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Surgeon General: Medical professionals must boost emphasis on prevention

November 19, 2015
 

By American Heart Association News

ORLANDO, Florida — As a youngster in Miami, Vivek Murthy enjoyed hanging out at his dad’s primary care practice. Being around those patients and learning their problems prompted an insightful diagnosis: So much of what brought them into the office was preventable.

These days, as Surgeon General of the United States, Murthy is doing something about it. And he wants the rest of the healthcare community to join him.

Speaking last Tuesday at the American Heart Association’s Scientific Sessions in Orlando, Florida, Murthy provided a series of anecdotes highlighting grassroots efforts that are getting people to eat better and move more. The stories served as building blocks for his call-to-action – encouraging clinicians and researchers to find more, and more modern, ways to help.

“Now is the time for us to expand our definition of success when it comes to health,” he said. “Success should be the patient who never has to walk through the door of a clinic or a hospital in the first place.”

Murthy emphasized that our nation’s longstanding efforts to fight diseases have produced “some of the greatest treatments in the world.”

“That’s something we should be proud of and continue to advance and invest in,” he continued. “But the result also is that we have an explosion of chronic disease that’s responsible for seven out of 10 deaths in America and well over $1 trillion in healthcare costs because we have failed to prevent illness as effectively as we treat it.”

Murthy said the key elements in building “a culture of prevention” are information and environment. Each presents a unique challenge.

“We have to recognize that people don’t get their information the same way they used to 30, 40 years ago,” he said. “That’s why we have to be creative about using different messages, using different messengers and employing different platforms to reach people where they are, to ensure that the maximum number of people are getting the information about health that they need.”

For instance, his appearance on Sesame Street talking to Elmo about the importance of vaccines.

Yet information is only a start. After all, he said, most people know they should exercise more or eat better. The struggle is getting them to do it.

That’s where the environment comes into play, such as cities and workplaces making healthy choices easier and more affordable.

Some examples:

In Wabasso, Florida, community leaders fixed up sidewalks and turned vacant lots into parks. Better lighting went up, making those areas safer and more inviting. “Just two years later, 95 percent of residents surveyed in Wabasso had actually increased their activity levels,” Murthy said. “And when asked why, they cited the improvement in the number of walkable spaces and safe lighting that pushed them to go out and be more active.”

“Food deserts” are areas where healthy food is unaffordable or simply not available. Murthy noted that this includes neighborhoods as well as workplaces where cafeterias, vending machines and nearby stores are packed with unhealthy options. Such environments can be turned around, though. Just last week, Murthy visited a school in Chicago where teachers and students are growing fruits and vegetables on campus and then turning them into meals. He’s seen similar programs at other schools and through community gardens. “What’s so interesting,” Murthy said, “is these programs, simple as they seem, have a powerful effect on shifting preferences and practices, not just for kids, but for their parents, too.”

“Given that we know that diet and physical activity are powerful factors in the development of chronic illness, we can’t afford not to change our environment to make healthy choices easier,” Murthy said.

Murthy acknowledged that the healthcare professionals in the audience likely haven’t been trained in modern communications or taught how to change environments. And he noted that taking on such roles, in addition to other burdens tugging at them, wouldn’t be easy.

Yet he urged his colleagues to try. He even offered one more example, the saga of Dr. David Sagbir, a cardiologist from Westerville, Ohio.

After years of counseling patients about diet and exercise, he found that only a handful of patients were getting the recommended 150 minutes per week of physical activity. So he began asking patients to meet him in a park so they could walk together.

More than 100 showed up the first time. Now, there are more than 160 chapters nationwide of an organization he built called “Walk With A Doc.”

“The patients who participate in this program are 80 percent more likely to increase their level of physical activity,” Murthy said. “The walks they do also provide time for doctors and patients to talk freely and to strengthen their relationship in ways that are often quite difficult in the hustle and bustle of a busy clinic.”

Murthy’s stories all indicate the nation is filled with people willing to make healthier choices – they just need guidance, the kind that he believes medical professionals can and should provide.

“Dr. Sagbir’s example teaches us that we, too, have the potential to bring good health to millions of people by building a prevention-based society,” he said. “That’s what our country needs. And that’s what I hope we can create together.”

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Physical Activity