If you think about what we do as physicians for people that have health conditions that we see in an office or even a hospital,

we really are seeing those people a tiny fraction of their lives.

So if somebody comes in the office with type 2 diabetes or hypertension, infection, whatever,

we adjust their medications, deal with other risk factors

and other very frequent comorbidities, and then people move on and live their lives outside

of the office. The 99% of those hours outside of the office or the hospital are by far the most

impactful in regards to their health and their outcomes.

And in this era where we are asked to be increasingly productive, which by the way is just

code for seeing people faster, and most like me in this era of big medicine are actually

given quarterly report cards on our productivity, the fact is to deal with all the

medications and maybe three to 12 medical problems or medications the patient is on in the office,

it's really hard to discuss lifestyle and then impact it significantly by seeing any patient

every three to six months.

It is hard for many healthcare professionals to believe that they're going to change lifestyle

based on a few doctor visits each year.

But while I understand that thinking, it appears to be incorrect.

When doctors do take the time to address health, diet, smoking, and other

lifestyle changes like exercise, it has actually been shown to have an impact. Now, obviously

not on everybody, but even if it is a minority of patients that decide to exercise or quit

smoking, that still is an important impact.

And I will be the first to admit that when I am 30 minutes behind in clinic or it's a really

busy day in the hospital, which seems to be most days, I am laser focused on dealing

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