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Your Checkup: Patient Education Health Podcast
Ever leave the doctor’s office more confused than when you walked in? Your Checkup: Health Conversations for Motivated Patients is your health ally in a world full of fast appointments and even faster Google searches. Each week, a board certified family medicine physician and a pediatric nurse sit down to answer the questions your doctor didn’t have time to.
From understanding diabetes and depression to navigating obesity, high blood pressure, and everyday wellness—we make complex health topics simple, human, and actually useful. Whether you’re managing a condition, supporting a loved one, or just curious about your body, this podcast helps you get smart about your health without needing a medical degree.
Because better understanding leads to better care—and you deserve both.
Your Checkup: Patient Education Health Podcast
96: The Motivation Checkup: Episode 5: Motivation vs Habits vs Discipline, What Creates Change
In this episode, we break down the difference between motivation, habits, and discipline — three tools people often confuse when trying to change their health. You’ll learn why motivation is great for starting but unreliable for consistency, why habits are the real engine of long-term change, and why discipline is best used as a short-term support, not a lifestyle. We show how relying too much on willpower leads to burnout, how “minimum viable habits” protect progress on low-energy days, and how to build systems that make healthy choices easier instead of harder. This episode helps you stop pushing yourself and start designing change that actually lasts.
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Production and Content: Edward Delesky, MD, DABOM & Nicole Aruffo, RN
Artwork Rebrand and Avatars:
Vantage Design Works (Vanessa Jones)
Website: https://www.vantagedesignworks.com/
Instagram: https://www.instagram.com/vantagedesignworks?igsh=aHRuOW93dmxuOG9m&utm_source=qr
Original Artwork Concept: Olivia Pawlowski
Hi, welcome to your checkup. We are the patient education podcast, where we bring conversations from the doctor's office to your ears. On this podcast, we try to bring medicine closer to its patients. I'm Ed Delesky, a family medicine doctor in the Philadelphia area.
SPEAKER_01:And I'm Nicole Ruffel. I'm a nurse.
SPEAKER_00:And we are so excited you were able to join us here again today. This happens about every like seven to eight years. Seven to ten years.
SPEAKER_01:What are you gonna talk about?
SPEAKER_00:The bomb cyclone.
SPEAKER_01:Yeah, it happened, it was 10 years ago. It's actually happened exactly every 10 years.
SPEAKER_00:Every 10 years, like clockwork?
SPEAKER_01:2006, 2016. The blizzard of 96. Then it was 2006, 2016, and now.
SPEAKER_00:Needless to say, it is very cold outside. I parked my car and I was walking no, because now I'm leaving my car in New Jersey again. And I was walking and I was wearing clothing and it felt like I was naked. It was that cold outside. Like my face hurt.
SPEAKER_01:Yeah, it does hurt your face.
SPEAKER_00:It's rough. And needless to say, like the last time we were like blissfully recording this, we were like, wow, it's like snowing outside. It's so pretty. It's been snowing forever. I don't think this snow is gonna leave till March.
SPEAKER_01:Oh, yeah. We never did our wager on that. Or put our um like bets in.
SPEAKER_00:Well, let's do it here. Okay. Let's do it live right now. How do we set a date?
SPEAKER_01:We're just gonna pick a date. Write it, get a notes out up on your phone.
SPEAKER_00:All right. All right, I'm getting it on my phone.
SPEAKER_01:Um, and then we're just gonna put our all right, we'll put our guesses for the date and then whoever's closest, what's our wager?
SPEAKER_00:What do you mean, um, like closest to the date? Like what are the terms and conditions of this agreement?
SPEAKER_01:We're betting when the snow goes away, right?
SPEAKER_00:Yeah, so like we put it we put a day, like when this snow is gonna go away.
SPEAKER_01:Yeah, I think we put it an exact date.
SPEAKER_00:Okay. And what how are we defining it with this mountain in front of our place?
SPEAKER_01:Uh yeah, sure.
SPEAKER_00:All right. So when that is gone.
SPEAKER_01:The one that's right there on the corner?
SPEAKER_00:Yeah.
SPEAKER_01:Yeah.
SPEAKER_00:When that is gone, that is the day. Whoever gets closest, are we counting going over?
SPEAKER_01:Yeah, the closest, like before or after, just the closest to the day.
SPEAKER_00:Okay. What if one of us picks a really good day and then the other wants it?
SPEAKER_01:Well, then we'll have to duel.
SPEAKER_00:Say less. All right. This isn't where I was expecting to do it.
SPEAKER_01:I think I have my date in my head.
SPEAKER_00:I think I have my date in my head. Kind of between two dates. But I think it's the same date that we have in our head. All right. Why don't we say it? Uh I'm not gonna change it. I'm not gonna change it. Ladies first.
SPEAKER_01:I'll type it on your type it on your uh phone.
SPEAKER_00:All right.
SPEAKER_01:Wait, I'm between two now. Two dates. Okay. And today's January 31st.
SPEAKER_00:Today's January 31st.
SPEAKER_01:One, two. Are you gonna show your screen? One, two, three. March 15th.
SPEAKER_00:March 3rd. That's your date. March 3rd is your date.
SPEAKER_01:Yeah.
SPEAKER_00:What's my date?
SPEAKER_01:March 15th.
SPEAKER_00:Yes. The Ides of March. It just felt right.
SPEAKER_01:Right, right. Put it in. Put both of our things on there.
SPEAKER_00:Eddie's no date. March 3rd. Nikki date. Yeah, so when I win, what am I gonna get?
SPEAKER_01:When I win. Hmm. Cool. What do either of us want?
SPEAKER_00:Hmm. The terms and conditions.
SPEAKER_01:They're gonna be signed in blood after this.
SPEAKER_00:Hmm. We used to do this. We used to place like fun little wagers about people in our lives.
SPEAKER_01:We did. I think I still have that note.
SPEAKER_00:And we were like, oh yeah, if this thing happens to this person in this timeline, you owe me like happy hour or something. Yeah. Like you take care of happy hour one day. We'll never blissfully do that with my schedule. So um maybe on a Thursday.
SPEAKER_01:Um I don't know.
SPEAKER_00:Maybe um one Balinese massage given by the other person for one hour.
SPEAKER_01:For a whole hour. Dang. An hour-long massage?
SPEAKER_00:An hour-long massage. All right. Sure. An hour-long personal husband or wife massage.
SPEAKER_01:I'll shake on it.
SPEAKER_00:All right, let's see how that goes. So that's been rough though. Um, my car, there was like, you know, the entire street was the snow was higher than the bumper of the blue bullet, which was a challenging thing for a little while there.
SPEAKER_01:It's also taller than Ollie. It's also taller than Ollie. Poor guy.
SPEAKER_00:I know. His um his routine's been disrupted a little bit. I mean, when it was actually happening, he was we were walking like on the street, and it felt like Yeah, we were walking him like in the middle of Pine Street because the snow was taller than him, and our street wasn't plowed for like three days. It was kind of cool to be able to do that though. So we're making do, you know, have nice shelter here. Um, I'm taking the train and driving to work again. Um taking the Oregon trail. And I don't know, is your walk to work pretty treacherous these days or is everything taken care of?
SPEAKER_01:Um, there are parts when it's a little bit treacherous. The good Samaritans of Philadelphia have actually done a great job on the sidewalks, but then when you get to like the corner, he's rolling around over there. When you get to like each corner, especially like when I have to cross Broad Street, I had to like climb Mount Everest to like get over those piles and then go back up to get over.
SPEAKER_00:Yeah, you gotta be careful to not uh not twist an ankle there. Um, yeah, I found it interesting that the mayor, I think, got on like in a public forum and said, like, Mr, you citizens of Philadelphia will be fined if you don't shovel your sidewalks. Meanwhile, I did see an article claiming that like several public-facing places have are still unaccessible because inaccessible rather, because of the snow, like our street.
SPEAKER_01:Yeah, like our entire street.
SPEAKER_00:So I thought that was a cool thing that they did.
SPEAKER_01:Yeah, that's pretty neat of them.
SPEAKER_00:Yeah. Cool thing I we did the other day. So I made salmon for dinner. Um, recently, you have been making the vast majority of the dinners, um, also because of the Amazon groceries, which I think we'll talk about after this. But I did this cool little thing that we saw online, and I took boiling water and put it over the salmon skin on top, and it peeled right off.
SPEAKER_01:That was crazy. And you get so frustrated taking off the salmon skin.
SPEAKER_00:I do. It was initially a blue job that you tried to imbue on me, but then Yeah, I sure did. I sure did. I was really bad at it. So then it flipped over to pink, and I wasn't able to make salmon, and then you've just been a good sport the last couple times I've made it. But yeah, I've been doing this, like, you know, garlic, capers, lemon, salmon. It's been delicious. And now, no skin. It did cook it a little bit when that was going on. So I don't know if like there's a little finesse to this that I have to learn. But literally, this thing peeled right off, and it was very cool. And it was cool to see it in like happen live right in front of me.
SPEAKER_01:Thank you, TikTok.
SPEAKER_00:Thank you. Yeah. No, you're always good. You're learning stuff on there all the time. You're also watching videos of fruit poop their versions of stuff.
SPEAKER_01:No, I keep getting served these video, these TikToks of like a food pooping out like their food.
SPEAKER_00:And they like their iterative food.
SPEAKER_01:Yeah, so like a potato is pooping out a French fry. Like a block of cheese was pooping out into a pot of boiling water, like mac and cheese. Or like a tomato was pooping out ketchup onto a plate of fries. Yeah, this is just or you know what, you know what? Um, what else I get?
SPEAKER_00:Da Vinci is like rolling over right now.
SPEAKER_01:Is um the AI food videos, and it's like if you could have one food, like you had to eat one food for the rest of your life, what would it be? And then it's like a plate onto a dispenser, and then it like comes out all these like different kinds of foods.
SPEAKER_00:Oh, really? Like one food for the rest of my life. Spaghetti meatballs.
SPEAKER_01:Yeah.
SPEAKER_00:Yeah. It's filling.
SPEAKER_01:But like they all look so good. Multiple food groups.
SPEAKER_00:All in one?
SPEAKER_01:Yeah.
SPEAKER_00:What would your food be?
SPEAKER_01:Well, it depends on the video I get served and what my options are.
SPEAKER_00:Oh, like you have to choose between. You can't just like have to pick up the litter. Oh, I thought you had to pick up the litter. I was mistaken.
SPEAKER_01:Yeah.
SPEAKER_00:A mortal error. So we've been getting Amazon groceries, which has been this is not an advertisement. We will be coming out with an advertisement soon enough, hopefully. We sure will. Um, but the this has been really helpful. Look, I mean, like, there was a time in my life where I was like, oh, on Thursdays I have to go like back to New Jersey to get to the grocery store. This is a very convenient service, I gotta say. I mean, like, whenever you're on your phone, I'm just like, is she shopping or is she on TikTok watching videos of pooping food?
SPEAKER_01:You'll never know.
SPEAKER_00:I'll never know.
SPEAKER_01:So I always give you always keep them guessing, you know. Due respect. Never let them know your next move.
SPEAKER_00:No, I don't. Or like you're buying an obscene amount of gifts for me. So like I never know what you're doing, so I can't make any comment. There is a moment though when I'm like on my phone, and I feel like the moment I pick up my phone, you notice, you immediately put down your phone and you stare at me.
SPEAKER_01:Yeah, because I want you to pay attention to me.
SPEAKER_00:I'm like, you were literally on your phone for half an hour, and I pick it up once to look at fantasy basketball stuff. I'm a big, I'm a big time manager. I'm leading the division right now, not for long, but you're leaving it? I'm leading. Oh yeah. But we got some injuries that we're trying to weather the storm. Hopefully the guys get healthy by middle of February, mayhaps.
SPEAKER_01:I hope so.
SPEAKER_00:I I hope so too. I might make a big trade tonight.
SPEAKER_01:Oh, yeah. Big day for Eddie's excellent team.
SPEAKER_00:Uh Eddie's excellent team. Um, all right. So then I also have um, let's switch it up a little bit, keep it a little educational here. Um, I have one thing. This is not what the episode is about today, but it is a little news article that I wanted to read, a little bit of a different flavor. Um, so this is about the there are some new guidelines apparently about alcohol limits, despite rising evidence health risks. So, this is an article that I read, and I wanted to share it with people just because, you know, you come here for a lot of, you come here once a week and want to keep it educational in multiple ways. So, as a lot of people know, this administration has a new dietary guideline, which we together have not spent a lot of time thinking about, but there's a lot of hoopla about it, and came out in January 2026. And in part, what it did was abandon concrete limits on alcohol consumption. And instead, it offered very vague advice to quote, consume less alcohol for better overall health, end quote. So Mehmet Oz, in some sort of weird world that we're living in now, is somehow the administrator for the Center of Medicare and Medicaid Services. And he made a non-evidence-based claim, terrific, coming from a guy of this political stature, that alcohol can serve as a social lubricant that brings people together. That was reported by NBC News. So that messaging, though, collides directly with a lot of mounting scientific evidence about the harms of alcohol, even at small levels. So there was a federal report published in January 2025 that included that even one daily drink could increase the chances of liver cirrhosis, esophageal cancer, oral cancer, and others. The World Health Organization has clearly stated there is no safe limit for alcohol consumption, and that even light or moderate drinking can cause cancer. Again, reported by NBC News. And there's more recent research that has mounted these claims as well, according to the National Institute on Alcohol Abuse and Alcoholism, reported that in May 2025, health risks exist even at low levels of alcohol consumption, including certain cancers and cardiovascular risks, with breast cancer risk rising with less than one drink per day. There is that old adage that cardiovascular benefits were once touted for people with moderate drinking, but that's even now in question. But to that end, the American Heart Association in 2025 made a scientific statement, concluding that it remains unknown whether drinking is part of a healthy lifestyle, noting that most of the research is observational and prone to bias. So I think Dr. Dr. Oz's God, Dr. Oz, I can't believe that he's a thing. Dr. Oz's claim about alcohol as a social connector lacks scientific support, at least. And research has shows that actually there's a relationship between loneliness and drinking. It's often complex and harmful. There are certain studies that came out around the COVID-19 pandemic and found that increased alcohol consumption was actually significantly associated with loneliness, with one Japanese study saying that it can double the risk. So, among individuals with alcohol use disorder, emotional loneliness actually may increase both drinking likelihood and quantity. But there's good news. What's the good news? As of July 2025, only 54% of U.S. adults reported consuming alcohol, which was down from 62% in 2023. So that was just some things I wanted to share, not related to today's episode.
SPEAKER_01:Can't believe Dr. Oz. I can't believe they regard him as a physician. I mean, I know he technically is. Yeah. Which I find hard to believe.
SPEAKER_00:Also find it hard to believe.
SPEAKER_01:I think he's one of those cases where like anyone can pass a test, you know.
SPEAKER_00:Yeah. No, it's like really sad that he has such like a wide, vast platform, like that started with the TV show, and now he has like political stake and power.
unknown:Yeah.
SPEAKER_00:Yeah. It's also just like a wildly unscientific claim that like once again demonstrates how like they make, I mean, there have been things that we haven't touched on the show that they make claims about that are like they make causal claims that willy-nilly that are dangerous and harmful without any evidence. And then it takes years for people of science to go ahead and say, like, there is a causal connection between hypertension and dementia coming out in the American Heart Association guidelines, a future episode that we're going to cover. But like, that's crazy that like it takes them such evidence and time to gather data and assess it and then be able to say, like, wow, look at this. And then these jerks come out here and they're like, Yep.
SPEAKER_01:They're like, you know what? Alcohol really brings people together. I mean, can you say the same for like drugs of any sort? Right. You know?
SPEAKER_00:No, they so that brings it, that's a very complicated thing. So that's a little wrinkle of something that we're trying to do. Um, you know, try to include a little news clip um here also in our banter section. All right, what do you think? Should we should we dive in? Yeah. So what are we gonna talk about today, Nick?
SPEAKER_01:Today we have episode five of our motivation series, and we're talking about motivation versus habit versus discipline.
SPEAKER_00:So let's clear something up right away. A lot of people think health change depends on one thing. They either think it's motivation, discipline, or willpower. And I think people tend to put these three words together and think they mean the same thing. But they're actually three different tools and they work at three very different times. And today we want to help you understand the difference between motivation, habits, and discipline. And more importantly, when each one is actually useful. Because if you're using the wrong tool at the wrong time, change feels way harder than it needs to be. So I'll take the first one, Nikki will take the second, and then we'll come back to me for the third. Motivation is the spark. It's the part of you that says, I want to feel better. I'm ready for change. I can't keep doing the things the same way. Motivation is emotional, it's future focused, and it's powerful, but it's also, as many people have experienced, is temporary. Motivation is great for starting, deciding, choosing a direction. But motivation is not great for consistency, boring days, stressful weeks, and long-term follow-through. So, Nikki, can you tell us about habits, which is different from motivation and discipline?
SPEAKER_01:Sure, can habits are the engine, is how you can think about it. It's what kind of lets your life run in autopilot. The habits are what takes over after the motivation phase sort of ends, and it's a behavior that does not require much thinking anymore. So habits are great for repetition and consistency. Maybe low energy days when you don't, you know, have the motivation to do things, but you're just in the habit of doing it, or just the busy seasons of life as well. So, like Eddie said, motivation is the spark, and then habits are the engine. Okay, we have the spark and the engine. Do you want to tell us about discipline?
SPEAKER_00:Yes. We can think of discipline as that break-the-glass emergency tool. Discipline is effortful self-control. It's the voice that says, I don't feel like it, but I'm doing it anyway. Discipline is useful, but like willpower, it's expensive and limited. It costs mental energy, emotional bandwidth, and stress tolerance. Discipline works best in short bursts for specific situations and when habits aren't built yet. Discipline is not meant to run your whole life. I see this a lot when we're online. People are like, if I was just more disciplined, or I'm going to be so disciplined. And I actually think it might be why people burn out, because most people try to live on discipline, but it is expensive and it is limited. I find that people they wake up and think, I just have to be better. I just need more willpower. I just need to push harder. And that works for a while, don't get me wrong. But then stress hits and something goes wrong. Or then sleep drops and you're tired and you're not sleeping as well. Or then life gets really busy and you are stretched in so many more directions than you ever could have imagined. And discipline collapses under that weight and that pressure. And it's not because you're weak, but because discipline was never supposed to do the job of habits. So this is how change actually happens. Here's the healthy sequence. Motivation helps you start, habits help you continue, and discipline helps you bridge the gaps. Motivation chooses the direction, habits carry the load, and discipline fills in when something breaks. What this may look like in real life, let's say your goal is to walk more. We'll keep it simple. Motivation says, I want to be healthier. Habit says I walk after dinner most nights. Discipline says, tonight I don't feel like it, but I'll go for the five-minute walk. Discipline doesn't replace the habit, it protects the habit. And that's when we go back to what we talked about in episodes three and four, the minimum viable habit. The goal isn't to be intense, the goal is to be consistent. So instead of asking, how much can I do, ask what's the smallest version I can still repeat when things get hard? And that's how habits are born. So take a moment and think in my day, in my health, what am I trying to do with discipline right now? And what could instead I turn into a habit? And where am I expecting motivation to do a job that it can sustain? Those answers are usually pretty revealing. And so you can try this exercise of self-talk. Instead of saying, I just need to try harder. You start saying instead, I need a better system. I need a smaller habit. I need less friction and more support. So build something that carries you. Motivation starts change. Habits sustain it. Discipline protects it. You don't need more pressure or guilt. You need a structure that works on your worst days, not just your best ones. So if you build what carries you, you won't have to keep pushing yourself forward. So thank you for coming back to another episode of Your Checkup. Hopefully, you were able to learn something for yourself, a loved one, or an unmotivated neighbor. You can check out the other episodes of our motivation miniseries or the motivation checkup mini series. You can also check out and share any of our other episodes, which are all pretty much evergreen anyway. You can find us on our website. You can email us to checkuppod at gmail.com. Find us on threads, that's where we're most active. But most importantly, but most importantly, stay healthy, my friends. Until next time, I'm Ed Delesky.
SPEAKER_01:I'm Nicole Rufo.
SPEAKER_00:Thank you and goodbye.
SPEAKER_01:Bye.
SPEAKER_00:This information may provide a brief overview of diagnosis, treatment, and medications. It's not exhaustive and is a tool to help you understand potential options about your health. It doesn't cover all details about conditions, treatments, or medications for a specific person. This is not medical advice or an attempt to substitute medical advice. You should contact a healthcare provider for personalized guidance based on your unique circumstances. We explicitly disclaim any liability relating to the information given or its use. This content doesn't endorse any treatments or medications for a specific patient. Always talk to your healthcare provider for a complete information tailored to you. In short, I'm not your doctor. I am not your nurse. And make sure you go get your own checkup with your own personal doctor.
