Resolving to start exercising again? These tips can help

Medical Post
Helping Hand Column, December 06, 2006

It can be hard to find time, but doctors owe themselves a healthy body and mind

Yesterday afternoon, I finished my workout, had a quick shower and headed out to meet a colleague over coffee. He arrived a few minutes later, looking refreshed and calm and apologizing for the short delay, explaining that he had just started to work out again and felt great, and really wanted to keep it up. He hoped I did not mind that he had tried to fit in the exercise before our meeting. Of course not; in fact, I was truly impressed. “One hundred per cent of the physicians at this table exercise regularly!”

We spoke of the clear benefits of exercise and how we know all about this, but admitted we did not always find time for it over the years. He had just joined a gym at the hospital, and found it was accessible and convenient to drop by on the way home. I agreed that if time could be saved, it made it more likely for us as physicians to do this regularly. I run every morning and have a personal trainer come to my office just after my last patient has left, two or three times a week. But I wonder what percentage of colleagues exercise regularly.

As doctors, most of us know that the recommended amount is 30 to 60 minutes of exercise three to five times a week. Yet, we do not always practise what we preach.
A 1992 survey described the health behaviour of physicians from a specific U.S. clinic and found their exercise habits to be typically better than those of the general population. Erica Frank and colleagues from Emory University school of medicine in Atlanta, writing in the Journal of the American Medical Women’s Association (2003; 58: 178-184), reported on the exercise habits of U.S. women physicians, and found that nearly all (96%) reported getting some exercise. The median time spent was three hours per week with the main activity being walking, followed by gardening, biking, swimming, running and aerobics. Half of these women exercised enough to meet the above recommended amounts.

However, my observations of colleagues both within my practice and within my medical community leave me doubting if doctors actually engage in this high level of activity.

Some experts suggest there are biases in the studies; that physicians who were proud of their activity level were more likely to respond; that the ones who were not so healthy did not have time or energy to respond to the survey; or that physicians responded by stating what they would like to be doing not necessarily what they were actually doing.

Understanding barriers to regular exercise for physicians involves understanding our basic personality. Physicians are very dedicated and conscientious, and so have other things higher on the list of priorities. Exercise is seen as something just for ourselves, a luxury.

Our sense of responsibility makes us feel guilty; thus we feel guilty to be exercising when there are other things to do with that time. Our perfectionism can set us up to fail. We start an exercise program and want to do it perfectly, each day. When reality intrudes and we miss a day or two, we feel we have failed and abandon it entirely.

There are other barriers that result from the lifestyle of medicine. Studies have shown that marriage, especially with children, is the main barrier to exercise for women physicians, as well as work pressures, perceived lack of time and lack of personal discipline.
Here are some general tips for starting and maintaining an exercise program:?

• Recognize this is not a luxury but an investment. Taking time for yourself makes you more available to meet the needs of everyone who is counting on you.

• See it as something you want to do, not a chore or duty. Regularly remind yourself why you want to exercise.

• Make it a part of your day, just like having dinner or a patient’s scheduled appointment. Thus, it is not if you have time to exercise, but when you will do it.

• Start slowly, and set a series of achievable goals, so you can feel progress and success.

• Don’t wait to get motivated. Push yourself to start when you said you would. Once the action happens, the motivation will kick in.

• Try the Five-Minute Rule—promise yourself that you only have to do it for five minutes and then you can stop if you wish. Chances are you won’t want to stop after five minutes, but it helps to know you could.

• Allow a degree of flexibility. If you cannot do the full routine that day, just do what you can. If you miss some days, just start again as soon as you can.

• You don’t have to do this perfectly. Just because you could do it at a high level, does not mean you need to, or should do so.

• Don’t get discouraged. Some changes occur immediately; others take more time to be evident.

• You have nothing to prove to anyone else.

• Enjoy the workout; choose something fun.

• Choose something you like to do, and that you are physically able to start.

• Exercise with a partner who is not judgmental, can help to make it fun and keep you sticking to it.

• No one method or routine works forever. Vary the workouts regularly or enjoy it for as long as you can. When it no longer works, look for something else that will work for this new phase of your life.

• Remember you are worth it.

I invited colleagues to share what they do to maintain exercise in their life. Here are some actual suggestions that colleagues have offered.

• Join a health club that is accessible—at the hospital, close to work or on your way home.

• Hire a personal trainer. Mine comes to my office, but they can come to your home or work with you at the health club.

• Use exercise as a form of transportation. Bike or run to and from work.

• Choose the stairs over the elevator as often as you can.

• Park your car as far away from the door as you can.

• Go to bed early and wake up early to exercise before the rest of the family is awake.

• Watch television as you work out; the time seems to fly.

• Don’t come home until you have completed your exercise. Stop by the club on the way home; it seems harder to take time for exercise once you are home.

• Hire a sitter daily to free up a couple of hours to workout, if your kids are young.

• Join a gym that has child care.

• Put the treadmill in the play room so you can supervise and work out.

• Exercise with the children-—swim, go for hikes, bike rides, chase them at the park.

• Go for a walk or run while you are waiting for your children to finish the music lesson or hockey practice.

• Join an activity with your partner, such as dance lessons.

• Learn yoga or Pilates. Look for opportunities to practise this during the day.

• Sign up for lessons for a sport or activity—tennis or skiing lessons.

• Join an active club, such as a running, biking, or cross-country skiing group, so the group can help to keep you motivated.

• Reward yourself with new gear from time to time.

• Dress like an athlete. Fake it until you make it!

If all else fails, try The Every Excuse In the Book Book: How to Benefit from Exercising by Overcoming Your Excuses, by Jeannie Murdoch, 2005. Murdoch offers fun yet rational responses for 120 of the more common excuses people use for not exercising.
Addressing this now allows you to beat the rush for New Year’s resolutions or, even better, to choose something else to resolve then!

Mamta Gautam is an Ottawa psychiatrist who specializes in treating physician patients. If you have a question you would like addressed in this column, please contact Dr. Gautam at mgautam@rogers.com. Please include “Helping Hand” in the subject line. All inquiries will be confidential. Your questions will not be replied to, but may be selected to be answered in this column, which is intended to be educational, not therapeutic.