During the first week of June 2016, my travels took me to Boston to attend and lecture at the Annual Meeting of the American College of Sports Medicine (ACSM) that was held in conjunction with the 7th World Congress on Exercise is Medicine. This is always my favorite meeting of the year because it brings together the top experts in the world from the field of sports medicine and exercise science. This year’s meeting was outstanding as usual and I particularly enjoyed getting to meet with our US Surgeon General Dr. Vivek Murthy, who was in attendance.
I also had the opportunity to take part in an onstage conversation with Dr. Murthy and question him about our most pressing healthcare issues that are relevant to the strategic goals of ACSM. In particular, I sought to gain his support in making PA assessment and exercise prescription a standard of care across the country. We have been doing this with great success at Kaiser Permanente since 2009, using what we call an Exercise Vital Sign in which all patients get asked 2 questions about their physical activity habits at every visit. First they are asked “how many days per week on average they engage in moderate or greater physical activity (like a brisk walk)?” The follow on question is “how many minutes on average do they engage in this activity?” Our electronic medical record then multiplies these two responses to record each patient’s minutes per week of physical activity. The goal for adults is 150 minutes or more each week and in kids its 420 minutes per week, which is in keeping with the US Physical Activity Guidelines.
Dr. Murthy and I also discussed the tragic issue of prescription narcotic abuse in this country. This has been fueled by the suggestion that pain should be looked at as the 5th vital sign. This has been horrible mistake that has resulted in doctor’s dramatically over-prescribing narcotic pain medicines, which are highly addictive and carry a strong risk of causing death from overdose. It seems like every week we hear of another celebrity or ordinary person who has died related to narcotic addiction and overdose. In fact, more people die each year from prescription narcotics than cocaine and heroin combined! That is a chilling fact and something we have to change.
I suggested to our Surgeon General that Exercise, rather than pain, be looked at as the 5th vital sign. This makes sense because pain is a part of life and a symptom we need to manage and help patients cope with. It has become clear that the answer to managing pain is not medication, which should only be used as an adjunct to other treatments. We also know that exercise is the single best thing one can do to help cope with pain. In fact a recent study showed that simply getting patients to walk every day did more for their back pain than taking pain medications. Not to mention the fact that walking also helps treat and prevent chronic disease, helps us lose weight and relieves depression – something pain medicines will never do. So that is why I continue to urge all my patients to walk every day. I know it is the single best thing they can do to stay healthy and live longer.
Of course, while I was in Boston I made sure to get out and walk every day. The weather was mostly sunny and warm, and Boston is a great city to explore on foot. I especially enjoyed an afternoon walk to Fenway Park to see the Red Sox play with my good friends from New Zealand and South Africa, who were attending the ACSM meeting.
Thanks again for reading this blog and spreading the word on the great health benefits of walking!
Bob