Doc Quixote

Huntington, West Virginia is reportedly the unhealthiest city in the United States.  But one Huntington family doctor is doing…uh, well, the best he can:

There’s a connection between education and lack of exercise, too, said Dr. Thomas Dannals, a Huntington family physician.

“The undereducated don’t know the value of it. They don’t have the drive for it. There’s a reason you’re successful, you’ve got drive. The same is true for exercise,” said Dannals.

Dannals has been trying to change cultural attitudes. The local newspaper has called him “an exercise evangelist” for founding the city’s triathlon, marathon and other projects designed to make exercise popular and fun. He’s also spearheading a riverfront exercise trail project…

Dannals can’t even get a company to sponsor the Huntington marathon.

The article quoted above, written by Associated Press medical writer Mike Stobbe, says that exercise is not Huntington’s only health problem:

Smoking – a common sin in West Virginia – has been hard to control, [Dr. Harry] Tweel [director of the Cabell-Huntington Health Department] said. When the health department tried to restrict smoking in local bars and restaurants, a group of local businesses fought it all the way to the state Supreme Court. (The restrictions were upheld in 2003.) Even hospitals have fought smoking restrictions in the past, Tweel said.

“People here have an attitude of ‘You’re not going to tell me what I can eat.’ The cultural attitude is ‘My parents ate that and my grandparents ate that,'” he said.

While Huntington is an extreme example, these kinds of problems are very common throughout the country.  Human beings aren’t evolved to go out of their way to expend effort or to eat in moderation.  And there is only so much “educating” that health care professionals can do.

The pay for performance crusaders should take note that a patient visit is frequently an eleventh hour attempt by a health care provider to repair a lifetime of unhealthy behavior on the part of the patient.

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