Personal Health Practices and Patient Counseling of German Physicians in Private Practice

We examined physicians' personal health behaviors and the influence on their patient counseling practices in a representative sample ( ) of physicians in private practice in Schleswig-Holstein, Germany. Physicians reported significantly better physical but poorer mental health compared to the general population (GP; ). The majority presented with normal weight (47.9% male, 73.1% female physicians versus 24.5/41.0% GP) or overweight (47.5% male, 20.0% female versus 52.9/35.6% GP). Frequency of exercise and fruit and vegetable consumption was higher than in the GP. About 70% drank coffee or tea more than once a day, but only 13.2% of female and 21.8% of male physicians were current smokers (GP 20.1/30.5%). More than half (56.1%) usually or always counseled a typical patient on exercise versus nutrition (47.0%), weight (45.8%), smoking (39.9%), and alcohol (30.0%). Doctors with better personal exercise, nutrition, smoking, and alcohol behaviors counseled their patients significantly more often on related topics. Despite better physical health and health behaviors in these German doctors compared to the GP, there is room for improvement (smoking, overweight), which could be expected to positively influence the counseling practice and impact of doctors' role modeling on patients. 1. Introduction Chronic, lifestyle-related diseases challenge health care systems worldwide with cardiovascular disease, chronic pulmonary disease, diabetes, and cancer accounting for about two-thirds of global mortality [1]. Lifestyle choices are critical for the prevention of these diseases [2]: WHO reports that the four leading risk factors for noncommunicable diseases are tobacco use, unhealthy diet, insufficient physical activity, and the harmful use of alcohol. Globally, tobacco causes almost six million deaths annually and alcohol 2.3 million. Insufficient exercise increases all-cause mortality 20 to 30%, and fruit and vegetable consumption is important to prevent obesity, cardiovascular disease, and gastrointestinal cancers [1]. For most patients in western societies, physicians in private practice are their first contact regarding their personal health practices. Studies have shown the importance of doctors’ recommendations for their patients’ practices [3]. It has also been shown in North American studies that physicians have healthier habits than the general population and that doctors with the healthiest habits are more likely to counsel their patients about healthy lifestyle practices [4, 5]. In addition, physicians with healthier behaviors, who discuss it with their