ACLM Lifestyle Medicine Newsletter

Insider News Archives

From the DESK of ACLM President

Dexter Shurney, MD, MPH, MBD, FACLM, DipABLM

Lifestyle Medicine as a Solution to 
Health Disparities


June 30, 2020

Dear ACLM Members,

I consider it a tremendous privilege to serve as president of the American College of Lifestyle Medicine (ACLM), an organization that represents a field of medicine that delivers health and healing to all people, regardless of race, creed or sexual orientation. Lifestyle Medicine is also not a red issue or a blue issue, it’s a humanity issue, for one and all.  

ACLM’s definition of Lifestyle Medicine is the use of a whole food, plant-predominant dietary lifestyle, regular physical activity, restorative sleep, stress management, avoidance of risky substances and positive social connection as a primary therapeutic modality for treatment and reversal of chronic disease. This definition unites us, through our dedication to a first-treatment approach focused on identifying and eradicating the root cause of disease. 

Covid-19 has shone an even brighter light on the urgent need for Lifestyle Medicine to become the foundation of a transformed and sustainable system of health care.  The recent CDC report showed that people with underlying medical conditions, such as heart disease and diabetes, were hospitalized six times as often as otherwise healthy individuals infected with the virus. Moreover, the death rate among this vulnerable population was 12 times higher. The report also highlighted the disease’s striking disparities between whites and minority groups, wherein Native Americans or Alaska Natives have been hospitalized at 5 times the rates of white; rates of blacks’ hospitalization has been 4.5 times higher; and rates for Hispanics 4 times higher.  

Addressing these alarming health disparities is a priority of my ACLM presidency. Actions speak louder than words. It was during our Lifestyle Medicine 2019 conference that I announced the formation of our ACLM Minority Member Interest Group, which has now evolved into our Health Equity Achieved through Lifestyle Medicine (HEAL) MIG. The exceptional leadership of Drs. Marsha-Gail Davis, Jasmol Sardana and Terri Stone in championing what is now a group of more than 100 strong is evidence that the time is NOW for Lifestyle Medicine to become a solution to addressing health disparities.

By smartly leveraging our partnerships and event opportunities, we plan to raise awareness and prompt calls to action:

In July, we’ll be hosting a webinar entitled Health Disparities and COVID-19 - Is there a role for Lifestyle Medicine? Register for this webinar today!

Additionally, in August we’ll be making a live, virtual presentation at the National Medical Association (NMA) Annual Meeting on the impact of Lifestyle Medicine on health disparities in the Black community.

During our October 22-25 LM2020: Health Restored virtual conference, I’ll be moderating a panel on the topic of health disparities.  

I’m also delighted to announce that, through the generous support of the Ardmore Institute of Health, ACLM and our HEAL MIG will be serving as the convener for an event we’re calling the Health Disparities Solutions Summit, where we’ll bring together the foremost health disparities thought leaders and researchers, with the goal of publishing a plan of action, documenting specific Lifestyle Medicine solution recommendations.  

The American College of Lifestyle Medicine represents the future of health care. We, as an organization, stand firmly against any form of racism, while recognizing intrinsic bias and the vital need to proactively reach our underserved communities with the health, hope and healing that Lifestyle Medicine can deliver. 

Thank you for your membership in what is recognized by many as the fastest growing medical professional association in the United States. We are, as our Executive Director Susan Benigas always says, a magnet for purpose, passion-driven people who, together, are a galvanized force for change.

We are!  We can.  We will!

United with you,

Dexter Shurney, MD, MPH, MBA, FACLM, dipABLM
President

Questions or suggestions? We value your input. Please contact HEAL@lifestylemedicine.org.
 

May Newsletter Spotlight: Lifestyle Medicine and DPC

The natural combo that is getting LM to the primary care level. 
By Amy Mechley, MD

Direct primary care is a new financial model for health care delivery that allows the patient and doctor relationship to thrive. It is based on the premise that primary care is essential and personal to one’s well being across their lifetime. Primary care is just that, primary. It is focused on prevention, primary and secondary screening of predictable medical issues and early diagnosis and treatment of many common chronic diseases.  It can typically be managed without a great cost relative to other medical care in the US.

The fundamental concept of keeping insurance out of primary care works. The cost of care is known and can be budgeted per individual. Insurance is used for the unpredicted. Your car insurance is used for accidents, not oil changes, gasoline and battery replacements. Your homeowner’s insurance is used for tragic occurrences like fires, floods and burglaries, not HVAC cleaning, lawn maintenance and roof inspections. Primary care is the first level of care and maintenance for all US citizens. Tragically what has happened is 40% of a primary care doctors overhead in a fee for service system is dedicated to paying for the interaction with the insurance, which adds zero value to the health and wellbeing of the patient. As we are looking for improved health care delivery, we need to critically look for the value of each dollar spent. Insurance has no value in the primary care office.

Don’t get me wrong, insurance is very important when used appropriately. We do need to plan and pay for coverage for more expensive care like colonoscopies, hospital stays, advanced cancer care, accidents and specialty pharmaceuticals when judiciously used.  And that is exactly what it was designed for.

In a Direct Primary Care (DPC) arrangement, the patient or employer pays a set fee to cover the care for the patient, usually a year at a time. It is a direct relationship, both personally and financially. It is transparent, able to be budgeted and upfront. I work for the patient. Period.  When this happens many other ill constructed policies fall away: Like not being able to treat a patient for an issue  at a well visit (a rash or refill of a diabetes medicine at a pap appointment); like having to see a patient every 10 minutes to make your quota or having to refer to your groups specialist when you prefer another specialist outside your system.  Also I am documenting for communication and organization; not to make a base level of checkboxes for a certain billing requirement. Common sense rises and my energy and focus return to the patient and what is important to them.

As a direct primary care doctor, your schedule and panel number is set by you. You design your day, create a schedule template that supports the care you want to deliver. Lifestyle Medicine takes organized time and focus. DPC supports LM in that you have the time and systems to deliver complete care. It should be a part of every interaction and then also can be delivered more intensely with focused LM visits or LM group visits. Telehealth has been a wonderful addition to using the doctor and patient time wisely to continue to gain on goals and behavior changes.  It is easily integrated in a DPC practice.

Personally, this model has reinvigorated in me the passion for patient care. I feel more than ever I am practicing the best medicine of my 22 year career. I am having the kind of positive impact on patients' lives that I hoped for in medical school. It is truly a model for CARE, both for the patient and for you,  the doctor. If I measured my quality scores in hugs, it would be off the charts!

To learn more about DPC, please join us at a DPC conference (AAFP DPC Summit, HINT Summit) , talk to a DPC doc or find more info at DPCfrontier.org.