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Why should anyone care about physician health?

Indeed why should anyone care about physician health? As a group, North American physicians have healthier lifestyles and lower mortality rates than do our patients, even our high socioeconomic status patients. But it’s still worth promoting physician health, because there is a strong and consistent relationship between physicians’ personal health practices, and what we discuss with our patients.

That’s the bottom line – so here’s some evidence (for more on this, and references, see*). First off, regarding mortality, we showed in a study of over 3 million men (in the U.S. National Occupational Mortality Surveillance 1984-1995 database) that physicians lived longer (average age at death, 73 years) than did lawyers (72 years), all professionals (71 years), and men in the general population (70 years).2 We and others have also shown that both male and female physicians (both in the U.S. and Canada have healthier practices than our patients for major health determinants, like tobacco, alcohol, diet, and exercise.

And we’ve shown that patients often care about their physicians' health habits: patients seeing a diet-exercise video found that the physician was more believable and motivating if when disclosing their own personal healthy practices.

But most importantly, physicians with healthy personal habits are more likely to discuss related preventive behaviors with their patients. One of the first large (n= 2610) studies of this relationship showed that exercising internists were more likely to report counseling their patients about exercise, seat belt users to recommend seat belt use to patients, and nonsmokers to encourage smoking cessation. Our U.S. Women Physicians’ Health Study found similar associations between female physicians' personal habits and their likelihood of counseling patients about diet, exercise, alcohol, tobacco, diet, breast exams, skin cancer prevention, influenza vaccine, and hormone therapy. And our Canadian Physicians’ Health Study (in review) showed a similar strong relationship between Canadian physicians’ personal and clinical practices. And finally, our study of 2316 U.S. medical students also showed that medical students’ personal health practices are also strongly correlated with their counseling frequency (p<0.0001) and the perceived relevance of counseling (p=0.008).

But perhaps the most important finding from our medical student study is that we learned that one can “grow” healthy medical students who are more likely to counsel their patients about prevention; both counseling frequency (p=0.002) and perceived relevance (p=0.0007) were positively related to attending a school that encouraged healthy personal practices.

Unfortunately, while it’s a reasonable hypothesis, it is not yet proven whether (and how) we can also train physicians to have healthy personal habits, and have a positive effect on their patients. This would be a valuable research question to explore, and I (and others in the physician health research community) would welcome collaborations with health systems interested in trying and testing the effects of physician health promotion.

REFERENCES

*This article is a synopsis and update of a brief report, “Physician Health and Patient Care” JAMA. 2004;291:637, http://jama.ama-assn.org/cgi/content/full/291/5/637