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Physician Fitness Matters, but It Takes Practice

Op-Med is a collection of original articles contributed by Doximity members.
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Physicians are busy. As healthcare providers, we all know the demands that come along with seeing 30 patients a day, charting the visits in our ever-changing EMRs and filling out reams of additional paperwork. With every new regulation and task outside of patient care that is added to our daily routine, physician wellness has become a priority in our field.

Most of us have thought about picking up a new fitness hobby, but for many of us, daily life gets in the way. However, as shown in this article, a physician who goes out of his way to stay in shape and improve his overall health can be a compelling example for patients to follow. When a physician makes positive changes in his or her own life, this can enhance the doctor-patient relationship and help the doctor remember why he or she went into medicine in the first place. Besides, we as physicians work in high-stress jobs, and not unlike performance athletes, we need to take care of both our minds and our bodies.

Thinking about making a change? First, let’s discuss some tips to help get you back in the swing of things, then some specific ideas for exercise and wellness.

First, make things easier on yourself. A habit is hard to start if you set yourself up for failure. If you wake up one day and decide “I will run 5 miles today” and you haven’t run for years, it probably won’t happen. Set a reasonable goal and limit the amount of times per week you workout so you have ample time to recover. For instance, a realistic goal could be running twice a week and setting an obtainable distance target. In the beginning, time is not a concern; it doesn’t matter if your mile takes 8 or 18 minutes, as long as you get there. This also gives the body time to recover, as doing too much too soon can lead people to burn out on their new hobby. Just take a look at any gym in the beginning of January and again in mid-February. The swells of eager New Years resolution makers have given up and the place has turned into a ghost town.

Other things that help are preparation and scheduling your workout. If you plan on exercising after work, bringing your workout clothes and shoes with you makes one less stop at home. If you are married with kids, you may need to do additional planning so both you and your spouse can get in some exercise. Accountability also helps, so having a buddy to workout with and keep you motivated and committed will ensure you keep up the habit. If this isn’t available to you, there are plenty of good social activity apps such as Strava, where you can post your activity online for all to see and encourage you on your way.

If you’re looking to try something different or even just to get back into an old activity, here are a few suggestions to consider.

  1. Running: This is the old standby that just about everyone has dabbled in at some point. Nothing is quite like pounding the pavement when it comes to getting in shape. You get a great cardiovascular workout and your legs get a workout too. However, you need set a routine to keep going: organize your shoes and clothes so they are easy to find, set a route ahead of time and make sure to get out the door at least 3 times a week. The key is to set up some achievable targets to keep you motivated. The setting can also help. My hospital is adjacent to a nature preserve with some great paths for trail running; whenever I get done with work at a reasonable hour, I try to get a run in.
  2. Cycling: Riding a bike is not only fun, it’s also very good for you. It’s a low-impact cardiovascular workout that spares the joint issues that come with running. Beginners or those who need a refresher can start with rentals or signing up for beginner bike classes offered at places like REI. For those who live close to work, cycling to work is something to consider not only because of the health benefits, but because you’ll get to work with a renewed energy. Plus, it beats sitting in traffic in a car.
  3. Swimming: As opposed to the first two, this is much easier on the joints and still has many health benefits. It also has the added benefit of working different muscle groups than running or cycling. Just like the other activities, it’s important to focus on form and not push yourself too hard. Consider a coach if you’ve never swam before, as the technique can make or break your success.
  4. Yoga: Not every fitness endeavor needs to be based on burning as many calories as possible. Yoga is a great activity as a primary exercise or an adjunct to other ones. Yoga is really helpful for working on flexibility, balance and breathing. It also has additional effects on stress and mindfulness which helps you get through a tough day of charting in the EMR. If you don’t have a schedule that allows you to make it to a yoga class, YogaGlo provides a large number of online yoga classes you can do at home. However, a beginner should probably go to some yoga classes prior to starting an online routine to make sure they have a good foundation and proper technique in order to prevent injury.
  5. Meditation: The mind is a tricky thing to master, and all of us have stressful days that get the best of us. Rather than falling into a destructive habit like stress eating or drinking, consider regular meditation into your routine. Don’t know how to meditate? Fortunately, there are apps for that too. Headspace is a very popular app with guided meditations that start at 10 minutes a day. If 10 minutes seems unattainable, there’s also Aura, which gives you a personalized 3-minute meditation every day.
  6. HIIT (High Intensity Interval Training): If you easily get bored with the steady pace of running, cycling, or swimming, consider incorporating intervals into your workout. These consist of high intensity periods of exercise (30 to 60 seconds), followed by a period of active rest. This is repeated for about 20 minutes or so. While some may associate HIIT with high-level athletes, evidence suggests this can be a very effective training method for people with chronic illness and even reduce the risk of heart attack. You could easily adjust your running, cycling or swimming routine to incorporate HIIT. You could also consider classes that incorporate HIIT into the workout such as Orange Theory or even a (non-contact) boxing class.
  7. Weightlifting/Bodyweight Training: Weight training is probably an undervalued addition to a fitness routine. While thoughts of meatheads grunting while using poor form to lift the heaviest weight possible might come to mind, this is not what I mean. Circuit weight training is a good way to get a whole body workout while also working up a good sweat. It also allows for variety in the routine. This approach focuses on tone and overall body fitness rather than just bulking up the glamour muscles in the chest and biceps. For another approach, consider bodyweight training. Even a simple routine with pull-ups, dips, push-ups and squats can provide a quick total body workout. If you need more guidance, there are apps that take you through challenging routines. My personal favorite is TouchFit by George St Pierre, although I wouldn’t recommend this for a total beginner.

Lastly, don’t forget the most important thing outside the workout: diet. Most humans actually eat too much in terms of portion sizes, which can counteract any benefits with the above activities you hope to see. As you get into a routine, you’ll start to find it slightly addicting and look forward to your next workout. Most of us (including myself) aren’t professional athletes, but we are a profession known for our work ethic and considered model citizens by our patients. Let’s try to live up to that. For anyone needing someone to encourage you on the way, feel free to add me on Strava.

Joseph DePietro, MD, is a Voice and Swallowing specialist practicing in New York’s Hudson Valley and a 2017–2018 Doximity Fellow.

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