What the Doctors Do

It's no surprise when your doctor encourages you to have a healthy lifestyle, but it's also not always pleasant. You've tried living healthy and you know it's hard to do. Confronted with your own past failures, you may begin to wonder if your doctor really practices what she preaches. Sorry, but the chances are that she does. A survey of primary-care physicians several years ago found that doctors who regularly get aerobic exercise are more likely to counsel their patients about its benefits. We wouldn't want it any other way. Fair or not, people still hold doctors to high standards. Maybe it goes back to "physician, heal thyself": if you are going to tell me what to do, for goodness' sake, you'd better do it yourself.

The Harvard Health Letter surveyed the Harvard Medical School faculty about their health habits a couple of years ago. As with all volunteer surveys, the results were probably a bit skewed toward the virtuous; people who have good things to report about themselves and their behaviors are more likely to fill out such surveys. The 2,000 or so correspondents had impressive eating habits, for example, and only a tiny percentage (1.9 percent, or a total of 39 faculty members) smoked.

They also reported admirable amounts of exercise. About 46 percent said they exercised three to five times per week, and 12 percent said they did so more than six times. Plain old walking (35 percent) and jogging (24 percent) were the most popular forms of exercise, but the "other" category (17.4 percent) was large.

Does all that sound too good to be true? Well, in a recent round of interviews, there were some Harvard doctors who confessed to dreading the sight of a treadmill or StairMaster. "I hate to exercise. It bores the pants off me," said one adamant physician (he didn't want his name used). Several female physicians said job and child-care responsibilities crowded out exercise until their children were older. "I didn't feel entitled to something that was purely for me—plus not liking it much anyway," said Dr. Jo Shapiro.

Some of the doctors seem to find stick-to-it-iveness by getting up at the crack of dawn. But others struggle to find the time and the psychic energy—given the demands of their work and family. Physicians like to be role models, said Dr. Susan Pauker. "But our ability to make excuses is as good as anyone else's."

Paula Johnson
The iPod helps. Her 11-year-old son, Jonathan, has loaded hers with some Brothers Johnson, Stevie Wonder and James Taylor. The stack of unread New Yorkers also helps; she works her way through them when she's on the treadmill. Because it's definitely not natural athleticism that gets Dr. Johnson out of bed most mornings by 5:30, so she can spend about 40 minutes exercising before the day really gets going. "No, no, no. Absolutely not," she protests. "I am not an athlete. This is about my general health—and weight control." A nice side effect: good modeling for her two children. Other equipment in the study-slash-gym in her house includes a NordicTrack, free weights and those stretchy exercise bands. Perhaps because exercise doesn't come naturally to her, Johnson seems especially aware of the problems that patients face. Her No. 1 piece of advice: have a plan. "People have very busy lives. If you don't have a plan for exercise, you probably aren't going to do it." And No. 2: be ready to deviate from said plan. "If on any given day the plan isn't going to work, try to squeeze in some exercise. If you don't have time for a full 40 minutes, then 20 minutes might be just fine. Flexibility is very important."

Diana Post
"I would much rather be reading a book. I am one of those!" says Dr. Post with a laugh. But for now, she's spending a lot of time spinning her wheels. Seven days a week, five of them at about 6 a.m., Post is at her neighborhood gym, huffing away along with other devotees of indoor cycling, the knee-sparing alternative to aerobics. "Spinning is now part of my life," she says. "If I travel somewhere, I look for a place to take a spinning class." The zeal of the conversion is tempered by good humor. The endorphins, the "runner's high" that is supposed to turn the pain of aerobic exercise into pleasure—it never comes. "All I get is thinking, How many more minutes do I have to go?" Her spin mates "all look like they're about 18 and wear lots of spandex." Still, Post says she does feel better overall and is happy that she finally has time to exercise. Her husband, a Harvard hematologist, is an avid runner. Post jokes, "I took care of the kids while he was running!" When she talks to patients about exercise, she wants them to be realistic about turning svelte. "I don't tell them that they'll lose weight, because I haven't lost weight. You feel better if you exercise, but the pounds don't just melt away. I think you also have to go on a diet to lose weight."

Jo Shapiro
Ear, Nose and Throat Specialist
Dr. Shapiro says she was a really active, athletic kid—skiing, water skiing and tennis kept her busy. But once she hit medical school, the sports stopped and the exercise never got started. Taking classes, joining gyms and health clubs—forget it. The only exercise was in futility. Even if she liked to run or lift, the guilt-limned, zero-sum schedule of a working mother was in the way: "I didn't want to take time away from my kids." But Shapiro's children are older now, and she's discovered that exercise is at least tolerable if a personal trainer comes with it. "I know—a personal trainer. It seems so bratty and so expensive. But I have tried so many different things." For an hour a week, she gets one-on-one help with Pilates and other sorts of exercise. She also does a lot of walking on the job and makes a point of walking about 40 minutes on Saturday and Sunday. Her physical-activity level is up, her guilt level down.

James Richter
Internist and Gastroenterologist
If Dr. Richter were ever to give up medicine, he could always open a gym. A partial list of the equipment in his basement: a treadmill, an elliptical trainer, a StairMaster, a stationary bike, a NordicTrack, free weights and a Universal. His "baseline program" includes running four to five miles most days of the week and lifting weights for one hour on two days. That keeps him in shape for the fun stuff: twice-a-month sessions at an indoor rock-climbing gym with his son, outdoor climbs several times a year, tennis games with his wife, hikes in New Hampshire's White Mountains and out west, the occasional sprint triathlon. At 5 feet 10 and 155 pounds, Richter's got a BMI of 21, which most of us can only dream of. Always an athlete, he credits his parents with instilling in him a love of physical activity and being outdoors. He emphasizes the value of weight training to patients, telling them that it's the way to increase your metabolism as you age, which helps keep the weight off. But otherwise, he includes a healthy dose of hedonism in his pep talk: "The most important thing is to find something you enjoy, or you're not going to do it."

Graeme Steele
For many of us, exercise is a sweaty, labored means to an uncertain end. Then there are those like Dr. Steele, who runs (and runs) for its own sake: "To me, it is the key to life." He was drawn to long distance as a boy in his native South Africa, knocked off his first marathon when he was 19 and figures he has run 49 of them since, including last year's New York City Marathon. Steele refers to them as "standard marathons," because he's also run an ultra version—the legendary 56-mile Comrades Marathon from Durban to Pietermaritzburg in his native country—five times (best time: eight hours, eight minutes). Knees are the Achilles' heel of most runners, but his have held up: Steele has never been injured. He's cut back some, so he now runs just three times a week, although that includes two runs of 10 to 15 miles on the weekends through some woods near his home in suburban Boston. His preferred companions are his two vizslas: "Just me and the dogs, and that's it."

Susan Pauker
"Tai chi makes people think of something that is done at 5 a.m. in a city park, and they don't want to go there," says Dr. Pauker. Neither does she. But Pauker does think that some elements of the martial art can be incorporated into daily life and possibly help patients with posture problems. She started doing tai chi about 10 years ago. The antiquity (the roots of tai chi go back 2,000 years) and having "positive control over my body" strongly appealed to her. She's taught a few tai chi techniques to young people with Marfan syndrome, a connective-tissue disorder that affects bone growth and posture, among other things. She herself doesn't do the "whole form," which requires a great deal of training and practice, but finds spare minutes for applying small pieces of tai chi. "In the elevator, instead of slumping against the wall, you can use that opportunity to stand up straight, bring the shoulders down and back, the head up, the belly and buttocks in," she says. "You can feel the power. It feels so straight compared to the way we're usually crouched over a computer or bent over a table."

I-Min Lee
Dr. Lee grew up to be one of the world's foremost experts on the health effects of physical activity (177 studies published and counting, although not all are about exercise). But there was little in her childhood in Malaysia that was conducive to her becoming a paragon of exercise virtue. Like many parents there, her mother and father encouraged her to hit the books and not "waste" time on exercise. And the heat and humidity in the tropical Asian country are enough to make you sweat without moving a muscle. Lee says she changed when she started presenting and publishing her research. "People would come up to me at conferences and want to know what I do." Now she runs 15 to 20 miles a week and lifts weights five days a week at a gym next door to where she works. Weekends are for fun: skiing, hiking, walking, Rollerblading and other activities "that I don't have to do out of a sense of duty." Lee, whose studies have documented myriad benefits of exercise, mentions one that's little known: even if you're only 5 feet 2 like her, brawnier arms mean you'll be able to heave your carry-on luggage into the overhead bins on airplanes on your own. There's also immunity from charges of hypocrisy--if you happen to be an exercise researcher. "I do fully satisfy all the current recommendations for exercise," says Lee with a laugh.

Donald T. Reilly
Orthopedic Surgeon

Exercise? Not Dr. Reilly. Not enough time. And when he gets home late, sometimes after being on his feet much of the day in an operating room, he's bushed and "pretty much want to go to bed." So far, he hasn't paid any noticeable price for his treadmill truancy. He figures that "genes ... and not smoking" will continue to keep him mainly out of harm's way. But is he inactive? Orthopedic surgery can be quite physical, even if it's not aerobic and doesn't constitute weight training. Moreover, during the warmer months Reilly spends long days out on his fishing boat, muscling tuna, mahi-mahi and the occasional marlin onboard. "On a boat, you're moving all the time," he says. Reilly goes on about 10 intense, weekend-long trips a season. Besides the benefits of reeling the creatures up from the depths, think of the healthful omega-3 fats in his catch. With a little soy sauce and wasabi, he sometimes eats them raw right there on the deck.

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