No. Just.....no. My primary care provider already does as little as possible while billing for as many visits as possible. There is no way she would include a fitness test at a normal office visit. My provider already pushes extra follow up visits, mammographies and colonoscopies and STD tests on her patients - I'm talking MORE than standard practice. Each one means missing a day of work, and a day of pay. If I followed my primary's recommendations, I'd miss 8 days of work a year - even without being sick. Yet if I actually need a specialist or a test, my primary drags her feet on it. It takes two visits with her just to get a referral out of her. Its not just my primary - every provider that office is pressured to do the same. The LAST thing I need is another day spent in a waiting room, ANY waiting room.
34
Just say no. My doctor recommended a Vitamin D level and I said no because when I worked in a medical laboratory this was the #1 test performed incorrectly. Also, without insurance the test would have cost me a significant amount of money. I told her I would get more sun instead.
We CAN say no and SHOULD say no to excessive testing by doctors and other healthcare professionals. When I had dental insurance my dentist used to do full mouth x-rays every year and I didn't even think of saying no. Now I consider, and do research, and sometimes consult other health professionals, before every test.
We CAN say no and SHOULD say no to excessive testing by doctors and other healthcare professionals. When I had dental insurance my dentist used to do full mouth x-rays every year and I didn't even think of saying no. Now I consider, and do research, and sometimes consult other health professionals, before every test.
3
I do not understand why a "fitness check" does not include strength testing as well as aerobic measurement. Surely muscular strength as determined by hand squeezing, weight lifting, etc. is an important aspect of the definition of fitness as it relates to wellness and longevity.
32
My biggest concern with annual fitness testing is its implementation. I am not overweight and I dread going to the doctor because they force (yes, force) me to be weighed in the hallway. It's dreadfully humiliating. It's bad enough most physicians are not trained in motivational interviewing and rarely consider the whole patient. They are also totally bogged down in electronic reminders and data goals from their practice administrators. How is this recommendation going to look to most patients? Just another guilt trip from a provider who is in no position to encourage or even help to affect a positive behavioral change? How will this build relationships between providers and patients?
Don't get me wrong. Self-awareness about fitness is so important physically and mentally. But aren't we all tired of "guidelines" that get pushed forth with little context or guidance on how to make them meaningful to patients?
Reading this brought me back to grade school and the dreaded Presidential Fitness Test. I "failed" it every year because of one test (the pull-up/bar hang). So despite spending most of my adult life trim, strong, and competing in endurance athletic events, by the numbers, I was a loser. These recommendations need nuance and if the AHA wants providers to roll them out, they need to train providers how to be coaches and not prescribers.
Don't get me wrong. Self-awareness about fitness is so important physically and mentally. But aren't we all tired of "guidelines" that get pushed forth with little context or guidance on how to make them meaningful to patients?
Reading this brought me back to grade school and the dreaded Presidential Fitness Test. I "failed" it every year because of one test (the pull-up/bar hang). So despite spending most of my adult life trim, strong, and competing in endurance athletic events, by the numbers, I was a loser. These recommendations need nuance and if the AHA wants providers to roll them out, they need to train providers how to be coaches and not prescribers.
18
I think I failed every single Presidential Fitness Test every single year, except the "sit-up" test, but this is pretty far down my long list of life regrets. In fact, if I ever do think about the Presidential Fitness Tests - I really only remember the thrilling shock of passing the sit-up test, and can't even name the other tests. You really need to work on sharpening your selective memory skills.
Seriously though, I am really concerned about the number of obese children I see. I hated Phys. Ed., but wish there was much more money spent on it now in schools. Bringing back the Presidential Fitness Tests would do more good than harm in today's world.
Seriously though, I am really concerned about the number of obese children I see. I hated Phys. Ed., but wish there was much more money spent on it now in schools. Bringing back the Presidential Fitness Tests would do more good than harm in today's world.
6
Also, I am fully clothed, have my keys in my pocket, have had a meal or two and the doctor's scale weight, which usually includes my shoes too, is at least five pounds higher than the scale at home. When I weigh myself at home I do it naked, with privacy, first thing in the morning before food and water!
No white coat needed. The easiest fitness test is described below, a one mile brisk walk and measurement of your heart rate and time at the finish.
http://www.exrx.net/Calculators/Rockport.html
This is particularly good for people of lower fitness because most people don't have "ask their doctor if they are healthy enough" to walk a mile.
And if you are unsatisfied with the result, walk or run as far as you can in 30 minutes every day. Avoid car and truck traffic, the exhaust is bad for you.
http://www.exrx.net/Calculators/Rockport.html
This is particularly good for people of lower fitness because most people don't have "ask their doctor if they are healthy enough" to walk a mile.
And if you are unsatisfied with the result, walk or run as far as you can in 30 minutes every day. Avoid car and truck traffic, the exhaust is bad for you.
12
If a person isn't already exercising and has a low fitness level, fitness testing as part of the annual physical exam is not likely to inspire change.
People like me who don't exercise and are not aerobically fit already know it and are highly unlikely to change their behavior pattern based on outside prodding.
Would the point of this proposed new feature of the physical exam be to determine whether or not the person is a candidate for, for example, prophylactic cardiac drugs (in conjunction with other factors predictive of cardiac risk)?
People like me who don't exercise and are not aerobically fit already know it and are highly unlikely to change their behavior pattern based on outside prodding.
Would the point of this proposed new feature of the physical exam be to determine whether or not the person is a candidate for, for example, prophylactic cardiac drugs (in conjunction with other factors predictive of cardiac risk)?
10
"The authors also suggest that if your physician does not begin to determine your aerobic fitness in the near future, you should do so yourself, using any of several scientifically validated online tools."
Such as...?
Such as...?
3
Such as what is suggested in the last three paragraphs: "He suggests using an online fitness calculator developed by Dr. Kaminsky and others, based on data from millions of users, at www.worldfitnesslevel.org."
1
Such as the link at the very end of the last sentence of the last paragraph. :)
1