Doctors, Nurses Give Lifestyle Advice but Are Skeptical It's Heeded

Marcia Frellick

March 29, 2018

All nurses and physicians who responded to a Medscape Medical News poll said they advise at least some of their patients to change lifestyle practices to reduce risk for disease, but only 61% of physicians and 53% of nurses said they always offer such advice.

About a third of physicians (32%) and 36% of nurses/advanced practice nurses said they "often" offered lifestyle advice and 6% of physicians and 8% of nurses said they "sometimes" offer it.

The poll question was asked in November last year in light of mounting evidence that making positive lifestyle changes is a powerful strategy to maintain health and prevent disease.  Total responses numbered 515: 358 physicians and 157 nurses.

The poll showed a large disparity in the numbers of providers offering the advice and the numbers of patients they believe are heeding it.

Table. How Often Do Your Patients Follow Your Recommendations?

Frequency Physicians' Estimates (%)a Nurses'/Advanced Practice Nurses' Estimates (%)
Always 3 1
Often 21 12
Sometimes 56 60
Rarely 16 15
Never 1 1
I don't know 4 11
aNumbers may not add up to 100 because of rounding.


Some comments on the poll show frustrations providers have regarding giving lifestyle advice.

A registered nurse wrote, "Diabetes, Hypertension and Kidney Failure is so high in the community I live in. Every effort is made to educate our patients, [but] too often [patients] don't make the effort to make changes. Not too sure how much more can be done if people don't make the effort to make healthy lifestyle modifications."

Another registered nurse cited lack of an industry-wide focus on making changes proactively.

She wrote: "Unfortunately the health care industry mostly considers healthy lifestyles to be a personal issue rather than a healthcare system issue.  While the healthcare system is very good at treating the effects of an unhealthy lifestyle, it has shown itself to be disinterested in creating healthy lifestyles."

Most Common Advice Given

Increased physical activity (90%), improving nutrition/diet (80%), and quitting smoking (82%) were among the lifestyle changes physicians were most likely to suggest.  Nurses answered similarly in their likelihood to make those recommendations.

However, physicians were much more likely than nurses to advise losing weight: 76% of physicians vs 61% of nurses recommended that lifestyle change.

Among advice less likely to be given, recommendations to increase socializing were made by 23% of physicians and 24% of nurses. Twelve percent of physicians and 8% of nurses said they advised patients to make a change in sexual behavior.

Some commenters brought up "motivational interviewing" and the need to help patients discover their own motivation for change.

A psychiatrist who commented wrote, "Recommending alone doesn't do anything. You have to actively work together on this. Most people will resist such efforts. If you think about yourself, you'll notice how hard it is to change habits. It's even hard to do things you like to do. You have to work with the individual and figure out what works for them. Dictates or a tossed off suggestion or handouts won't work."

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