Why Don’t Doctors Prescribe Exercise for ADHD?
Exercise may be the most important treatment you bring into your overall ADHD management plan.
Why Don’t Doctors Prescribe Exercise for ADHD?
According to a 2017 ADDitude survey of over 4000 readers self-reported as having ADHD or being caregivers of someone with ADHD, only about 37% of adults with ADHD report satisfaction with their treatment plans. People with ADHD may get some relief from their medications (reported by ADHDers in the survey as being “very or extremely effective” only 40% of the time), but they don’t work for everybody.
Meanwhile, these same respondents reported that they felt exercise as a treatment for ADHD was “very or extremely effective” over 56% of the time, yet their clinicians had only ever mentioned exercise about 13% of the time.
What accounts for this disparity?
With such potent academic and clinical support for the brain-boosting effects of exercise, and such positive self-reports from patients, how can doctors fail even to mention exercise? Especially as research indicates that clinicians really do have a strong influence on whether their patients exercise.
Why aren’t doctors prescribing exercise in general?
The answer may lie in the health care system as a whole.
In Canada, the BCMJ reports, “Physicians cite lack of time and remuneration as barriers to exercise prescriptions.” This article then goes on to mention the lack of training that medical students receive around exercise, and reports that “only 15.8% of Canadian physicians provide patients with exercise prescriptions.”
The same appears to be true in the Australian health care system. Here, doctors may refer to exercise as “essential, evidence-based medicine”, but the rate of application of that opinion seems to be about the same: exercise is prescribed for disease treatment only about 15% of the time. Here, too, the dominant systemic blocker to exercise as a prescription seems to be lack of medical training — doctors may not know which exercises to prescribe for which diseases and how to get patients to be successful with them — as well as the health care system’s resistance to any form of treatment that’s difficult to bill for.
According to a study based in Jordan which evaluated current practicing physicians’ approaches to exercise, doctors’ beliefs about patient adherence come into play strongly. As summarized in the abstract: “Most physicians believed that less than half of patients will start exercising (91.3%) or will continue exercising if they were repeatedly counseled at follow-up visits (85.4%).” Since doctors themselves are evaluated on their own effectiveness by their hospital or clinic, prescribing a treatment that the patient will not follow may be a recipe for a poor evaluation.
Conclusion
In Time Magazine’s 2016 article, The New Science of Exercise, Dr. Mark Tarnopolsky could not be more effusive on his view that exercise should take primacy in patient health recommendations, who says that “as time goes on, paper after paper after paper shows that the most effective, potent way that we can improve quality of life and duration of life is exercise.”
Regardless of what your doctor may or may not tell you, the evidence is clear that exercise may be the most important treatment you bring into your overall ADHD management plan.
