The Key to Behavior Change

Coming up on this week's episode of the Doctor's Pharmacy.

Everybody knows that they shouldn't be smoking a lot, drinking a lot, they should get some sleep and they should exercise. So are they not doing it because they don't know? Of course not. They're not doing it because they don't know how to change and they don't.

Have the support that they need to change. Hi, I'm Kaya Perowit, one of the producers of the Doctor's Pharmacy podcast. Every day, doctors recommend that their patients implement lifestyle changes, yet this rarely results in altered behavior. In this mini episode, we explore why this is and what is really needed for individuals to implement change. Let's turn now to Dr. Hyman's recent conversation with functional medicine practitioner Chris Kresser.

The average visit with a doctor is 10 to 12 minutes. Some say now with new residents, now it's as low as eight minutes. That's barely enough time to say hello and write a prescription. It's certainly not enough time to talk.

About diet, lifestyle and behavior change. And the other problem is they don't let you talk.

Like the average time before you get interrupted is 18 seconds. Yeah, 18 seconds, 12 seconds, I've seen that. Yeah, because they're not, because That's not, it's just what's the symptom? What drug can I prescribe to suppress that symptom? And so, you know, I realized that most healthcare is self-care. As you said, like at least 80%, if not 90% of healthcare really happens outside of doctor's offices, even a functional medicine doctor's office. So, you know, a patient might come see me three or four times a year, but the other 99.9% of the time- They eat three times a day. They eat three times. Yeah, exactly. They sleep every night. They sleep every night and have to manage their stress and deal with all that stuff. and behavior change is hard. That is the reality. And we know this because according to the CDC, about 6% of Americans consistently engage in the top five health behaviors. And we're not talking about complex stuff like intermittent fasting and keto cycling. 6%. So these behaviors are maintaining a healthy weight, not smoking, not drinking excessively, getting Enough physical activity and getting enough sleep.

Okay, you and I are hopefully in the 6%.

6%. So, and Mark, it's not because people don't know. There is a lot of controversy over paleo vegan, all that. There's not a lot of controversy about those five things.

Well, we know from the science very clearly that friend power is far more powerful than willpower to create behavior change. And we talked about this, but I created this faith-based wellness program in a church where we got 15,000 people to lose a quarter million pounds in a year and get healthy. It wasn't a weight loss program, it was a health program. And they did it in small groups with each other, without a health coach, without a nutritionist, without a doctor. But use the power of love and each other and connection and accountability and feedback and support. which is exactly what a health coach does.

Absolutely.

So it's, Rick Warren said it best. He says, Everybody needs a buddy. So your health coach is your buddy. And the science supports this.

Hands down. Hands down. It's evidence-based.

The same thing with health coaching. You don't have to be a PhD in nutrition or a doctor or have extensive knowledge, but if you understand the operating system, of what we're teaching. That's what happened in the church. We provided the content, the IP, the operating system, and then it was easy for them to implement it.

Yeah, and in fact, that kind of expertise can often get in the way because health coaching is not about telling people what to do. That's the expert approach that comes out of the conventional medical field. And there's a place for that. If I break my arm, go to the doctor or the hospital, and they tell me what to do, I'm going to, you know, I'm going to listen to that and I'm going to do that because it makes sense in that scenario. But telling people to how to change what to do to change their behavior doesn't work. I mean, look, like, yeah, do you like to be told what to do? I don't like to be told what to do. Most people don't like to be told what to do. We have this natural inclination to resist. Yeah. And health coaches, when they're properly trained in these modalities like motivational interviewing and character strengths, positive psychology, goal setting, accountability. They become what we call behavior change ninjas or change agents. They are experts in asking powerful questions, helping people to discover their own motivation for change.

The why.

Yeah, the why.

Having external support to identify the reason behind why you would want to make lifestyle improvements can be tremendously transformative. Dr. Hyman further spoke about the powerful role of community in promoting health with family physician Dr. Sean Lucan.

That was the most striking thing that you said today for me was you are dealing with some of the most sick and disadvantaged people in this country, and they want to get better. They want to do the right thing. They want to make healthy choices. They don't know how they can't get access, and they aren't aware of what to do.

And one of the other things I didn't mention that we do in our clinic is group visits. And the nice thing about a group visit is you don't need community health workers. You create a community of patients and patients learn from each other and everyone knows something and everyone contributes to the group.

So true.

And so you get that group think or that group knowledge. Very powerful. And then you can have group successes and you build those groups and then they translate to broader changes, broader cultural, community, cultural societal changes.

Families, yeah.

Yeah. So and that's another part of the solution, I think.

Yeah, we do that at Cleveland Clinic and what we're finding is that people who are in the group have far better outcomes and medical outcomes than the ones doing one-on-one visits with the doctor.

Absolutely, well, because there's value in social support. There's value in recognizing you're not the only one. There's value in learning from your peers. There's value in having that support network.

I always say community is the cure and group is the medicine.

Dr. Hyman always says getting healthy is a team sport. By fostering community and connection both in and out of the doctor's office, we can make massive change. To build and strengthen community connections in your own life, Dr. Hyman recommends the following. First, start an accountability group with your friends and family. Whether you meet up for tea or coffee once a week or hop on a group call, an accountability group is a great way to talk about your goals and challenges. Next, you can also join an online community. In this digital age, there's an opportunity to meet people from all over the world. Finally, start your own Meetup. Services like meetup.com offer a great way to build community. Whether it be a book club, cooking group, or a fitness group, there's a community for everyone. Thanks for tuning in to this week's mini episode of the Doctor's Pharmacy. If you enjoyed this episode, please consider.

Sharing it with a friend.

Thanks for tuning in. Hi everyone, I hope you enjoyed this week's episode. Just a reminder that this podcast is for educational purposes only. This podcast is not a substitute for professional care by a doctor or other qualified medical Professional. This podcast is provided on the understanding that it does not constitute medical or other professional advice or services. If you're looking for help in your journey, seek out a qualified medical practitioner. If you're looking for a functional medicine practitioner, you can visit ifm.org and search their Find a Practitioner database. It's important that you have someone in your corner who's trained, who's a licensed.

Healthcare practitioner, and can help you make.

Changes, especially when it comes to your health.

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