Your Next Doctor's Appointment Should Be Outdoors
David Sabgir, founder of Walk with a Doc, on why exercise is 100 times better than medicine
Fifteen years ago, David Sabgir, a practicing cardiologist in Columbus, Ohio, tried something new that would prove to be revolutionary. Having spent countless years vainly urging his patients to get more active, even if just to take a walk around the block, in a moment of desperation one winter day, he asked a patient to meet him outside the clinic. “I decided I wanted this patient to say no to my face,” Sabgir remembers, laughing. “I said, ‘Can I invite you to join my family and me in the park one Saturday morning?’” His patient’s response was immediate and enthusiastic. “That was really kind of magical,” Sabgir says.
Based on the good response, Sabgir went on to ask other patients to attend a group outing. In the end, when he finally hit the park after the snows of winter had melted, Sabgir was joined by over a hundred patients and colleagues. Since then, this simple idea—walk the talk with your patients—has caught on with health care providers in nearly every discipline. The organization Sabgir went on to found, Walk with a Doc, now supports provider-led walking excursions for patients around the world, with nearly 500 Walk with a Doc chapters leading monthly outings in 48 states and 25 countries, on six out of seven continents.
Sabgir, who has personally led more than 450 outings, estimates that over the last decade, Walk with a Doc has helped hundreds of thousands of people get outside. Nearly 40 percent of participants say it’s their first time out [for the purpose of well-being] in years, if ever.
We caught up with Sagbir recently, as his organization finished its most ambitious outing yet: 50 consecutive miles.
Outside: You’ve just led the longest walk of your organization’s history. What motivated you to try for 50 miles? Sabgir: The idea grew out of these 50-mile walks that leaders in American history have organized over the years. Teddy Roosevelt started it in 1908, to improve the readiness of American troops, and JFK and Bobby Kennedy picked up that mantle 50 years later. It’s now been over 55 years since the first Kennedy March, so we thought the time was right for a big event.
How did it go? It went great. Collectively, we had 158 people walk over 1,700 miles. I believe 14 people did the full 50 miles. And we exceeded our major fundraising goal.
I’m embarrassed to say that I myself did not do the walk. Although my training went fantastically—I still feel the endorphins pumping from a 26-mile walk my wife and I did the previous weekend—I injured my back lifting a planter a few days before the event. Most likely I herniated a disk.
That must have been disappointing. Despite being in pain, it was a ten out of ten for me. After the event, I went home and was pretty much flat on my back the rest of the day. Thank God the park was literally next to my house.
Our original goal was: let’s all walk 50 miles. But seeing the looks on the faces of our attendees when we announced that distance, I realized it just wasn’t right. A lot of them were thinking, I can’t walk 50 miles. We want them to be a part of every walk, so we ended up designing options for everyone. The goal became to push yourself: if five miles is a reach, we want to help you do that.
Over the years, you’ve inspired thousands of health care providers to hit the trails with their patients. Why do you think this idea has caught on? My goal was pretty simple—just get more people outside and moving. Probably 5 percent of my patients were achieving the weekly recommendations, and probably 80 percent were not doing anything at all.
Initially, I didn’t think the idea was that revolutionary. I know from studies that walking or any physical activity is by far the best medicine. But no one was doing it. I spent months Googling this to see what other people had already done. I knew it had to be around already—it was too easy, and it made too much sense.
We were also at the right time in history. The internet had been out for, what, eight years when we started? So it was easy to coordinate, and cell phones made it even easier. We just got to be the lucky ones to ride this roller coaster. We added 189 chapters last year. And this year we are on pace to add about 20 per month. These days, I’m 90 percent cardiologist, 10 percent Walk CEO.
You say the couch is the dangerous thing. How much can something as simple as walking help? To say exercise is the best medicine is a massive understatement. It is 100 to 1,000 times better than the best medicine.
There’s this negative cycle to inactivity, a cascade where excess weight leads to back pain, leads to bad sleep. I see it magnified every time I open the exam-room door: back pain, arthritis, sleep apnea, coronary artery disease, depression, anxiety. Being active reduces stroke and heart disease by 50 percent, depression by 50 percent, and Alzheimer’s by 50 percent. The answer is right there! The fact that we aren’t doing this before more invasive or expensive interventions is sickening. We aren’t taking care of what we can take care of easily.
What kind of patients tend to join a walk? It’s pretty diverse. A lot of times it’s people that may be scared about either a recent diagnosis or a family member with a diagnosis. And they may bring out someone, like a sick family member, that they are concerned about. But they are so diverse that I have a hard time categorizing them. When we’ve surveyed our walkers, around 78 percent say that they feel they are getting more physical activity then they otherwise would have without Walk with a Doc.
I’m constantly impressed by our walkers. I had one patient who came to the walk every month for years, even after she couldn’t walk. She just loved being in the park with us. It would warm your heart to see her covered with blankets on a 30-degree day, out in her wheelchair. She eventually left us an endowment that we have allocated completely to partnerships with medical schools, to raise the next generation of walking doctors.
Being stretched too thin is a common complaint of doctors. Why ask them to lead walks on the weekend? People still feel strongly about their health care providers. For a lot of the 30 to 40 percent of attendees doing this for the first time, it’s comforting to have a health professional out there with them. A lot of them are scared to do this, even though the actually dangerous thing is staying on the couch. And they think, If my health care professional is out here with me, then it must be good for me.
Yes, doctors—really all health care providers—are stretched thin. I see in the range of 2,000 to 2,500 patients a year. Visits are 30 minutes each for new patients, 15 minutes for repeats. It’s easy to get nervous about your numbers. But, gosh, what you get back from these outings is so much more than you put in.
And what has been the reception among doctors who participate? For starters, it feels really good to help your patients actually meet their goals. So that’s a primary reinforcer. But there’s also something special about being outside and opening up with your patients that I didn’t necessarily expect.
Typically, patients get a very brief allocation of time with their provider. They don’t love that—and trust me, your doctor isn’t thrilled about it either. People who go into health care dream about forming connections. On Saturday mornings, suddenly there’s time to connect. You get to meet your patient’s family. They get to meet your family. There is time to talk about the bigger picture, health or otherwise. You form friendships very quickly.
What a great thing to be able to offer a patient: Hey, I’d like to meet you outside of here—I’ll be at the park next Saturday, and we can catch up, and I can learn more about your family.
What’s next for you and for Walk with a Doc? Every morning I’m like a kid at Christmas—you never know where a request for a new chapter will come in from. Australia, Nigeria. I want to stay in the game as long as I can, and I want to see thousands of walks around the world.
We now have partnerships with 25 medical schools. That’s part of our grand vision. We want to transform the way medicine is practiced, to make it more open, accessible, and rooted within a community. I hope that there will be a time, within my lifetime, when people won’t remember when they didn’t take walks with their doctors. There are around 855,000 doctors in the U.S. and so many more nurses and nurse practitioners. With a broad enough net, we can reach every community. That’s what keeps me going—imagining that this incredible, simple, powerful thing is eventually going to be all over the world.
posted Saturday January 30th
by Outside On Line