Why Do Some Physicians Cling to Unhealthy Behaviors?

Thursday, October 25th, 2007
This post was written by Melanie Matthews

Nick Jacobs at the World Health Care blog describes the unhealthy behavior of attendees at a world cardiology conference. Happily, the patient outcomes reported at the conference were positive.

My last four days were spent at a world conference on cardiology where the work done by our research institute’s cardiac team on the impact of behavioral modification on this disease was our presented topic. Our research revolves around diet, exercise, stress management and group support, and the results observed from our patients have been nothing less than remarkable.

It is fair to say, however, that, upon observing the actions and choices of those present my heart sank. The secret of life appeared to be firmly seated in the minds of at least 40 percent of those in attendance that tobacco, alcohol, heavy fats and little exercise are the keys to happiness.

…What then is the problem? Denial? The high pressure life styles of these life saving physicians, cultural considerations, a laissez faire attitude toward the Boogie Man or just another version of man’s on going stupidity and ignorance toward what appears to be very clear evidence?

I just don’t get it. I suppose that physicians are human, after all. The behavior described in this post may contribute to the low ratings many healthcare providers get for coaching patients to rid themselves of unhealthy behaviors. Nick’s experience is dismaying, especially after two experiences this week—one personal and one professional—that emphasized providers’ commitment to reducing the effects of heart disease.

First, my 73-year-old mother, who had a quadruple bypass five years ago, was hospitalized with chest pains. A catheritization determined that some additional blockage was the cause of her pain, and they are treating this with medication for now. Upon leaving her hospital room, I noticed a bulletin board devoted to discharge instructions. Every flyer on the board emphasized the danger of smoking for heart patients.

Secondly, in my professional life here, I am editing a book on Successful Management of Heart Failure Patients: Multidisciplinary Approach to Reducing CHF Readmissions, which chronicles the effort behind the dedicated heart failure unit at Hackensack University Medical Center in New Jersey, an exercise in pursuing perfect care. I am impressed by the dedication of the two cardiac nurses who head this effort. They have done similar work at other hospitals and are doing a phenomenal job at reducing hospital readmissions among this population.

When surrounded by evidence of the risk associated with these behaviors, wouldn’t providers make the obvious behavior choices? Or do they, like many adolescents, believe they are invincible?

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