The 30 Second Annual Checkup?

Authored by IHRSA

“I don’t have enough time” is probably the most common excuse for not exercising, which is one of the reasons why the 7 Minute Workout has become a fitness sensation for individuals healthy enough to participate. 

According to the NY Times, the 7 Minute Workout “fulfills the latest mandates for high-intensity effort, which essentially combines a long run and a visit to the weight room into about seven minutes of steady discomfort — all of it based on science.”

And since the 7 Minute Workout requires nothing more than a wall and chair to complete, it goes a long way toward eliminating barriers to exercise on those days when a trip to the gym or local bike trail are out of the question.

I’m wondering if the concept of the 7 Minute Workout – condensing the elements of a program to maximize efficiency for time strapped individuals – could be applied in the primary care setting.

How about a 30-Second Annual Checkup?

Just the following two questions…

  1. In the last 7 days, on how many did you do moderate to strenuous exercise, like taking a brisk walk? 
  2. On the days that you engaged in moderate to strenuous exercise, how many minutes, on average, did you exercise at this level? (Based on the “exercise vital signs” developed by Kaiser-Permanente.)

 …and an appropriate exercise prescription.

Now, let me be clear. I am not a doctor and I am totally unqualified to be discussing medical protocol. But given a situation where a physician has a very limited window of time to gather information and provide feedback to a patient, is it unreasonable to think that physical activity should be the first topic of discussion?

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Consider the list of health benefits associated with regular physical activity:

  • Lower risk of early death
  • Lower risk of coronary heart disease
  • Lower risk of stroke
  • Lower risk of high blood pressure
  • Lower risk of adverse blood lipid profile
  • Lower risk of type 2 diabetes
  • Lower risk of metabolic syndrome
  • Lower risk of colon cancer
  • Lower risk of breast cancer
  • Prevention of weight gain
  • Weight loss, particularly when combined with reduced calorie intake
  • Improved cardiorespiratory and muscular fitness
  • Prevention of falls
  • Reduced depression
  • Better cognitive function (for older adults)

The list covers nearly every condition that might be addressed during a standard checkup. I understand, of course, that a checkup or wellness visit must be longer than 30 seconds and much more comprehensive than just two questions about fitness. But, here’s what I don’t understand: Given all we know about the benefits of physical activity, given the overwhelming time restraints that require overworked physicians to maximize a very brief time with their patients, and given that the topic of physical activity can be covered in just 30 seconds during a checkup, why do so many checkups not include any physical activity questions at all?

What do you think? Why don’t more doctors talk about physical activity?