How to Make Changes for Health

We all know the basics about how to be healthier and how much that can influence our risk of cardiovascular (and other) disease in the future.  Knowing is easy.  Changing is hard.

There is no doctor who wants to be fat, smoke, or eat poorly.  If you smoke, don’t exercise, eat poorly or are significantly overweight you already know

a) you have a higher risk of premature death and, worse, disablility

b) you’ll have decreased energy and generally feel worse than people who are fit

c) it’s going to be a lot harder to counsel patients about what to do for their health

It would be fantastic if we were all issued a magic wand as part of our medical supplies.  It would be so much easier to make changes in our lives and our patients lives by a wave of a magic wand.  There is no magic wand, but we (and our patients) can make changes using what is known about behaviors and changing behaviors.

The American Heart Association has recently published a review of the literature and recommendations on how to sustain changes that improve health.  I’ve put the link below to the entire article but here’s my summary (and slight translation) of what they found worked to change behaviors:

  1. Set goals
  2. Use a system to monitor the change
  3. Create or discover a support system you can use on a frequent and regular basis
  4. Establish a way to get regular feedback on your progress
  5. Believe you can do it (and work on strengthening this belief)
  6. Reward yourself when goals are achieved
  7. Find role models for your new behavior and spend time with them (or what they have written)
  8. Brainstorm to use your innate ability to problem solve.  Don’t accept “I can’t”
    or “never” in your vocabulary of change – find creative ways to move past these obstacles.
  9. Learn from the times you fail (which is normal). ‘Try again. Fail again. Fail better.’  Samuel Beckett

Interventions to Promote Physical Activity and Dietary Lifestyle Changes for Cardiovascular Risk Factor Reduction in Adults. A Scientific Statement From the American Heart Association Artinian et al, Circulation. 2010;122:406-441

Do’s and Don’ts of Goal Setting from

Elements of Change from

Religion and Spirituality

People who are ill or hurting often turn to their religious roots for solace.  The mind and body connection is a powerful one, and one that can contribute to good patient care.  Spirituality in medicine can take an overtly religious tone, but only if both the physician and patient are completely comfortable.  No matter what your religious background, you will care for patients whose belief system is different from your own.  The true root of spirituality in medicine is compassion. Regardless of your religious background and your personal beliefs you can cultivate a philosophy of compassion.  Both you and the patients you care for will do better because of it.

 The workday can be onerous and fatigue can make you lose perspective.  It is important to find something greater than you and spend some time there everyday.  The most efficient method is to look inside of yourself by just sitting.  Learn to just sit.  It is harder than it sounds, but very powerful when achieved.  Slow your breathing, close your eyes and let the thoughts go.  Concentrate on your breathing and relax all your muscles.  Don’t fidget, don’t move.  When the thoughts start running (and they will), just acknowledge them and let them go.  Try to get to a moment (and that it all it will usually be) when your mind is silent and your body relaxed.  This is the moment to listen.  Being able to quiet yourself this way is very conducive to allowing your mind to work on the “big picture”.  If you spend even 10 minutes everyday in this kind of meditation, you will be surprised at how some of the things that are worrying you become “solved”.

 Work at finding beautiful places where you can sit for a minute or walk.  Nature is one of the most powerful spiritual experiences.  If you have a favorite place to hike or be outside, take some pictures and blow them up for your house or call room.  Put beautiful plants in your house and then take care of them. (Dead plants are a bad way to cultivate spirtituality…)  Watch for the surprising moments of beauty in a day and notice them.  Look for the flower blooming outside a patient’s room, the proud look of a father watching his two-year-old totter into the hospital, a new painting on the wall.

Cultivate a sense of wonder.  Have you ever seen anything more incredible than a beating heart in a surgeon’s hand?  Allow yourself a moment to be amazed in the middle of the day.  People have incredible resilience at times – notice it and appreciate it.