Pick one patient every day and spend an extra five minutes with that person on correcting a high-risk behavior. The Awards and Promotions committee identified some topics where family physicians have the greatest potential to positively impact a patientís health.

The busy clinician, with the multitude of issues related to delivery of care, often is overloaded with the additional pressures of running a business. But, by investing a small amount of time we can make a significant difference in the lives of our patients.

Here are some topics that you can use in practice every day. Pick one that applies to one of your patients and spend five extra minutes to do three things

1. Talk about the facts surrounding the issue
2. Listen to the patientís concerns and obstacles
3. Work together to outline solutions, achievable goals, and a follow up plan

1. OBESITY ‚ More than 60 percent of U.S. adults are overweight up from one in four in 1960. One-quarter of U.S. adults are obese, and childrenís obesity has doubled to one in five over the past decade.

The facts: Obesity is a major risk factor for diabetes, hypertension, arthritis, elevated cholesterol, and heart disease. White men aged 20-30 with a body mass index greater than 45 have a maximum of 13 years lost, for white woman the loss is eight years. Obese black men lose 20 years of life and black women 5 years.

Listen for clues from the patient: What are the eating habits? How many times and at what times of the day does patient eat? Where do they get most of their food? Do they equate food with emotions (bad day, stress, celebration, boredom)?

Solutions: Should you refer patient to a dietician for nutrition counseling? Can you agree on simple changes that the patient can make alone, such as eliminating late night snacks or limiting fast food meals to once or twice a week? Can you set goals for fruit and vegetable intake every week? Make a plan and check with patient at a reasonable interval.

2. ALCOHOL ‚ See the special section on Alcohol Abuse in this kit.
Realize how powerful it is when your personal physician takes the time to show a concern over personal habits and overall well-being. A patient may not agree or may even become angry but remember to connect alcohol abuse to potential problems on the job, with family or even with the law.

3. TOBACCO Talk to a tobacco user every visit. Telling a patient "you really need to quit" is not enough. See the extensive list of resources in this toolkit.

The facts: Tobacco use is the number one preventable cause of death. There is nothing more powerful you can do for your patients than help them quit. Smoking also endangers all the non-smokers around you ‚ your family and friends. Ask many questions about the patients smoking history and habits.

Listen for clues: Have they tried to quit? When do they smoke? How many per day? Where do they smoke (work, home, in the car)?

Solutions: Always offer a treatment: gum, patch, bupropion, bupropion with the patch, clonidine or nortryptyline. Connect them to local support groups and cessation services. Give them the Illinois Tobacco Quit-line toll-free 866-QUIT-YES for free cessation support services by phone from trained counselors. Set a quit date and continue to follow up.

4. EXERCISE - This is a mandatory part of any weight loss program and also contributes to good health and disease prevention on many levels. We all feel better when we exercise.

The facts:Exercise improves cardiovascular system, as well as improves bone, muscle and joint health. Exercise has been shown to reduce risks of virtually any disease and is connected with improvement in physical and mental health. To generate real benefits, all you need is 30 minutes of exercise four times a week.

Listen to patient for barriers to exercise or lack of motivation.

Solutions: Plan a course of action for the patient and make them look at their schedule and carve out some time for this. Physician should also recommend exercise options that are safe for patients with any pre-existing conditions or other limitations.

5. GOAL SETTING ‚ Family physicians have a special relationship with patients and sometimes this gives them special opportunities. Everyday we see overworked, stressed- out people who keep taking on more and more. We donít tell people what to do, but maybe we can show them what they are doing and how it is causing negative effects on their life or their families. We can offer sound recommendations and strategies on everything from getting 30 minutes more sleep each night, adding one piece of fruit to lunch or taking 15 minutes each morning to organize your schedule for the day and reduce your stress.

We can engage our patients with these topics and set follow-up times to deal with issues and to make notes to bring up some of these more sensitive issues when appropriate.