
Quebec doctors can now prescribe exercise - the_duck
http://www.cbc.ca/news/canada/montreal/quebec-doctors-can-now-prescribe-exercise-1.3215821
======
WalterBright
My dad's doctor once told him to lose the spare tire, and sent him to a
nutritionist, who gave him a diet plan.

Some months later, he went back to the nutritionist for a checkup, and the
nutritionist was shocked that he'd actually followed her plan. He became one
of those unicorns who kept the weight off until he passed away 30 years later,
though he complained that he was always hungry.

~~~
logicallee
> nutritionist, who gave him a diet plan.

> Some months later, he went back to the nutritionist for a checkup, and the
> nutritionist was shocked that he'd actually followed her plan

"I didn't _mean_ it! You know usually it's just a formality. But, uh, keep up
the good work."

~~~
spacehome
The password policy includes not sharing it at the drop of a hat.

~~~
logicallee
yeah sorry, I deleted that part.

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CydeWeys
It's so obvious it's amazing this hasn't already been a thing since the
beginning of the obesity epidemic. Specific exercise instructions are more
likely to be followed than a vague admonition to "exercise more". I wonder if
gym memberships will be covered as care by health insurance plans? They're
certainly a lot cheaper that hospital stays!

~~~
Frozenlock
> "It's so obvious it's amazing this hasn't already been a thing since the
> beginning of the obesity epidemic."

Why is that obvious? Because you think there's a link between being overweight
and exercise?

Exercise does not promote weight loss. (You can do a quick google search if
you don't believe it.)

The most important thing to influence weight loss is the nutrition.

On a related note, I find it borderline sadistic that we make fat people
believe they are fat because they are lazy and don't exercise enough.

~~~
15155
Exactly this.

Fat people are generally fat because of excess caloric intake. The amount of
physical (aerobic) exercise needed to even burn off a can of Coke is
incredible.

~~~
harmarsupercar
A can of coke contains about 155 calories. An average person can do
practically anything which is reasonably considered exercise for 30 minutes
and burn that off: [http://www.health.harvard.edu/diet-and-weight-
loss/calories-...](http://www.health.harvard.edu/diet-and-weight-
loss/calories-burned-in-30-minutes-of-leisure-and-routine-activities)

Hardly "incredible".

Research has shown that diet is more critical than activity in the occurrence
of obesity, but that doesn't been that activity doesn't matter at all.

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Steltek
In 2014, doctors in Boston were able to begin prescribing a Hubway bike share
membership: [https://www.bostonglobe.com/metro/2014/03/27/new-program-
wil...](https://www.bostonglobe.com/metro/2014/03/27/new-program-will-allow-
boston-medical-center-doctors-prescribe-bike-sharing-
program/zjwfLfCEtAEGfWYxVn4CiN/story.html)

In Boston's case, it's a mutually beneficial arrangement for the city:
healthier citizens and less traffic on the roads by converting drivers to
bikers.

~~~
ebiester
I'm not sure -- is the increased health contraindicated by the increased
chance of injury or death from unobservant car drivers?

~~~
femto
The health benefits outweigh the risks [1], if measured by increased life
span. This is a relatively common question about cycling.

[1]
[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2920084/](http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2920084/)

\---

Edit for clarity.

~~~
ebiester
"For deriving the relative risks comparing car driving and cycling, we
specified a hypothetical scenario based on statistics in the Netherlands."

YMMV.

------
adrusi
I'm not entirely sure who wins here. The prescription doesn't mean much aside
from that insurance will pay fitness-related bills. But exercise doesn't have
to cost anything. Even in the most unwalkable cities there's some place you
can go to just walk around in.

And who wouldn't doctors prescribe exercise to. If someone comes asking their
doctor for an exercise prescription so that they can get a free gym
membership, there's no reason for the doctor to say no (save for cases where
the patient has a heart disease or similar where regular exercise is
inadvisable). Not only will it not _hurt_ the patient, it'll in fact help
them. It will also help the doctor as it will help present them as someone who
listens to patients and it helps fill appointments.

If this becomes widespread, the result will be more expensive insurance (or in
Quebec, higher taxes) and more expensive fitness programs.

~~~
x5n1
It helps a lot to have a trainer. In fact we should be paying for gym and
fitness trainers for pretty much anyone who wants it. The benefits are
extraordinary especially in Canada where we all pay for everyone's healthcare.

Yes exercise costs nothing. But it is often repetitive and boring. And in
Canada it's cold 1/2 the year so having some place indoors is very helpful and
having it paid for is even more encouraging.

We need to make exercise free, fun, and with trainers that work with people.
It needs to be like gym in school on days where the gym teacher didn't have a
stick up his/her ass... for anyone at any age.

~~~
monochromatic
> It helps a lot to have a trainer. In fact we should be paying for gym and
> fitness trainers for pretty much anyone who wants it. The benefits are
> extraordinary especially in Canada where we all pay for everyone's
> healthcare.

This mindset that the government should be spending tax revenue on _anything
beneficial_ is bizarre.

~~~
x5n1
Yes the government should only be spending it to bail out distressed financial
institutions, bankrupt individuals, etc.

~~~
danharaj
No, clearly the government's only job is to enforce property rights and
suppress anyone who is discontented with the condition of their society.

------
dr_
Any doctor can prescribe exercise, including doctors in the US. You don't
really need a lot of equipment, you don't really need gym membership. The
issue is whether or not the patient will be compliant with an exercise
regimen, and educating them on the importance of exercise and physical
activity in general.

If the purpose of this is to allow exercise during the actual work day - that
would be interesting, but would require the cooperation of employers or some
type of federal regulation - in the US, maybe thrown under FMLA.

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guiomie
All that is missing now are doctors to give the prescription. (seeing a family
doctor in Quebec is really difficult)

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meggoirech
Thats great. Yeah, there is a huge difference between saying, go exercise, and
giving a prescripted regimen. Hopefully they can start having funded exercise
programs in the community or based on the general prescriptions the doctors
are giving.

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vonnik
[http://theshrug.com/this-is-the-best-drug-commercial-you-
wil...](http://theshrug.com/this-is-the-best-drug-commercial-you-will-ever-
see/#VupduoDRE4TDYBPz.01)

------
jasonlotito
Considering all the problems the Quebec medical industry has at the moment, I
still wouldn't trust Quebec with the care of myself or my family. It's such an
abusive system.

~~~
stuxnet79
In Ontario it's not that much better sadly.

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anon4
I wonder how well this meshes with the fact that a lot of cities aren't built
for walking. Walking is in general good, but is it responsible for your doctor
to prescribe you an activity that is actually illegal in the area where you
live, due to there being no sidewalks and walking on the street being illegal.

~~~
anu_gupta
Can you name some cities where walking is illegal? Or even areas of cities
where walking is illegal?

~~~
trgn
I'm not certain about the illegal part, but plenty of urban development is
very unpleasant to walk in. A lot of suburbs and a lot of city centers ravaged
by urban renewal are plain repulsive, and even dangerous due to all the high
speed traffic, to walk around in. It's easy to say for a doctor to "go walk
outside", but not everybody can exit their front door in an area that's
welcoming to walking or cycling.

~~~
bpodgursky
Most suburbs are incredibly easy to walk in. As newish development almost all
have sidewalks and are on residential streets.

Are you going to walk to a grocery store? Probably not. But if your goal is
walking there is no problem.

~~~
s_q_b
A lot of the ticky-tacky McMansion cul-de-sac developments constructed from
about 2000 to the end of the last housing boom in the United States don't have
sidewalks. However, in my experience, the streets become de facto multiple use
pathways for walking, bicycling, driving, etc.

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6d0debc071
I imagine that goes down well at an appointment. Someone you might see once a
decade or less giving you lifestyle advice.

~~~
apricot
Once a decade? Everyone in my family gets annual checkups from our family
doctor.

~~~
tptacek
[https://www.sciencebasedmedicine.org/re-thinking-the-
annual-...](https://www.sciencebasedmedicine.org/re-thinking-the-annual-
physical/)

