The President’s Report from George Guthrie

Real Health Care Reform: Vision into Action

by: George Guthrie, MD, MPH, FAAFP, FACLM, CDE

October 2018

My term as ACLM president is ending after our annual October meeting. It has been an honor to serve in this capacity, filled with opportunities, challenges and success. It has been personally rewarding to join with a team of committed individuals who are working hard together to change the way medicine is practiced.

I had the privilege of building on the shoulders of those who had gone before. Growth was slow at first, as it requires a lot of energy to birth and nurture a new professional organization. It has been my pleasure to be president during a time of unprecedented growth. Membership continues to rapidly increase. We now have diverse income streams providing for a solid financial basis enabling the college to move strategically. The ACLM reputation is growing both nationally and internationally: We are becoming the definer of lifestyle medicine for the medical community as we build upon a sound foundation, demonstrating for the nation and the world the knowledge and skills to prevent and reverse much of the chronic, non-infectious disease. As we work together, the specialty of Lifestyle Medicine is coming of age.

When I became president two years ago, I chose three main areas of focus.

The first has resulted in our Hierarchies of Evidence Applied to Lifestyle Medicine (HEaLM) Task Force, led by our immediate past president, focused on creating a tool with which to evaluate the evidence supporting lifestyle medicine practices that looks beyond the tyranny of the randomized controlled trial. As good as it is for evaluating drug treatments, the RCT just cannot provide clarity long-term effects of lifestyle practices on morbidity or mortality. The process has taken significantly longer than expected but has also been a helpful experience. We eagerly anticipate its completion in the coming weeks.

The second was to focus the energy of our members by involving them in projects for which they have passion and skills. We now have numerous active committees, working groups and task forces that are focused on important aspects of college growth and influence. The Education Committee will soon have a curriculum for primary care residencies around the world to incorporate lifestyle medicine into their training. There are numerous continuing education programs in the pipeline which will help inform the medical community as to the effectiveness and functionality of lifestyle interventions. We have expanded our membership to include nurses, physician assistants, registered dietitians, and other team members, with each of these having established their respective working groups. We have started the process of developing treatment guidelines for various chronic diseases, as well as a wide array of other projects, made possible by the energy and passion that all the various members bring to the table. It is rewarding to see so many of you, our members, working to make ACLM effective in our mission. Your energy and passion are key to our success.

The third area is the story telling. Whether it is the story of an individual patient or a health care system, the stories need to be told. Martin Tull, our director of partnerships, and others have begun creating video vignettes for the purpose of communicating successes and casting vision for members and non-members alike. I often say, “Facts don’t change behavior, stories do.” We continue to document what others are effectively doing to advance lifestyle medicine, as these stories then serve to inspire others to take action and become part of the solution.

As we previously shared a few months ago, the leadership team had a strategic planning meeting early in 2018 where we reviewed what had been accomplished, as we dreamed about where we should go in the future. What I found to be most significant was the identification of a BHAG (Big Harry Audacious Goal). It has become clear to me that our ACLM BHAG is defining lifestyle medicine for the medical community and the public, as well as for the government and other payers. Success will be demonstrated when lifestyle medicine is included as a specialty within the house of medicine and when lifestyle medicine providers are adequately reimbursed for our essential services. This will be “Real Health Care Reform.”