SECTION 4 – The role of physician health and the physician´s personal
health
Question 1 (1 point)
A 52-year-old physician with type 2 diabetes who was sedentary and
smoked 10 cigarettes per day had a heart attack 3 years ago. Since then,
he has adopted a plant-based diet, quit smoking and walks 30 minutes
daily. According to the literature, which of the following changes is
expected in his current approach to medical practice compared with 3
years ago?
Question 1 options:
a. More emphasis on scientific articles related to healthy lifestyle
b. More time spent on counseling patients about healthy habits
c. Reduction in work hours to accommodate his exercise schedule
d. More referrals of patients for cardiac perfusion studies
Question 2 (1 point)
Which of the following is true regarding physician counseling on lifestyle-
related behaviors?
Question 2 options:
a. Physicians who do not smoke are less likely to emphasize the risks of
smoking.
b. A physician's personal level of physical activity does not affect their
likelihood of counseling about physical activity.
c. Physicians who eat healthy food are more likely to counsel about
cholesterol levels.
d. Vegetarian and non-vegetarian physicians are equally likely to counsel
overweight and obese patients about weight loss.
Question 3 (1 point)
Which of the following is the best example of a SMART lifestyle-related
personal action plan?
Question 3 options:
a. Walk two miles, twice a week, for the next 3 weeks
b. Eat more fruits and greens daily, starting this month
c. Quit smoking after getting a job promotion
d. Lose 20 pounds (9 kilograms) this year, starting after vacation
Question 4 (1 point)
The Blue Zones Project is an example of lifestyle medicine advocacy. Which
of the following is a characteristic of people living in Blue Zone
communities?
Question 4 options:
a. Feeling a sense of purpose
b. Eating a 50% plant-based diet
c. Stopping eating after 60% full
d. Weekly medical visits
Question 5 (1 point)
Which of the following best represents an example of lifestyle medicine
advocacy at the health system level?
Question 5 options:
a. A vocal, rigid, upfront approach to practice change
b. Restricting access to non-lifestyle medicine interventions
c. Active involvement in a newly established task force exploring cardiac
rehabilitation data and potential opportunities for improvement
d. Refusing to acknowledge a coworker's opinion related to cafeteria food
concerns
Question 6 (1 point)
Which of the following best represents leadership support that may
prevent or decrease burnout?
Question 6 options:
a. Hydration stations in work areas
b. Providing more accolades for jobs well done
c. Offering workers more responsibility
d. Removing unnecessary tasks and demands
Question 7 (1 point)
Which of the following best represents the concept of a clinician's and
patient's/participant's mutual engagement in the treatment plans work?
Question 7 options:
a. Cooperation
b. Clinical interactivity
c. Therapeutic alliance
d. Physician/patient education
Question 8 (1 point)
A data-driven United States initiative that includes resources to improve
health and well-being over a decade and involves multiple stakeholders is:
Question 8 options:
a. Healthy People 2030
b. Healthy Nurse, Healthy Nation
c. US Preventative Services Task Force
d. Intensive cardiac rehabilitation
RESPOSTAS SECTION 4
Question 1 0 / 1 point
A 52-year-old physician with type 2 diabetes who was sedentary and
smoked 10 cigarettes per day had a heart attack 3 years ago. Since then,
he has adopted a plant-based diet, quit smoking and walks 30 minutes
daily. According to the literature, which of the following changes is
expected in his current approach to medical practice compared with 3
years ago?
a. More emphasis on scientific articles related to healthy lifestyle
Correct Answer
b. More time spent on counseling patients about healthy habits
c. Reduction in work hours to accommodate his exercise schedule
d. More referrals of patients for cardiac perfusion studies
Hide question 1 feedback
Feedback: Doctors who exercise (aerobic or strength training) are more
likely to counsel patients on exercise than those who don't. Physicians
who consume a plant-based diet are more likely to counsel on weight loss
and nutrition. Non-smoking physicians are more likely to emphasize the
risk of smoking.
Citation(s):
Abramson S, Stein J, Schaufele M, Frates E, Rogan S. Personal exercise
habits and counseling practices of primary care physicians: a national
survey. Clin J Sport Med. 2000;10(1):40-48.
Frank E, Rothenberg R, Lewis C, Belodoff BF. Correlates of physicians'
prevention-related practices. Findings from the Women Physicians' Health
Study. Arch Fam Med. 2000;9(4):359-367.
Bleich SN, Bennett WL, Gudzune KA, Cooper LA. Impact of physician BMI
on obesity care and beliefs. Obesity (Silver Spring). 2012;20(5):999-1005.
Olivia Y. Hung and others, Physicians' Health Habits are associated with
Lifestyle Counseling for Hypertensive Patients, American Journal of
Hypertension, Volume 26, Issue 2, February 2013, Pages 201–208,
https://doi.org/10.1093/ajh/hps022
Belfrage ASV, Grotmol KS, Tyssen R, et al. Factors influencing doctors'
counselling on patients' lifestyle habits: a cohort study. BJGP Open.
2018;2(3):bjgpopen18X101607. Published 2018 Sep 19.
doi:10.3399/bjgpopen18X101607
Question 2 0 / 1 point
Which of the following is true regarding physician counseling on lifestyle-
related behaviors?
a. Physicians who do not smoke are less likely to emphasize the risks of
smoking.
b. A physician's personal level of physical activity does not affect their
likelihood of counseling about physical activity.
Correct Answer
c. Physicians who eat healthy food are more likely to counsel about
cholesterol levels.
d. Vegetarian and non-vegetarian physicians are equally likely to counsel
overweight and obese patients about weight loss.
Hide question 2 feedback
Feedback: Physicians who do not smoke are more likely to emphasize the
risk of smoking than physicians who smoke. Physicians who exercise
(aerobic or strength training) are more likely to counsel patients on
exercise than physicians who are inactive. Physicians who consume a
vegetarian diet are more likely to counsel on weight loss than physicians
who are not vegetarian.
Citation(s):
Abramson S, Stein J, Schaufele M, Frates E, Rogan S. Personal exercise
habits and counseling practices of primary care physicians: a national
survey. Clin J Sport Med. 2000;10(1):40-48.
Frank E, Rothenberg R, Lewis C, Belodoff BF. Correlates of physicians'
prevention-related practices. Findings from the Women Physicians' Health
Study. Arch Fam Med. 2000;9(4):359-367.
Vickers KS, Kircher KJ, Smith MD, Petersen LR, Rasmussen NH. Health
behavior counseling in primary care: provider-reported rate and
confidence. Fam Med. 2007 Nov-Dec;39(10):730-5. PMID: 17987416
Question 3 0 / 1 point
Which of the following is the best example of a SMART lifestyle-related
personal action plan?
Correct Answer
a. Walk two miles, twice a week, for the next 3 weeks
b. Eat more fruits and greens daily, starting this month
c. Quit smoking after getting a job promotion
d. Lose 20 pounds (9 kilograms) this year, starting after vacation
Hide question 3 feedback
Feedback: Providers should be able to develop their own personal action
plans.
The SMART goals, with the following attributes, should be used to achieve
the best results:
1- Specific (identify the exact behavior to be addressed)
2- Measurable (how one will know he has reached the goal)
3- Achievable (the goal can be accomplished)
4- Relevant (the goal will help her reach the specific behavior change
chosen)
5- Time (the timeframe for accomplish that goal or task)
Citation(s):
Prochaska JO, Norcross JC, di Clemente CC. Changing for Good: A
Revolutionary Six-Stage Program for Overcoming Bad Habits and Moving
Your Life Positively Forward. Harper Collins; 2010.
Prochaska JO, Velicer WF. The transtheoretical model of health behavior
change. Am J Health Promotion. 1997;12(1):28-48.
White ND, Bautista V, Lenz T, Cosimano A. Using the SMART-EST Goals in
Lifestyle Medicine Prescription. Am J Lifestyle Med. 2020;14(3):271-273.
Published 2020 Feb 17. doi:10.1177/1559827620905775
Question 4 0 / 1 point
The Blue Zones Project is an example of lifestyle medicine advocacy. Which
of the following is a characteristic of people living in Blue Zone
communities?
Correct Answer
a. Feeling a sense of purpose
b. Eating a 50% plant-based diet
c. Stopping eating after 60% full
d. Weekly medical visits
Hide question 4 feedback
Feedback: The Blue Zones Project is based on five geographical locations in
the world where people live the longest. These particular communities
share nine common characteristics: they move naturally (physical activity),
feel a sense of purpose in life, eat a mainly plant-based diet, stop eating
after 80% full, relax and down shift, put loved ones first, have wine at 5,
find the right tribe to do life with and belong to something greater. Weekly
medical visits are not characteristic of people who live in Blue Zone
communities.
Citation(s):
Blue Zones. https://www.bluezones.com/2016/11/power-9/. Accessed
August 26, 2023.
Question 5 0 / 1 point
Which of the following best represents an example of lifestyle medicine
advocacy at the health system level?
a. A vocal, rigid, upfront approach to practice change
b. Restricting access to non-lifestyle medicine interventions
Correct Answer
c. Active involvement in a newly established task force exploring cardiac
rehabilitation data and potential opportunities for improvement
d. Refusing to acknowledge a coworker's opinion related to cafeteria food
concerns
Hide question 5 feedback
Feedback: While activism may involve a vocal, rigid, upfront, and/or all or
nothing approach to making changes, the role of an advocate is more
supportive and guiding. Offering expertise as a healthcare professional is
an example of advocacy.
Citation(s):
Merriam-Webster. Activisim. merriam-webster.com. Accessed: May 25,
2022. https;//www.merriam-webster.com/dictionary/activisim
Earnest, MA, Wong SL, Federico SG. Perspective: Physician Advocacy: What
Is It and How Do We Do It? Acad Med. 2010; 85(1): 63-67.
http://doi.org/10.1097/ACM.Ob013e3181c40d40
Cullerton, K., Donnet, T., Lee, A. et al. Effective advocacy strategies for
influencing government nutrition policy: a conceptual model. Int J Behav
Nutr Phys Act 15, 83 (2018). https://doi.org/10.1186/s12966-018-0716-y
Question 6 0 / 1 point
Which of the following best represents leadership support that may
prevent or decrease burnout?
a. Hydration stations in work areas
b. Providing more accolades for jobs well done
c. Offering workers more responsibility
Correct Answer
d. Removing unnecessary tasks and demands
Hide question 6 feedback
Feedback: Healthcare workers are at a high risk of burnout. Research has
shown that decreasing unnecessary tasks and allowing more time for what
is important to the worker can prevent or decrease burnout. Other
reasons for burnout include working long hours, excessive bureaucratic
responsibilities, lack of support, and exposure to traumatic events.
Citation(s):
National Academies of Sciences, Engineering, and Medicine; National
Academy of Medicine; Committee on Systems Approaches to Improve
Patient Care by Supporting Clinician Well-Being. Taking Action Against
Clinician Burnout: A Systems Approach to Professional Well-Being.
National Academies Press (US); 2019.
Scheepers RA, Boerebach BC, Arah OA, Heineman MJ, Lombarts KM. A
Systematic Review of the Impact of Physicians' Occupational Well-Being on
the Quality of Patient Care. Int J Behav Med. 2015;22(6):683-698. http://
doi.org/10.1007/s12529-015-9473-3
Wilkinson S. How nurses can cope with stress and avoid burnout. Emerg
Nurse. 2014;22(7):27-31. http://doi. org/10.7748/en.22.7.27.e1354
Sturgess J, Poulsen A. The Prevalence of Burnout in Occupational
Therapists. Occupational Therapy in Mental Health. 1983;3(4):47-60.
http://doi.org/10.1300/J004v03n04_05
Schuster ND, Nelson DL, Quisling C. Burnout Among Physical Therapists.
Phys Ther. 1984;64(3):299-303. http://doi.org/10.1093/ptj/64.3.299
Question 7 0 / 1 point
Which of the following best represents the concept of a clinician's and
patient's/participant's mutual engagement in the treatment plans work?
a. Cooperation
b. Clinical interactivity
Correct Answer
c. Therapeutic alliance
d. Physician/patient education
Hide question 7 feedback
Feedback: The therapeutic alliance is a positive patient-provider
relationship known to lead to better adherence of the treatment plan.
Being genuine, listening, and being aware of the perceptions of the patient
can all help improve the therapeutic alliance.
Citation(s):
Stubbe DE. The Therapeutic Alliance: The Fundamental Element of
Psychotherapy. Focus (Am Psychiatr Publ). 2018;16(4):402-403.
http://doi.org/10.1176/appi. focus.20180022
American Psychological Association. APA Dictionary of Psychology |
Therapeutic alliance. 2022. Accessed: May 25, 2022.
https://dictionary.apa.org/
Question 8 0 / 1 point
A data-driven United States initiative that includes resources to improve
health and well-being over a decade and involves multiple stakeholders is:
Correct Answer
a. Healthy People 2030
b. Healthy Nurse, Healthy Nation
c. US Preventative Services Task Force
d. Intensive cardiac rehabilitation
Hide question 8 feedback
Feedback: Healthy People 2030 offers tools and resources for private and
public entities to improve health indicators. Twenty-three are measurable
Leading Health Indicators, and 8 are measurable Overall Health Indicators
chosen for their impact and upstream potential.
Citation(s):
U.S. Department of Health and Human Services. Healthy People 2030.
https://health.gov/healthypeople
