Prescribing Nature to Get People Moving Outside - Park Rx America [Podcast Series]

• [:56] Dr. Bantham introduces her guest, Dr. Robert Zarr

  • Dr. Robert Zarr is the Founder and Medical Director at Park Rx America.  

  • Dr. Zarr is also a physician researcher at Unity Healthcare.

• [1:14] Founding DC Park Rx, now Park Rx America

  • “And it was simply to, at that moment in time, to be able to give something to doctors and healthcare providers for them to be able to write what we called park prescriptions for their patients.”

• [2:49] Encouraging physicians to prescribe nature

  • “But what I have been able to do, through Park Rx America now, is really sort of codify the act of prescribing, the way of prescribing. I've been able to give it what I like to call some architecture, some structure to it. So that it's easy to do, easy to understand, easy to do for the physician or healthcare provider and easy to understand from the patient or client perspective.”

• [6:08] Addressing time as a barrier to physicians prescribing nature

  • “So rather than spending a minute or two talking about the importance of exercise or the importance of being outdoors, why not ask maybe one or two important questions? For example, one question that I really encourage providers to ask their patients during the visit is where do you feel safe and comfortable outside? And as your patient answers these questions, the next one would be what do you see yourself doing outside?”

• [10:16] Tools and training to support physicians in prescribing nature

  • “It affords them a really rich opportunity for them to follow up quickly in terms of how that prescription went, and for them to write another one. So the prescription itself is really not so much written by the doctor, it's really written by the patient and the doctor is there to sort of amplify it when need be and tweak, help tweak it so that it really has more of a therapeutic effect.”

• [12:55] Raising public awareness of nature prescriptions

  • “One of the things that we're working towards doing and hopefully we'll have done in a few months is this robust information that's available to patients. to the public, that we hope will trigger them to almost write that prescription before they go to their doctor.  What I envision is reaching out to the public in a way we haven't done before so that they know more about this concept of a nature prescription, and really have already thought about it before they go, and in some ways could be the person to sort of initiate this conversation, rather than depending just on the doctor to do it.”

• [15:49] Patient follow-through on nature prescriptions

  • “And so I'm in my EHR, the EMR, I double click on that unique code that's affiliated with that prescription that's been copied and pasted into the treatment plan. And I toggle back into Park Rx America's platform. And I can find that prescription in less than a second and I can see how many times it was filled.”

• [18:50] Language around prescriptions

  • “When I'm asked this question, do patients roll their eyes when I talk about a nature...I've never seen anybody roll their eyes. They're actually so thrilled that I am legitimizing their wishes and their desires to be outside, to spend time outside, to move outside, because most doctors don't do it in that way.”

• [21:35] Stages of change

  • “And, like with any new intervention or new medication or...in health care, it takes a little time to get used to it because most of us are not trained in Prochaska and Diclemente’s stages of change.  We're not as good and as familiar with talking and listening to our patients and trying to figure out where they are in that readiness stage.”

• [24:20] Health benefits of being active outdoors

  • “I think a lot of this, this conversation should be intuitive. I mean, we know, it's the right thing to do to spend some more time outdoors. And, to be more active is really important. And we, I think, know that, intuitively, that being active outdoors confers some additional mental health benefits. You just feel better than running in a gym or on a treadmill.”

• [28:12] Access to nature

  • “In some ways, I do think that what we're doing right now with these nature prescriptions is a bit subversive. I mean, really, we're sort of bypassing a lot of the barriers, and maybe even sort of structural barriers, by going directly to the physicians and I hope soon to the patients and public to say, you know, there is something you can do, right? You also have a right to this.”