Podcast interview with Cleveland Clinic Chief Wellness Officer/RealAge author Dr. Michael Roizen (transcript)

This is the transcript of my recent podcast interview with Dr. Michael Roizen regarding the GE Better Health Study.

David Williams: This is David E. Williams, co-founder of MedPharma Partners and author of the Health Business Blog.  I’m speaking today with Dr. Michael Roizen, Chief Wellness Officer at the Cleveland Clinic and Chairman of the Wellness Institute there.  We’re talking about the results of the recent GE Better Health Study, which was conducted in cooperation with the Cleveland Clinic and with Ochsner Health System.

Dr. Roizen, thanks for joining me today.

Dr. Michael Roizen: My privilege.  Thanks for allowing me to join you.

Williams: What was the motivation for conducting the survey?

Roizen: GE, the Cleveland Clinic and Ochsner wanted to help Americans take ownership of their health and improve the relationship with their health care provider. We’d like to see healthy living become part of your daily life rather than an obligation or something difficult to do. We’re trying to find the barriers to healthy living, since 75 percent of our health care costs are caused by chronic diseases, which are totally preventable by our choices. This survey was the first step to find out what the relationship was with the health care provider and what the barriers to healthy living are.

Williams: The survey showed major differences between how health care providers view the world and how patients were thinking.  Can you tell me about some of those?

Roizen: The study included 1,000 health care professionals plus an oversample of 200 physicians, so 1,200 total plus 2,000 Americans aged 18 and over with extra people in Atlanta, Chicago, Cincinnati, Houston, and San Francisco.

The key findings were that Americans are fundamentally deceiving themselves about how healthy they are and whether they’re actually taking the right steps to stay healthy as well as their misappropriation of time and information gathering.  Physicians are generally dissatisfied with the role they get to play in health care and they feel they don’t have enough time.

Neither health care providers nor citizens were putting enough emphasis on the time they spend for healthy living, which will be needed to change things around and allow people to live healthier and with less disability.

Williams: The survey talked about how people often try to avoid the physician and also mentioned that when patients go to their physician or other health care professional that they sometimes lie or omit some critical health facts.  Do you have a sense of why that is?

Roizen: Let me give you an overview. Most patients gave themselves an A or B on their health care habits.  They give their neighbors –that is the rest of Americans– a C or a D.  Health care providers give Americans a C, D, or E and think their patients are deceiving themselves. So either Americans are in denial or they think they are doing healthy things and don’t have enough knowledge to do healthy things.

I’d like to think that Americans are trying to do healthy things.  We see it all the time with patients. They say, “I’m eating healthy” and then you ask them what they’re eating. Most of them don’t know what is healthy versus unhealthy and how to pick the healthy things.

Williams: Is that connected at all with the findings about whether patients know their health numbers?  They seem to think that health numbers like cholesterol or glucose levels are important yet they don’t know those numbers.

Roizen: Right. In other words when the physicians were asked what percent of their patients know their cholesterol, the physician said it was a much lower number than the patient said. When patients commented about their neighbors, most of them said their neighbors didn’t know.  Roughly 50 percent of patients thought they knew their cholesterol number, but only 12 percent did.  If you looked at blood pressure, it was much lower than that.

Actually physicians said about 12 percent of patients knew their cholesterol levels.  Most of the patients in fact thought their cholesterol numbers were more important than their blood pressure numbers, meaning they knew them better. But in fact blood pressure is a much more important number. So we don’t even know what is most important to know. And we don’t know those numbers, at least according to the physicians.

Body mass index is a very important number to know and so is blood glucose level, but less than 30 percent of Americans say they know those. In fact physicians and other health care professionals, when asked what percentage of their patients know it, it was under 10 percent who knew it. So again, a significant dichotomy.

Maybe we just aren’t emphasizing the right things in our conversations with patients.

Williams: I was reflecting on how the findings apply to me. Like everybody, I consider myself to be above average in health care knowledge.  However, I don’t know my exact blood pressure or cholesterol or BMI and I wonder: is it important to know the exact number or just to know what range you’re in qualitatively?

Is part of the challenge that the numbers may change a bit over time and also that they’s not so intuitive?

Roizen: The numbers aren’t intuitive and they do vary.

Your blood pressure is the most important number to know.  It should be 115/75. I realize your question wasn’t about this, but your LDL, your “lousy” cholesterol –I remember it by the first initial– should be less than 100.  Your HDL, “healthy” cholesterol should be over 50 and your triglycerides, TG, should be under 100.  So you’ve got to remember 150 for the lipids. Your glucose should be 100 or less and your blood pressure 115/75 but most of us don’t know those.

The important thing is that it is not hard to work these into your daily schedule, but patients said that the leading thing blocking them from doing healthy things was in fact not knowledge but was time.  The physicians thought it was both knowledge and time.  In other words the physicians feel that they don’t have enough time to talk to the patients, but the patient said that their leading problem was finding the time to exercise. Only 26 percent said the problem was finding the time to eat right.  In fact you probably can work these things into your daily life if you know how important it is.

Williams: I assume that the survey didn’t get at this, but how do health care professionals do when they are patients?  Do they exhibit better habits or do they fall into some of the same habits as those who are less educated medically?

Roizen: I can’t get that from the survey as you said, but at the Wellness Institute of the Cleveland Clinic we have an executive health program and we see around 1,400 physicians.  I’m sorry to say this, but most of the physicians don’t know what healthy eating is or what the minimum exercise is for maximum health gain.

We teach a cooking class for physicians. The interesting thing is when we get the physicians in our cooking class, 85 percent of them don’t even know how to hold a knife correctly, which is true of all Americans between 20 and 40.  One of the keys in learning how to eat healthy fruits and vegetables is learning how to cut the fruit and vegetable. Most people don’t know how to hold a knife to cut efficiently and safely.  So we’re at a basic level where our physicians –I don’t mean just Cleveland Clinic physicians but the physicians we see and we care for– don’t know their vitamin D levels, don’t know their blood pressure, don’t know their body mass index and give themselves much better grades just like normal Americans do on their health choices than they deserve.

Williams: You mentioned what’s going on at the Clinic.  Are there programs in place that are accessible more broadly that address some of the issues that were raised by this research?

Roizen: Sure, on the iVillage site there are programs. Although iVillage is a site that is directed at women, there are programs there for both men and women that get at stress management. There is a program that gets at what foods to eat. All those programs are available on the iVillage site.

You can also go direct to a Cleveland Clinic site rather than through the iVillage site, but the iVillage site is a wonderful site because it answers questions and provides more material.  The Cleveland Clinic direct site for this is www.360-5.com and you can access those programs for stress management.  It’s an eight-week program that teaches you how to manage stress and another eight-week program that teaches you the basics of nutrition and cooking and then gives you a whole bunch of recipes and exercises to try each week for great tasting food in under 30 minutes.

Williams: Dr. Roizen, this has been very informative.  Are there other points that you would like to make this morning?

Roizen: The only other one is that we really can control our quality of life and our health. You aren’t condemned to the history of your family. In other words if your mom had breast cancer, you may have the genes for it but whether you turn those on or not is your choice.

If your father had prostate cancer or your father had heart disease or Type II diabetes you may have the genes for it. But whether you express that, whether you turn those genes on or not are to a large degree your choices in lifestyle. Your lifestyle choices: food, physical activity, management of stress, smoking or smoking cessation –even secondhand smoke– govern which of those genes are on to a great degree.

So you get to influence your quality of life a huge amount. Anyone who reads this, they’re probably more interested in health than not, they can change their family history if they want to.

Williams: I’ve been speaking today with Dr. Michael Roizen, Chief Wellness Officer at the Cleveland Clinic and Chairman of the Wellness Institute.  We’ve been talking about the recent GE Better Health study.

Dr. Roizen, thank you very much.

Roizen: Thank you so much.

April 8, 2010

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