I will leave responding to the issue of billing in relation to “lifestyle or preventive counseling” to those engaged in prioritizing health system spending. However, I would like to acknowledge that those are important conversations, particularly given the inequity of health and outcomes that have been exemplified throughout the pandemic and reported extensively elsewhere. Thank you, Dr Horton, for placing the topic back on the table for discussion.
When this article was written and the core messages conceived, we anticipated that by November 2021 much of COVID-19 would be in the rearview mirror. We anticipated looking forward—addressing what we learned from the pandemic about health inequities and re-engaging in proactive use of health promotion knowledge and evidence. Sadly, we are still facing the strain of a fourth wave.
The capacity of family physicians to engage in these conversations is recognizably dependent on their practice contexts, their community resources, and their own comfort with and knowledge of the topic. The suggestions offered in the article were provided in response to requests from physicians for specific information that would assist them in promoting physical activity to whatever extent is feasible in their roles as physicians. There was no intent to add burden to physicians who already have a full plate, but rather to enhance opportunities for physicians to be part of a large cross-sectoral strategy to enable British Columbians from all walks of life, across the life course, to benefit from health-enhancing physical activity.
The province of BC’s comprehensive physical activity strategy, Active People, Active Places, and the 2020 update documents provide a framework for collective action by multiple stakeholders. Physicians belong at the implementation table and have much to offer at multiple levels—from what happens in our offices to advocating for policy and spending priorities. Collectively, we can make a difference, just as we have in the areas of seatbelts, helmets, and smoking cessation.
—Anne Pousette, MD, MPH
Council on Health Promotion
This letter was submitted in response to “Re: Re-embracing physical activity after COVID-19.”
Read BC Family Doctors’ response in “Re: Re-embracing physical activity after COVID-19. BC Family Doctors replies.”
1. Province of British Columbia. Active people, active places – British Columbia physical activity strategy. November 2015. Accessed 12 November 2021. www.health.gov.bc.ca/library/publications/year/2015/active-people-active-places-web-2015.pdf.
2. Province of British Columbia. Active people, active places – British Columbia physical activity strategy. 2020 update report. Accessed 12 November 2021. www2.gov.bc.ca/assets/gov/health/managing-your-health/physical-activity/active-people-active-places-2020-status-update-report.pdf.
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Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.
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