Carson Boone used to take three types of medication for high blood pressure, and he needed a mechanical breathing aid to sleep.
Though the Raleigh 82-year-old had a gym membership and considered himself pretty active for his age, his doctor thought that if Boone sweated a little bit more, hed realize substantial health gains.
So, Dr. Ben Fischer of Raleigh convinced Boone to join a special exercise and healthy-living program at the YMCA, where the doctor works out alongside his patient.
A person of my age can be a little frightened about how much you can do, Boone said. But I found out through this program I was not working hard enough. On my first gym visit with the doctor, he told me to go around the track at my normal speed. Pretty soon, I noticed somebody was walking beside me. It was Dr. Fischer saying: Carson, you need to pick it up.
Boone did, and he now has better health as a result.
I sleep better, and I think Im stronger, too, said the retired construction contractor and photographer. Hes cut out two of the blood pressure medications and no longer uses the nighttime breathing device, and he said hes reduced his medical costs by half.
Doctors across the nation have stepped up recommendations to patients to lose weight, change their diets and exercise. But Fischer, 41, is unusual in working out side-by-side with patients.
Its a little weird, I know, but its fun for me, he said. How often does a doctor get a chance to get into the pool with patients? And if Im not there, they wont take it as seriously.
The sessions are billed as office visits, but Fischer thinks they are more beneficial.
Its much more productive and useful than a typical office visit, he said.
Fischer started the program about three years ago, after seeing how many of his patients were suffering from lifestyle diseases such as high cholesterol, diabetes, high blood pressure and obesity.
These diseases often play a role in heart attack and strokes, which account for more than a fourth of all deaths in North Carolina.
Because these are health problems we bring on ourselves, opportunities exist also to address them ourselves, said Fischer, who joined Raleigh Medical Group in 2007.
Thats what he had in mind when he came up with the idea of pairing supervised exercise with information on nutrition, fitness and lifestyle habits.
Its my homegrown attempt to help people be healthy, he said. I tell them its either this, or theyre going to be treating chronic illness for the rest of their lives.
About 65 people have participated in the project over the past three years, each signing on for a three-month session of weekly workouts and information seminars at the Alexander YMCA in Raleigh. The Y donates weekly meeting space and waives membership fees for patients in the program. Fischer encourages the participants to return to the gym for additional workouts throughout the week.
This week, a Meredith College graduate student helped the class learn to navigate restaurant menus with an eye toward healthy eating.
Catherine Pelone, a nutrition major, urged patients to look for words such as baked, grilled, broiled and lightly seasoned and to avoid items described as crispy, fried, smothered, creamy, buttery and rich.
Go ahead and order your takeout box to arrive when your dinner comes, she added. Put in half your food and just close it. You can have that as another meal.
Other sessions have focused on health issues from cancer to osteoporosis, led by physical therapists from WakeMed and specialists from Fischers Raleigh medical practice.
Ive learned a lot about diabetes, arthritis, liver function, blood pressure, heart disease, said John Logan, 61, as he prepared for Tuesdays aerobic workout. When you hear about all the problems and diseases you can have, how can you not afford to get in shape?
So far, Logan has lost more than 10 pounds and trimmed his waist by 2 inches. He said he hopes to get rid of his cholesterol medication soon.
Fischer graduated from Baylor College of Medicine in 2000 and served his residency at the Naval Medical Center in Portsmouth, Va. He also worked as a staff physician at a hospital at the Whidbey Island Naval Air Station in Washington state.
A fitness buff, he often bikes to work and exercises several times a week. He recognizes that not every physician is willing to jump into the pool with patients, and even some of his colleagues at Raleigh Medical Group have expressed skepticism.
He has encouraged them to consider adopting the approach with some of their own patients.
At this point, Im still trying to get some of the people at my own medical practice on board with the program, he said.
Fischers approach, while unconventional now, has taken shape against the backdrop of an intense debate nationally over how to reform health care with an emphasis on better patient outcomes. One of the central tenets of what has become known as Obamacare is a greater focus on preventative care.
Help control costs
Elaine Ellis Stone, communications director for the North Carolina Medical Society, noted that preventive care like that offered by Fischer can ultimately help in controlling health costs.
The medical community is very serious about encouraging patients to take responsibility for their health through exercise and eating right, she said. If we dont take care of ourselves, were at risk of diseases such as diabetes and heart disease and all that costs the health care system more money.
She said she had not heard of any other local physician going so far as to go to the gym with patients.
Kate Fonville, another of Fischers patients, said she started the 13-week program to aid her recovery from a brain tumor.
I was mostly looking to feel better and be able to move without pain, said Fonville, 65.
I didnt think Id ever feel this good again, she said.
Boone agreed that joining Fischers program has been worth the extra effort. Hes already lost 13 pounds.
Having a doctor who will take off his clothes and put on gym shorts to work with you is a real plus, he said. It made me more confident that I could do this.