 Dr
David Jenkins doesn't think it's realistic to expect MDs
to be the fountainheads of sound diet and lifestyle advice
for Canadians. Physicians have enough on their plate just
taking care of the sick. But don't think he doesn't value
the importance of exercising and eating a balanced diet.
"I'm much more vulnerable to illness than many other people
since I have high cholesterol and I'm doing my best to
lead a healthy lifestyle," says the director of the Risk
Factor Modification Centre at St Michael's Hospital and
a professor of medicine and nutritional sciences at the
University of Toronto.
To help keep his cholesterol levels
in check, Dr Jenkins relies on good old-fashioned techniques;
namely, regular exercise and eating well. "I love to
go swimming and jogging and I eat a plant-based diet,"
he says. Dr Jenkins would certainly like to see more
people following his lead and trying their best to live
a healthy lifestyle. But in practice it can be a little
difficult to find time to educate patients about exercise
and diet given that appointments are already hurried
thanks to the long patient queues a typical family physician
faces.
LET
THEM EAT CAKE?
"Physicians just don't have the time to ask their patients
what they've had for breakfast, lunch and dinner," says
Dr Jenkins. "It becomes even more time consuming to
tell them what they should've had instead," he
adds. And don't forget about exercise. For Dr Jenkins,
trying to help patients come up with a good fitness
program tailored to their needs and that they'll stick
to is easier said than done. "Seeing patients and helping
them with health problems they're having and also providing
them with dietary counselling is a little much to deal
with from the physician's perspective," says Dr Jenkins.
"We're in a bind at the moment because we don't have
the time to properly educate patients and, just as importantly,
the ability to do followups with them."
Dr Jenkins is, however, thoroughly
unhappy with the nation's eating habits. "People simply
eat too much and don't eat the right foods," he says.
"There's an increasing number of educational books and
information on obesity, but it's still on the rise,"
he says. "Society's going in the wrong direction."
ALTERNATIVE
ADVICE
Dr Jenkins believes that although patients value the
advice given to them by their physician, good counsel
doesn't necessarily have to come from that quarter.
"I've always said that patients can do just as well,
if not better, if they deal with a dietician or nutritionist
on matters concerning diet and exercise."
An ideal solution in the modern
battle of the bulge would see doctors and dieticians
working together closely to monitor the patient's progress,
which should help with patient compliance. "This partnership
would be very useful for patients and it would provide
them with the support that many of them need," he says.
"The most important thing with dietary change is thorough
reinforcement, which comes from repeat visits." But
with the shrinking budgets in the healthcare system,
it may not be a solution that would come anytime soon.
Dr Jenkins does envision an inexpensive
solution: "What we need to do is offer group sessions
taught by experts, be they MD or dietician, with individual
billing in order to truly help people learn how to balance
exercise with nutrition."
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