Through blogs and comments, patients and experts explore what it takes to find good health care and make the most of it.

Inside Health Care: The Uneven Terrain of Behavior Change


Inside Health Care posts showcase a collection of recent blogs from health care professionals and are part of the Center for Advancing Health's portfolio of free, evidence-based coverage of what it takes to find good care and make the most of it.'  Written by Sarah Jorgenson, CFAH Communications and Research Associate.

Glenn Laffel, M.D., Ph.D., of Pizaazz hypothesizes about why we often don't make changes that would benefit our health. He says:

'Somewhere in the course of our daily lives, though, most of us do exhibit behavior that suggests at least some disregard for our health. We don't change our diet, though we know we should. We don't floss, take medications as prescribed, or get the screening tests we're supposed to.'

He knows multiple complex causes exist for this and questions whether being diagnosed with a chronic condition motivates people to improve health behaviors exploring whether the delay between health behaviors and health outcomes contributes to unhealthy behavior. After looking at attrition rates in a diabetes self-management program, he concludes:

'It calls attention to a key distinction behavioral psychologists like to make in explaining human motivation: there's a difference between awareness of the need to act, and the volition to act.'

Family doctor Kenny Lin, M.D., previously recommended that people 'tackle one behavior at a time.' He says:

'Instead of advising a patient to simultaneously try to quit smoking, cut down on calories, and start a daily walking program, for example, I would advise her to focus on the single change that seemed the most doable, and to postpone the others until that first change was well established.'

But recent studies lead him to question his 'one behavior at a time' approach. He says, 'For me, the take-home message from recent research is that all of us can change multiple health-related behaviors at once, as long as we receive structured support from health professionals and peers.'

Specialist Bruce Campbell, M.D., had his quit smoking speech prepared when he smelled tobacco smoke on a woman while examining her. He 'expected the usual litany of excuses' for her not quitting only to discover she was experiencing greater adversity. She replied:

'I'm sorry, Doctor. I really am. I did quit for' a few' weeks but then started again' Remember the big guy with the Green Bay Packers jacket that always came to my appointments? My husband? Remember him? Well, he dropped dead of a heart attack about a month after I quit smoking. It has been a hard time; real hard. I went out and bought a pack of smokes the day of the funeral. Maybe I will quit again. I don't know.'' ' 

This business of being patients is far from all we do.' 

Glenn Laffel, M.D., Ph.D., recently served as Senior Vice President of Clinical Affairs at Practice Fusion. He blogs at Pizaazz.'  You can follow him on Twitter @pizaazz. Family physician Kenny Lin, M.D., blogs at Common Sense Family Doctor and his posts appear on U.S. News and World Report Consumer Health Blog, Healthcare Headaches. You can follow him on Twitter @kennylinafp. Specialist Bruce Campbell, M.D., writes on Reflections in a Head Mirror on Froedtert Hospital and the Medical College of Wisconsin's website.

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