In my medical school training, except for a little bit in psychiatry, I didn't receive any formal training in communicating with patients. Many people would say that medical education makes doctors less capable of communicating on a meaningful level. Are there any signs that this is changing?

Well, coincidentally, I just finished reading a report on self-care from the Association of American Medical Colleges. They're getting together a major project in which they will begin teaching self-care communication skills in a number of medical schools. Dr. James Hudson is going to be the Project director.

The American Medical Students Association also has modest self-care programs going at a number of medical schools. And of course there are all kinds of new and fairly informal projects at individual schools—there's something here at the University of Minnesota Medical School, the University of Arizona has one, as does Georgetown University. There's a big interest at UC Berkeley, and you were just telling me about the self-care class you visited at Wright State School of Medicine in Dayton. There's actually quite a lot going on in the medical schools already.

Any signs of health insurance companies being willing to reimburse policy holders for self-care education expenses?

Blue Cross of Montana has started doing this on a very small scale, and some of the other Blue Cross plans have been saying they're going to get into this area— they're putting on some prevention education programs now. Several other insurance companies are looking into self-care education. International Group Health in Washington has started several projects. IGP's head guy, Jim Gibbons, is a real self-care advocate.

Could you comment on the kinds of people who are—and should be—teaching self-care classes?

I've always felt that the ideal teacher was the nurse. Certainly the greatest enthusiasm for self-care has come from nurses, nurse practitioners, and physicians' assistants. Many of these allied health professionals feel much more strongly about prevention and self-care than about diagnosis and treatment—which continues to be the main concern of most physicians.

Do you think it's important for the people teaching these classes to have clinical experience?

It certainly helps. One of the real dilemmas these days is that people hear this from Reader’s Digest, that from the National Inquirer, and something else from Prevention. They need to be able to ask someone who has done more than just read the books.

How about in the schools? Do you think it would be an advantage to include people with clinical experience as a part of health-education classes?

Yes. Not only are clinical workers more likely to have experience with these matters, but it'd be very valuable for kids to be able to talk to a health worker at some time other than when they're sick or need shots.

Do you see a connection between the widespread popularity of running and the developing self-care movement?

Absolutely. Because as people start feeling better from jogging, and begin to sleep better and eat better, they're going to discover they have more energy than they ever did before. Then they begin to realize that health is a resource to be conserved, not something you can waste and then discard like a cigarette butt or a wrecked car.

Yes. Your body is a temple. Why treat it like a motel?

Yes, that's a good one. So when people increase their nutritional awareness, or start jogging, or get into stress reduction, they feel better. And taken they say, "Well, gee, maybe I can kick smoking and kick alcohol and practice a healthier lifestyle. And it'll pay off." And it does!