I commend Dr Ron Wilson for encouraging doctors to practise health promotion in his article “Chronic-disease rates cut in half!” [BCMJ 2016;58:101 [3]]. As much as medical practitioners give lip service to the idea of a healthy lifestyle, few seem to understand the degree to which much, if not most, of the chronic disease we see is not only preventable but reversible through diet and lifestyle changes.

He closes by stating, “Let’s take every opportunity we have to remind patients of these risk factors and direct them to resources that will help them manage or prevent these chronic conditions.”

I don’t think Dr Wilson goes nearly far enough. Lifestyle of our patients is not a minor issue that we should just give lip service to if we have the time. It is probably the most important issue! We should not refer to dietitians, nurses, and web sites for more information. If we truly want to help our patients stay well or get well, we must take responsibility for learning how to manage lifestyle in our patients ourselves. Of course those of us who walk the walk successfully, through healthy habits, will be more authentic and effective when we talk the talk with our patients.

If you are too busy rushing from exam room to exam room putting out fires in the health of your patients and you think you don’t have time for this, think again! Just like health care costs are never going to come down, we are never going to have any fewer fires to put out until we systematically start investing in the health education and lifestyle fine tuning of our patients. This is not a job for dietitians and nurses. Lifestyle is a critical issue for all our patients. Doctors are the most influential health care practitioners. Therefore, it is the doctor who needs to take responsibility for systematically influencing the well-being of every patient.

However, until we get serious about training medical students on how to do this in practice, I don’t expect to see much change in the prevalence of chronic diseases in Canada any time soon. If Doctors of BC is interested in patients as much as doctors, they would establish a campaign to influence change at UBC to balance the medical school curriculum away from the 95% emphasis on disease care and focus more on true health care.
—Ron Cridland, MD
Kelowna