“Do as I say, not as I do,” may work well when counseling a recalcitrant child, but it’s a poor strategy when attempting to change adult behavior. So, using the principle of leading by example, Robert Wood Johnson Foundation (RWJF) Clinical Scholar (2009-2012) Lenard Lesser, MD, is advising physicians, and other medical professionals, to take an active, more public and personal role in encouraging health eating habits.
“Like all physicians, I’ve trained at many institutions and attended many meetings,” explains Lesser, a family medicine physician at the Palo Alto Medical Foundation Research Institute. At those venues, he notes, you seldom see healthy fare. That may seem like a small point, but physicians attend a staggering number of Continuing Medical Education (CME) seminars, grand rounds sessions, annual meetings, academic seminars and medical conferences during their careers.
“Yet, even when you try to negotiate with a caterer or hotel for healthy foods, you have very little wiggle room,” Lesser says. “They are going to put out soda because that’s what they have.” As any business traveler can attest, those sodas are usually stacked on snack tables laden with warm cookies, brownies and chips. Diners at hotel banquets are also likely to find themselves eating meals doused in cream sauces and finished with cheesecake, or other high-fat fare.
“Medical professionals should talk about these catered and hotel meals, as well as the food in many hospital cafeterias and conference centers,” Lesser advises. “If we were to get together and stipulate some basic standards for healthy foods served at medical gatherings, we might not only improve physician eating habits, we could encourage caterers and hotels to have healthier fare on hand for everyone.”
Lesser asserts that putting the power of the million-dollar medical meeting industry behind a push for healthier eating would bring change. “Just imagine, for example, if the American Heart Association or American Medical Association said to hotels, ‘you cannot host our meeting unless you meet our basic healthy eating standards.’ That would lead to the creation of a menu of broader choices. In addition, this is money from the health care system that is being spent in meeting venues. That money should be spent on healthy food, not soda.”
Lesser’s essay on the topic, “Changing Eating Habits for the Medical Profession,” published in the September 12 issue of the Journal of the American Medical Association (JAMA), is a follow up to earlier work, funded by RWJF, on the quality of food in children’s hospital cafeterias on the west coast. His study, “Assessment of Food Offerings at California Children’s Hospitals,” was published in the journal Academic Pediatrics in January 2012.
Through his body of work, Lesser has concluded, “unhealthy food is common in all of these environments, yet as physicians, we spend a great deal of time trying to get people to eat healthier. So it seems appropriate to me that we would get involved in encouraging the availability of more nutritious foods.”
Physician Slim Thyself
Of course, Lesser is not suggesting that catering managers and cafeteria staff take all of the responsibility for the examples set by the medical profession. Recent studies show, for instance, that roughly 40 percent of physicians are overweight or obese. “Research also shows that overweight doctors are less likely to counsel their patients about the need to maintain a healthy weight,” Lesser says.
Therefore, the other important way that medical professionals can make a difference, Lesser explains, is by setting the proper example in their own lives. “Years ago, physicians were pressured to stop smoking in hospitals,” Lesser says. “Today, I think they should stop drinking soda while making rounds.” Acknowledging the difference between the dangers of passing along second-hand smoke, compared with the sight of a doctor swigging sugar-sweetened beverages, Lesser adds, “I still believe setting a healthy example can make a difference in patient behavior.”
To help bring about change, Lesser has a few suggestions to get things rolling:
▪ Tell the truth: “I’d like to see calorie labeling at conferences and meetings on the buffets, in conference center kiosks and other settings. And it should be nutrition information that provides information such as, ‘this dish has two servings of vegetables. You need to eat five to seven servings a day,’” he says.
▪ Cut the sugar: Beverages sweetened with sugar should not be served. “They are just liquid candy and we don’t need to have them during meetings,” he advises.
▪ Create guidelines: “I would like to see the major medical organizations get together and come up with healthy food requirements for their meetings. These would be solid standards that caterers or hotels would have to meet in order to host the meeting,” he says.
Lesser used his protected time as an RWJF Clinical Scholar to complete his JAMA essay and he credits RWJF Clinical Scholars program mentors Bob Brook, MD, ScD, and Debra Cohen, MD, MPH, with helping him shape his discussion. “They knew about my interests, so they talked with me, as did other Clinical Scholars, about how to frame these questions and approach this work.”
While Lesser realizes that bringing about a large shift in public behaviors is always an uphill battle, he adds, “I still think it will help to do every little bit that we can to bring about change. And that means that we should be eating the way we want our communities and patients to eat as well.”
The Robert Wood Johnson Foundation Clinical Scholars program advances the development of physicians who are leaders in transforming health care through positions in academic medicine, public health and other roles. The program trains clinicians in the program development and research methods that will enable them to find solutions to the many challenges posed by the health care system, community health and health services research.
▪ For an overview of RWJF scholar and fellow opportunities, visit RWJF Leaders.org