Quebec doctors can now prescribe exercise

http://www.cbc.ca/news/canada/montreal/quebec-doctors-can-now-prescribe-exercise-1.3215821

by the_duck • 11 years ago

73 74 11 years ago

Steltek• 11 years ago

In 2014, doctors in Boston were able to begin prescribing a Hubway bike share membership: https://www.bostonglobe.com/metro/2014/03/27/new-program-wil...

In Boston's case, it's a mutually beneficial arrangement for the city: healthier citizens and less traffic on the roads by converting drivers to bikers.

ebiester2• 11 years ago

I'm not sure -- is the increased health contraindicated by the increased chance of injury or death from unobservant car drivers?

femto• 11 years ago

The health benefits outweigh the risks [1], if measured by increased life span. This is a relatively common question about cycling.

[1] http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2920084/

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Edit for clarity.

6d0debc0713• 11 years ago

I imagine that goes down well at an appointment. Someone you might see once a decade or less giving you lifestyle advice.

brianwawok2• 11 years ago

I am sure it is ignored the same as people who are 200 pounds overweight ignore "You need to lose weight"

On the other hand, this is awesome. Giving them a concrete goal. A lot easier to say "Walk 30 minutes a day, 7 days a week" than "Exercise more"... go exercise!

(Not sure exactly how the cube system works, but it seems more concrete.. maybe it is the exercise version of the calorie?)

GFK_of_xmaspast• 11 years ago

Most people aren't in a situation where they can go a decade between seeing a doctor (and it's in Quebec, so the American healthcare exceptionalism doesn't apply)

6d0debc0713• 11 years ago

If that's the case, then people are much unhealthier on average than I'd assumed. What do they visit about?

apricot• 11 years ago

Once a decade? Everyone in my family gets annual checkups from our family doctor.

tptacek• 11 years ago

https://www.sciencebasedmedicine.org/re-thinking-the-annual-...

kelvin0• 11 years ago

How lucky are you! I live in Quebec, and Family doctors are almost non existent for the vast majority of adults, and even infants.

vonnik• 11 years ago

http://theshrug.com/this-is-the-best-drug-commercial-you-wil...

anon42• 11 years ago

I wonder how well this meshes with the fact that a lot of cities aren't built for walking. Walking is in general good, but is it responsible for your doctor to prescribe you an activity that is actually illegal in the area where you live, due to there being no sidewalks and walking on the street being illegal.

brianwawok2• 11 years ago

Does anyone outside of prison really live in a place where they can not walk as much as they want in a given day?

Even in Alaska in the middle of winter... you can walk around your work or a store or something... seems like a bit much to worry about, no?

anu_gupta• 11 years ago

Can you name some cities where walking is illegal? Or even areas of cities where walking is illegal?

arkem• 11 years ago

Highways and streets without sidewalks or suitable verges.

trgn2• 11 years ago

I'm not certain about the illegal part, but plenty of urban development is very unpleasant to walk in. A lot of suburbs and a lot of city centers ravaged by urban renewal are plain repulsive, and even dangerous due to all the high speed traffic, to walk around in. It's easy to say for a doctor to "go walk outside", but not everybody can exit their front door in an area that's welcoming to walking or cycling.

anon42• 11 years ago

If the road outside your house doesn't have a sidewalk, like in most of America, then you live in a place where it's illegal to walk, since you cannot legally walk on the road. Though technically, you can still do laps around your house, as long as trampling your lawn doesn't impede on the local homeowners' association's rules.

indlebe• 11 years ago

There are fitness clubs and/or access to treadmills everywhere. No-where has any ever said "every-time I try to exercise normally I risk getting arrested" ever.

Tsagadai• 11 years ago

I think everyone has been overly harsh. While walking is not illegal almost anywhere it is nigh on impossible in many countries, for example the UAE. Walking may also be very, very dangerous to be out on the streets due to corruption, reckless drivers, crime, oligarchs, etc.

meggoirech• 11 years ago

Thats great. Yeah, there is a huge difference between saying, go exercise, and giving a prescripted regimen. Hopefully they can start having funded exercise programs in the community or based on the general prescriptions the doctors are giving.

CydeWeys• 11 years ago

It's so obvious it's amazing this hasn't already been a thing since the beginning of the obesity epidemic. Specific exercise instructions are more likely to be followed than a vague admonition to "exercise more". I wonder if gym memberships will be covered as care by health insurance plans? They're certainly a lot cheaper that hospital stays!

0xcde4c3db5• 11 years ago

I think the problem is that the implementation process -- creating an actual exercise program -- is quite non-obvious. As far as I know, the studies that have been done on the dose-response curves of various exercises have reached somewhat inconsistent results, except that they consistently show significant inter-individual variability for a given tuple of type, dose, and outcome measure (NB: they do not generally show a single unified axis of exercise super-responders and non-responders, a common interpretation of such studies in the news media).

For the general population not trying to optimize performance in a specific sport, the nuts-and-bolts business of "what exercise should I do?" is fraught with bargeloads of pseudoscience, tribal lore, magical thinking, fad-chasing, and actively-amplified marketing nonsense.

And then if, despite the atmosphere of uncertainty, you convince yourself to try something and it doesn't work for you, that method's dedicated acolytes will waste no time in telling you that you must be doing it wrong, must by lying about something, are just looking for excuses to be lazy, and so on.

It's not really an environment that's shaped for success.

Swizec5• 11 years ago

For the general population not trying to optimize performance in a specific sport,

Therein lies the solution. Pick a sport you enjoy, do it as many times a week as your schedule permits, but bend your schedule so it's at least twice.

Voila, 2+ hours of strenuous exercise per week.

Frozenlock2• 11 years ago

"It's so obvious it's amazing this hasn't already been a thing since the beginning of the obesity epidemic."

Why is that obvious? Because you think there's a link between being overweight and exercise?

Exercise does not promote weight loss. (You can do a quick google search if you don't believe it.)

The most important thing to influence weight loss is the nutrition.

On a related note, I find it borderline sadistic that we make fat people believe they are fat because they are lazy and don't exercise enough.

15155• 11 years ago

Exactly this.

Fat people are generally fat because of excess caloric intake. The amount of physical (aerobic) exercise needed to even burn off a can of Coke is incredible.

Frondo• 11 years ago

That is an odd, bold claim to make, that exercise doesn't promote weight loss.

I'm at something of a loss to explain how, without changing my diet, but with adding 30-50 miles of cycling (plus a little jogging) a week, I've been losing around 5 pounds a month for the last six months.

Honest question time: if it isn't the exercise, what is it?

nathanvanfleet• 11 years ago

So many gyms are predatory and it just plainly irks me that they ask for such a high price or a long period of membership. It is valuable but I don't think their costs are so high.

I would definitely join a gym if it was deductible or even paid for or had state run facilities. But I guess that's a little too much to ask.

eru3• 11 years ago

Go to the YMCA?

guiomie• 11 years ago

All that is missing now are doctors to give the prescription. (seeing a family doctor in Quebec is really difficult)

adrusi• 11 years ago

I'm not entirely sure who wins here. The prescription doesn't mean much aside from that insurance will pay fitness-related bills. But exercise doesn't have to cost anything. Even in the most unwalkable cities there's some place you can go to just walk around in.

And who wouldn't doctors prescribe exercise to. If someone comes asking their doctor for an exercise prescription so that they can get a free gym membership, there's no reason for the doctor to say no (save for cases where the patient has a heart disease or similar where regular exercise is inadvisable). Not only will it not hurt the patient, it'll in fact help them. It will also help the doctor as it will help present them as someone who listens to patients and it helps fill appointments.

If this becomes widespread, the result will be more expensive insurance (or in Quebec, higher taxes) and more expensive fitness programs.

x5n13• 11 years ago

It helps a lot to have a trainer. In fact we should be paying for gym and fitness trainers for pretty much anyone who wants it. The benefits are extraordinary especially in Canada where we all pay for everyone's healthcare.

Yes exercise costs nothing. But it is often repetitive and boring. And in Canada it's cold 1/2 the year so having some place indoors is very helpful and having it paid for is even more encouraging.

We need to make exercise free, fun, and with trainers that work with people. It needs to be like gym in school on days where the gym teacher didn't have a stick up his/her ass... for anyone at any age.

monochromatic• 11 years ago

It helps a lot to have a trainer. In fact we should be paying for gym and fitness trainers for pretty much anyone who wants it. The benefits are extraordinary especially in Canada where we all pay for everyone's healthcare.

This mindset that the government should be spending tax revenue on anything beneficial is bizarre.

WalterBright5• 11 years ago

The business model of a gym requires that 90% or so of the members never actually show up. The rates charged would have to go up enormously if they did.

An awful lot of garages have a treadmill in the corner buried under other junk, as the resident's good intentions to get in shape inevitably evaporated.

viraptor• 11 years ago

fitness trainers for pretty much anyone who wants it

Oh god, yes! I did not realise how much difference it makes. Even just having the time scheduled on the days you'd rather do something else is really helpful. But a person to actually tell you what to do, or just chat with you makes the whole experience N times less boring.

dr_• 11 years ago

Any doctor can prescribe exercise, including doctors in the US. You don't really need a lot of equipment, you don't really need gym membership. The issue is whether or not the patient will be compliant with an exercise regimen, and educating them on the importance of exercise and physical activity in general.

If the purpose of this is to allow exercise during the actual work day - that would be interesting, but would require the cooperation of employers or some type of federal regulation - in the US, maybe thrown under FMLA.

WalterBright5• 11 years ago

My dad's doctor once told him to lose the spare tire, and sent him to a nutritionist, who gave him a diet plan.

Some months later, he went back to the nutritionist for a checkup, and the nutritionist was shocked that he'd actually followed her plan. He became one of those unicorns who kept the weight off until he passed away 30 years later, though he complained that he was always hungry.

hueving• 11 years ago

though he complained that he was always hungry.

What a miserable way to live. :(

steven777400• 11 years ago

I've lost a couple dozen pounds through dieting and now am in the keeping it off phase. It's hard because it's not like making progress toward a goal, it's just being hungry all the time. I was less healthy but more happy when I just ate delicious pastry all day long. It's hard to maintain.

WalterBright5• 11 years ago

Depends on what you want. A friend of mine told me he had come to terms with being overweight - he said he preferred being overweight over what it took to be slim.

My father enjoyed his life, and preferred the benefits of being slim.

logicallee2• 11 years ago

nutritionist, who gave him a diet plan.
Some months later, he went back to the nutritionist for a checkup, and the nutritionist was shocked that he'd actually followed her plan

"I didn't mean it! You know usually it's just a formality. But, uh, keep up the good work."

spacehome• 11 years ago

The password policy includes not sharing it at the drop of a hat.

jasonlotito• 11 years ago

Considering all the problems the Quebec medical industry has at the moment, I still wouldn't trust Quebec with the care of myself or my family. It's such an abusive system.

stuxnet79• 11 years ago

In Ontario it's not that much better sadly.

Quebec doctors can now prescribe exercise

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