CHAPTER 9:  Working with Physicians

Advantages to Having Physician Involvement

A Local Wellness Organization’s Role in Involving Physicians

Physicians’ Press Involvement

CHAPTER 9 Appendices

Advantages to Having Physicians Involved

Physicians are a key component in any wellness change and they can play a key role in the success of a walking campaign.  From Judi Hladek, BS-Ed, CPT, TWBCC, and President of The Wellness Bridge, a WHEELING WALKS partner organizations, here are the 8 top reasons to involve physicians in your walking campaign:

1.  People will take their physicians’ advice, especially if it is written in the form of a directive or prescription.  Also, the stronger the language the physician uses, the better the chances that the patient will comply.  That is, if the physician "suggests" that a patient try walking ten minutes a day, three times a day, the patient will not be as diligent in following the advice.  Another example is a physician saying, "You need to lose some weight".  This comes through to the patient as a suggestion, not as a prescription, so, in most cases, the patient will not comply.  However, if a physician gives a patient a specific directive, such as, ‘I want you to walk ten minutes a day, and journal your progress daily over one month; then I want you to make another appointment to see me,’ this is now a specific prescription with the time and the number of times the patient needs to walk.

The more assertive a physician is with a patient in regard to advising walking, the more likely it is that the patient will compliant.  In this way, the prescription pads play a crucial role in a walking campaign.

Follow-up visits with physicians are also essential so progress can be monitored and a walking prescription updated.  Vital functions such as blood pressure, pulse rates, lung capacity, cholesterol levels, etc., change, therefore, medications may need to be modified as well.  Also, because of the lifestyle changes with increased activity levels from a prescription for 20 minutes of walking every day, this can possibly be changed to 30 minutes of walking every day. 

Ultimately, as a patient’s fitness level improves and s/he sees the improvement and feels better, s/he is more likely to continue a wellness walking program, even after the campaign ends.  This is ideal.

2.  It is vital that physicians are involved with a walking campaign to ensure that some people do not get themselves caught up in the advertising of the campaign and end up injuring themselves.  Physician can evaluate a patient’s health status to specifically direct how far and how often s/he should walk to keep safe and healthy.

3.  Normally, the people who pay attention to a wellness campaign - and WHEELING WALKS is no different - are those people who probably are already involved in some types of wellness habits.  By involving physicians, we now reach more of the community’s population, such as the sedentary or inactive people with no interest in a fitness or wellness program.  Sedentary/inactive folks may make fun of wellness advertising.  However, when their physicians take the initiative to direct them with a specific exercise prescription, they will pay attention. 

4.  One of the best scenarios is when a physician joins patients in a walking activity, and show that his/her endorsement is not just lip service.  (WHEELING WALKS  held  walking activities throughout the Wheeling area all during the campaign gaving physicians such opportunity to participate with their patients.) 

5.  Physicians’ active involvement in walking lends extreme credibility to the program.  They are not just talking the talk.  They are walking the walk.

6.  The advertising that took place during the campaign (i.e., television, radio, newspaper ads, community seminars) accentuated the physician’s role in their patient’s wellness.  Physicians therefore felt responsible to their patients to get involved. 

7.  The more physicians are actually involved, the more successful the campaign will be.  Their involvement capped the success of the campaign. 

8. A dramatic side effect for the physician is that they can be pro-active with their patient’s lives instead of reactive to disease.  This becomes an upbeat time in the physician’s day. 

A Local Wellness Organization’s Role in Involving Physicians

Personal contact is vital in getting physicians to take the campaign seriously.  Also, a community that is going to start a walking campaign needs to work closely with the different wellness organizations in their community.  Finally, the wellness organization that works directly with local physicians needs to be well respected by the community’s physicians. 

Ms. Hladek noted that WHEELING WALKS dovetailed perfectly into The Wellness Bridge mission.  A total wellness program within the Wheeling area, The Wellness Bridge emphasizes lifestyle change, including proper nutrition and exercise, and teaches the value of connecting health to life. 

Consultants within The Wellness Bridge planned and organized methods for reaching local doctors (see Appendix 9-a). They then implemented their plan and both delivered and explained the campaign’s educational materials to local physicians: 

(1) a Patient Information Sheet for the doctors to give to patients to encourage    them to walk,
     including a log sheet to record the minutes and miles walked daily (Appendix 9-b) .

(2) Prescription Pads with 50 prescriptions (Appendix 9-c).

During the length of the campaign, The Wellness Bridge consultants periodically visited the physician’s offices to replace any supplies that were needed.  At this time they also ask how patients were responding to the campaign.

The visits communicated that the campaign had a serious and long-term message. They were also the “push” physicians needed to begin and to continue prescribing walking.

Physicians’ Press Involvement

As detailed in Chapter 7, a special campaign media event--the Physician’s Press Conference--was devoted to both involving and honoring local physicians.  Many were most willing to participate when asked and key to making the event possible was the advance organizing.  As very busy professionals, physicians would not be able to take the time to organize such an event, however, having everything prepared so they can essentially walk on and off the stage with few other responsibilities, makes it possible.

See Chapter 7 for details.

Appendix 9-a

Plans for Reaching Local Physicians

Wellness Bridge Planning for Reaching Local Doctors

Several weeks before the campaign was to begin, we had several meetings outlining the procedures we would follow as well as the deadlines we would need to meet.  We received a number of materials to begin our journey of the eight-week campaign.

Some of the items we received were:

          1.   Canvas carry bags with the campaign logo.

2.   Water Bottle(s)

3.   Tee Shirts with the campaign logo.

4.   Hand-out materials to be studied.  (These materials were very important because they were
      very informative and detailed.)

5.   Prescription pads.

6.   A sample of the Physician Packet, which included:  

a.   Pocket Folder with the campaign logo.
b.   Set of prescription pads.
c.   Log Sheets (Walking Diary)--along with the prescription, the physician would give
      the patient a eight-week log sheet so they could record their walking time.  These
      sheets would then be turned into the campaign at the end of the six weeks for the
      over-all community tallies.

7.   All of the above materials for the physician packets were given in bulk to The Wellness
     Bridge during this meeting.

8.   A list of all area physicians, including their addresses and telephone numbers, was given to
     the Wellness Bridge organization.

The first step in organizing for the campaign launch was to put together all of the physician packets.  We had the materials needed for each packet several weeks before the campaign actually began, so there was enough time to get them compiled.  We mapped out a time line of meetings so we could successfully complete our task:

TIME LINE

Meeting #1 - 2 Hours 

1.   Talked about the strategy we would use for the distribution of the physician packets and what our
      introduction would be when going to the physicians’ offices.

2.    Organized the packets so we could begin putting them together.

3.   Went over the physician list, separated it into groups, and assigned each of us a physician group
      list to contact.

Meeting #2 - 2 Hours

1.   Continued putting the physician packets together.

2.   Went over the procedure we would follow when presenting the materials to the physicians.

3.   Procedure used in Wheeling:

       a.    Introducing ourselves to the "Gate Keeper".

       b.   Presenting the material.

       c.   Shaking the person’s hand at closing.

       d.   Before going to another office you need to document what took place. We used one physician
             list and made notes beside each physician’s name.  This step is very important!

       e.   You also need a list of the physicians that were not in at the time of distribution. You will never
             remember once you start, and it could be very embarrassing to the campaign if a physician is
             left out.

        f.   Make sure you find out the hours of the physicians’ offices that were closed, so you can return
             within a couple of days.

Meeting #3 - 2 Hours

1.  This was a role playing meeting where we walked through the introduction and

     closing procedure.  We played with situations like:

--- Happy and receptive Gate Keeper.
--- Stern Gate Keeper.
--- Physical contact
--- Busy office.
--- Not interested Gate Keeper.
--- Gate Keeper refusing material.

2.  Practice documenting the situations.  This was a very important meeting because your group needs to be consistent.  May I stress that documenting each meeting is very important.  It helps with future meetings as well.  We were ready for the campaign to begin.

Meeting #4 - 2 Hours

Took place the 2nd week of the campaign.
During this meeting we did a check to make sure all of the physicians were contacted, and discussed the physicians’ responses to the WHEELING WALKS Campaign.

Don’t be alarmed if you are not received with open arms in the physician’s office. The ”Gate Keepers“ guard carefully.  You need to win the Gate Keeper over.  Just understand that some will not be won over. The word is "Next!"

Meeting #5

Took place at the end of the third week of the campaign.

During this meeting additional physician’s prescription pads were distributed to the consultants of The Wellness Bridge so they could follow-up with the physicians they had contacted during week #1 of the campaign.  Also, each consultant received one poster for each physician’s office.  These items were delivered to the physicians during week #4 of the campaign.

The response from some of the Gate Keepers and physicians was more receptive our second time through, than it was the first.   Actually, many said they were walking and keeping their own logs.  They were very excited about the posters, many of which are still hanging in their offices.

We remained alert for any physicians that may have slipped by unnoticed, but still may have needed information about the campaign, such as new physicians to the community who were not on the original physicians list.

During week 5 and 6 of the campaign we checked-in with the various physicians on their need for additional supplies.
 

Appendix 9-b

Patient Information Sheet & Walking LOG
-Assisting Your Patients Toward Better Health

Walking Program for the Sedentary Adult

Check with your physician if you have two of the following risk factors: diabetes, high blood pressure, high cholesterol, family history of heart disease, over 50 years of age, chest pain or pressure. 

WALKING TIPS

Do it out your front door.  There is no travel time.

Call a friend to join you.  The time will pass more quickly, and you are more likely to not miss your appointment.

Stretch for three minutes when you finish.

Drink a glass of water before you start and another upon completion.

Listen to your body.  If you have any extraordinary aches and pains, take an additional day off.  Check with your physician if the pain lasts.  If you have chest pain, call your doctor immediately.

Treat yourself to a good pair of comfortable shoes

MY WALKING LOG:

                                                                                                         Total miles:      ______

Note: Under how it felt, put E (easy), M (medium), or H (hard).
Shoot for variety during the week, and try not to have two Hard days in a row.

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Appendix 9-c

Prescription Pad

 

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