Wellness: Does your Doc Know What to Look For?

[BridgeTheGap]

Has your doctor ever given you an Rx for exercise? June Chapman got one last summer, a first for the 87-year-old retiree in San Marcos, Calif. "You sit on a chair, arms at your side," she says of the exercise her internist prescribed, "then rise up and sit back down on it. Every day. Repeat as often as you can."

Chapman's doctor was a little ahead of the curve in recommending this kind of chairobic activity. Starting Jan. 1, all 46.6 million Medicare beneficiaries become eligible for wellness visits. Unlike a physical, in which a doctor is mainly looking for big-time problems — and may spend only a minute or two scolding you for not eating right or exercising more — a wellness visit is designed to promote health and include lessons in how to make better lifestyle choices so you can avoid or reduce the effects of conditions like hypertension, diabetes and heart disease. Medicare recipients will be able to get this kind of coaching free once a year. And if the health care reform law kicks in as scheduled, many private health plans will be required — or, in some cases, given incentives — to offer expanded wellness benefits by 2014.

"For the first time, doctors will be reimbursed by Medicare for talking to patients on an ongoing basis about healthy behaviors," says Dr. Edward Phillips, director of the Institute of Lifestyle Medicine (ILM), an education and advocacy group co-founded in 2007 by Harvard Medical School and Boston's Spaulding Rehabilitation Hospital. The only downside: the current crop of physicians isn't nearly as good at improving patients' routines as it is at treating sickness. "The average doctor is hamstrung by lack of time, training and interest," says Dr. Alex Lickerman, former director of primary care at the University of Chicago. "How many sit down with patients and talk about the barriers to losing weight? Most doctors are not there ."

The new wellness benefit tasks doctors with creating "personalized prevention plans," which ideally will be tailored to each patient's daily routine, psyche and family life. And if that sounds more like a nanny-state mandate than medicine, consider that some 75% of the $2.47 trillion in annual U.S. health care costs stems from chronic diseases, many of which can be prevented or delayed by lifestyle choices.

Read more: http://www.time.com/time/magazine/article/0,9171,2040210,00.html#ixzz1DNJRjHeD