September 16, 2011

Doctors Should Prescribe Lifestyle Medicine

Okay, there are no medicines to prescribe, just prescribed advice, but for some this may be a bitter pill for some patients to swallow. Healthy lifestyle should be the first advice received, regardless of the illness you are seeing the doctor for. The doctor presently will always take care of the illness first, but seldom looks at any of the underlying causes from a lifestyle side of things.

With obesity on the rise and diabetes going up at an increasing rate, doctors must start changing their priorities. Yes, treat the illness, but also set up treatment for the other causes that my be there – like obesity and obesity-related causes, diabetes, and other potential problems.

Why is there so much resistance on the part of physicians to prescribing lifestyle changes. The reasons are many and vary from one physician to another. Some but all of the following may apply: clinician lack of confidence, skills, and training; inadequate payment; insufficient time during patient visits; and lack of integrated office flow and documentation processes to emphasize healthy behaviors and lifestyle interventions. One of the large barriers is healthcare providers' perceptions of lack of effectiveness of office interventions, biases about patient motivation, lack of awareness of community resources, and resistance to change.

Are doctors going to be required to do lifestyle prescribing? Yes, if, and this is a big if, the current healthcare law remains the law. Doctors will be required to preform effective prevention services as a part of medical practice. The longer the doctors delay making prevention practices, the more difficult it will become to provide for these prevention practices and those that are part of ACOs will either be squeezed out or will need to find other places to practice medicine.

Surprisingly, the Leaders in lifestyle medicine, such as the American College of Preventive Medicine (ACPM) and the American College of Lifestyle Medicine (ACLM), is encouraging this and published a list if 15 core competencies as Lifestyle Medicine Core Competencies which is included in this article.

They recognize that lifestyle medicine begins outside the clinical setting by having healthcare providers lend their expertise and authority in the community by serving as advocates on behalf of health promotion policies. Next the clinicians need to bring lifestyle medicine into the office. To be successful healthcare providers need to lead and perform a full assessment of the patient and order screening and diagnostic testing according to national guidelines. They need to realize the importance of their role in promoting health behavior as first-line prevention and treatment.

Lifestyle medicine is a recently defined field and has the15 core competencies for this practice. This should give healthcare providers a plan to help reverse the chronic disease epidemic in our country. There are three key areas – reframing the clinical practice to prioritize healthy lifestyles for patients, the providers adhering to healthy lifestyles themselves, and leading change in the medical system and in the community to support healthy lifestyles.

This may be a tall order for some healthcare providers, but will be a necessary component under the current healthcare law. Next, how will we as patients adapt? Hopefully it will be in a positive manner and that we will be able to meet the challenge and for those that are physically able, we will succeed.


Beth/Gran said...

I wonder if some doctors are afraid patients will get mad and not come back? Just wondering...goodpoints.

Bob Fenton said...

Anything is possible when it comes to many doctors. I do have two doctors that are working with me to try to reduce my weight.

I am finding that by removing whole grains (especially wheat) I am starting to loose weight - slowly now, but definitely in the right direction.