For some patients, there are moral implications of alcohol use, so it’s easy for a patient to feel defensive when a physician asks about their habits. Preface any discussions with a disclaimer (“This is a judgement-free zone!”) and explain that alcohol may be directly related to their symptoms. After calmly recording their response, inform them that even moderate drinking (more than seven drinks per week for women and more than 14 drinks per week for men) can have adverse health effects (Addict Health. 2019;11:129-137)—not to mention relationship effects (the weekend couch sleepers after a day of heavy drinking). Have a laugh about it together and then get back to business. Encouraging a break from alcohol of even just two weeks can illuminate its negative effects on sleep and improve postoperative wound healing. Many patients will settle back into a lighter consumption routine after the break.
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October 2022Clinical Implementation
Lifestyle medicine trains providers to facilitate changes using the theories behind it, such as the Health Belief Model (developed in the early 1950s by social scientists at the U.S. Public Health Service that suggests that a patient’s belief in the threat of an illness and in the effectiveness of the recommended health behavior will predict the likelihood that the patient will adopt the behavior) and the Transtheoretical Model of Change (developed in the late 1970s and also called the Stages of Change Model, it assumes that patients don’t change habitual behaviors quickly and decisively but instead through a cyclical process).
Learning how to motivate patients by determining what their values and goals are leads to better compliance with treatment recommendations, whether it’s a lifestyle change, a new medication, or postoperative care. Current noncompliance rates for medication use are over 50%, with lack of motivation given as the top cause (Perm J. 2018;22:18-33). Using the basics of cognitive behavioral therapy and positive psychology, physicians can support and extend a patient’s health behavior self-efficacy.
The expansion of knowledge, the renewed passion, and the rewards of building deeper relationships with patients brings a much-needed healing tincture for physician wellness. According to a recent Medscape report, burnout rates among physicians are at an all-time high, with nearly 50% of physicians feeling dissatisfied. Coming together holistically with our patients strengthens the bonds of trust and encourages a more meaningful connection, which is the key to longevity and wellness (PLoS Med. 2010;7:e1000316). In the continuous pursuit of well-being, educating ourselves and our patients on the benefits of healthy lifestyle practices will allow us to reap the future rewards together.