MADISON, Wis. (AP) — Find a shady spot under a tree, take a breath of fresh air and call me in the morning.
Health care providers have long suggested stressed-out patients spend time outdoors. Now hundreds of providers are going a step further and issuing formal prescriptions to get outside. The tactic is gaining momentum as social media, political strife and wars abroad weigh on the American psyche.
Of course, no one needs a prescription to get outside, but some doctors think that issuing the advice that way helps people take it seriously.
“When I bring it up, it is almost like granting permission to do something they may see as frivolous when things seem so otherwise serious and stressful,” said Dr. Suzanne Hackenmiller, a Waterloo, Iowa, gynecologist who started issuing nature prescriptions after discovering time outdoors soothed her following her husband's death.
Spending time in natural areas can lower blood pressure, reduce stress hormones and boost immunity, multiple studies have found.
“Study after study says we're wired to be out in nature,” said Dr. Brent Bauer, who serves as director of the complementary and integrative medicine program at the Mayo Clinic in Rochester, Minnesota. The program focuses on practices that usually aren't part of conventional medicine, such as meditation, acupuncture, massage and nutrition. “That's more than just ‘Woo-woo, I think nature is cool.’ There's actually science.”
Telling someone to go outside is one thing. The follow-through is something else. Starting about a decade ago, health care providers began formalizing suggestions to get outside through prescriptions.
Dr. Robert Zarr, who doubles as a nature guide, launched an organization called Park Rx America around 2016, offering providers protocols for prescribing nature outings. The guidelines call for talking with patients about what they like to do outside — walking, sitting under a tree, maybe just watching leaves fall — how often to do it and where to go. That all then gets included in a prescription, and Park Rx America sends patients reminders.
Nearly 2,000 providers have registered with the organization across the U.S. and a number of other countries, including Australia, Brazil, Cameroon and Spain. They've issued more than 7,000 nature prescriptions since 2019, said Dr. Stacy Beller Stryer, Park Rx America's associate medical director. About 100 other organizations similar to Park Rx America have sprung up around the U.S., she said.
Bauer specializes in treating CEOs and other business leaders. He said he issues about 30 nature prescriptions every year. The chief executives he treats sometimes don't even know where to begin and a prescription can give them a jump start, he said.
“I recommend a lot of things to a lot of patients,” he said. “I'm not under the illusion all of them get enacted. When I get a prescription, someone hands me a piece of paper and says you must take this medication … I'm a lot more likely to activate that.”
Hackenmiller, the Iowa gynecologist, said she's having more discussions with patients about getting outside as a means of escaping a world locked in perpetual conflict.
“When so many things are out of our control, it can be helpful to step away from the media and immerse ourselves in nature,” she said. “I think time in nature often resonates with people as something they have found solace in and have gravitated to in other times in their life.”
The effectiveness of nature prescriptions is unclear. A 2020 joint study by the U.S. Forest Service, the University of Pennsylvania and North Carolina State University concluded that more work was needed to gauge follow-through and long-term health outcomes.
But unless you're choking on wildfire smoke or swatting swarms of mosquitoes, getting outside — no matter what motivates you — can be helpful.
At William & Mary college in Williamsburg, Virginia, students issue nature prescriptions to their peers. “Patients” obtain prescriptions by filling out online applications indicating how far they'll travel to get to a park, times they can visit, whether they need a ride and favorite outdoor activities.
Students issued an average of 22 online prescriptions per month in 2025, up from 12 per month in 2020.
Kelsey Wakiyama, a senior, grew up hiking trails around her home in Villanova, Pennsylvania, with her family and their dog, Duke. When she started her freshman year in Williamsburg, she didn't know where to walk. She saw an advertisement for nature prescriptions in the weekly student email and eventually got one that helped her find trails near campus.
“I love the greenery,” Wakiyama said. “When you're sitting inside — I was in the library for four hours today — the fresh air feels very nice. It calms my nervous system, definitely. I associate being outside with a lightness, a calmness, good memories. That kind of comes back to me when I'm outside.”
FILE - In this March 5, 2020 photo, hikers head across a dune in White Sands National Park at Holloman Air Force Base, N.M. (AP Photo/David Zalubowski, file)
FILE - Virginia Davidson of Bridgton, Maine, paddles her kayak on Moose Pond, Oct. 13, 2021, in Bridgton, Maine. (AP Photo/Robert F. Bukaty)
