the components of healthy lifestyle. Both groups were comparable in their age, family status, income and self-rated health. Results of multivariable linear models revealed that healthcare workers adopt better nutrition (β=0.228, p<0.001), more physical activity (β=0.133, p=0.049), and greater health responsibility (β=0.131, p=0.016), compared to other professions. Such differences were not found with regard to spiritual growth (β=0.097, p=0.121), interpersonal relations (β=0.039, p=0.444), or stress management (β=0.053, p=0.299). Healthcare workers adopt better healthy lifestyle only in components that may be perceived to have direct influence on health outcomes, namely nutrition, physical activity, and health responsibility. Further research that will explore the reasons for the observed differences may enable designing health-improving interventions.

Diet, exercise and mental-wellbeing of healthcare professionals (doctors, dentists and nurses) in Pakistan

Background. “Health is wealth” is a time tested adage. Health becomes more relevant when it comes to professionals whose job is to provide people with services that maintain an optimum state of mental, physical and social well-being. Healthcare professionals (HCP) differ from general population in regards to the nature of their work, stress, burnout etc. which begs the need to have a robust state of health for the ones who provide it to others. We initiated this study to see if healthcare professionals “practice what they preach others.”

Methods. We employed a cross-sectional study design with convenience-sampling technique. Questionnaires were administered directly to the three groups of healthcare professionals (Doctors, Dentists and Nurses) across the province Punjab after their consent. 1,319 healthcare professionals took part in the study (response rate of 87.35). Warwick Edinburg Mental Wellbeing Scale (WEMWBS) was used to assess mental wellbeing. USDA Dietary Guidelines-2010 were employed to quantify diet. American Heart Association (AHA) guidelines were employed for the analysis of exercise.

Results. A total of 1,190 healthcare professionals formed the final sample with doctors and nurses forming the major proportion. Out of 1,190 participants only one healthcare professional was found to eat according to USDA Dietary Guidelines; others ate more of protein group and less of fruits, dairy and vegetable groups. 76% did not perform any exercise. 71.5% worked >48 h/week. More than 50% of healthcare professionals were sleeping <7 h/day. WEMWBS score of the entire sample was 47.97 ± 9.53 S.D.

Conclusion. Our findings suggest that healthcare professionals do not practice what they preach. Their mental wellbeing, diet and exercise habits are not up to the mark and should be improved to foster the whole healthcare system for individual and community benefits.

Physical activity, quality of life, and burnout among physician trainees: the effect of a team-based, incentivized exercise program

OBJECTIVE

To prospectively study the effects of an incentivized exercise program on physical activity (PA), quality of life (QOL), and burnout among residents and fellows (RFs) in a large academic medical center.

PARTICIPANTS AND METHODS

In January 2011, all RFs at Mayo Clinic in Rochester, Minnesota (N=1060), were invited to participate in an elective, team-based, 12-week, incentivized exercise program. Both participants and nonparticipants had access to the same institutional exercise facilities. Regardless of participation, all RFs were invited to complete baseline and follow-up (3-month) assessments of PA, QOL, and burnout.

RESULTS

Of the 628 RFs who completed the baseline survey (59%), only 194 (31%) met the US Department of Health and Human Services recommendations for PA. Median reported QOL was 70 on a scale of 1 to 100, and 182 (29%) reported at least weekly burnout symptoms. A total of 245 individuals (23%) enrolled in the exercise program. No significant differences were found between program participants and nonparticipants with regard to baseline demographic characteristics, medical training level, PA, QOL, or burnout. At study completion, program participants were more likely than nonparticipants to meet the Department of Health and Human Services recommendations for exercise (48% vs 23%; P<.001). Quality of life was higher in program participants than in nonparticipants (median, 75 vs 68; P<.001). Burnout was lower in participants than in nonparticipants, although the difference was not statistically significant (24% vs 29%; P=.17).

CONCLUSION

A team-based, incentivized exercise program engaged 23% of RFs at our institution. After the program, participants had higher PA and QOL than nonparticipants who had equal exercise facility access. Residents and fellows may be much more sedentary than previously reported.

Prevention of cardiovascular disease: why do we neglect the most potent intervention?

Despite a large volume of evidence supporting its cardioprotective properties and its other numerous established health benefits, physical activity is not a serious prescription option for the primary prevention of cardiovascular disease. On the other hand, health services increasingly focus on pharmacological prevention without considering properly the long-term consequences of medication. Ethical and feasibility considerations suggest that evidence on the protective value of physical activity may need to be evaluated using criteria different from those applying to pharmacological trials. The collateral health benefits of physical activity prescription support its use as standard option in preventive health care.