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Lifestyle Medicine in Action
A monthly publication of the American College of Lifestyle Medicine
October 2011
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Welcome New Members

 

 

Banji Awosika, MBBS, MD   

Private Practice Physician, Internal Medicine and Nephrology, West Orange Nephrology  

Ocoee, Florida  

 

Ted Barnett, MD  

Diagnostic Imaging, and   

Vascular & Interventional Radiology   

Rochester, New York

 

Paul Bendheim, MD

Founder, Chairman & CEO

BrainSavers LLCAmerica's Healthy Brain Aging Company

Phoenix, Arizona  

 

Uwe Goehlert, MSc, MD, CM, MPH, MBA  

Corporate Wellness & Injury Prevention Consultant. Concierge Medicine Adviser. Public Health Policy, Medical Legal & Ethics Reviewer.     

South Burlington, Vermont 

 

Charles Harpe, MD

Physician, Internal Medicine, Asheville Hospitalist Group  

Fletcher, North Carolina  

 

David Johnson, MD

Preventive Cardiologist, West Michigan Heart, PC,  

Med/Surg Hospital   

Holland, Michigan  

 

Kriston Kent, MD

Medical Director & Owner, Naples Facial Plastic Surgery, MPH Student, Loma Linda University 

Naples, Florida  

 

Thomas Luton, MD, ABEM

Emergency Physician, Texas Health Resources Harris Methodist Hospital    

Fort Worth, Texas  

 

Jerry Morris, PsyD, MBA, MSPharm

Director of Behavioral Healthcare for Primary Care & Mental Health Centers & Med/Surg Hospital  

Nevada, Missouri 

 

Josefa Rangel, MD

Consultive Private Integrative Medicine Practice, Consults for Wellness, LLC     

Cincinnati, Ohio  

 

Daniel Schweigert, MD

Integrative Medicine, Family Practice & Sports Medicine Silverton Specialist clinic

Woodburn, Oregon

 

Stefanie Stevenson, MD

Physician, Integrative Medicine Consulting, Nourish    

Cincinnati, Ohio

  

Anthony Vuturo, MD, MPH   

Senior Vice President Canyon Ranch Health Resorts & Faculty University of Arizona College of Medicine and Pubic Health  

Tucson, Arizona  

 

Matthew Whitacre, MD

Enrolled in the University of Arizona Integrative Medicine Fellowship   

Neah Bay, Washington  

 

Rhonda Whitney, PhD

Director of Lifestyle Medicine Department, 

Feather River Hospital  

Paradise, California 

 

MEMBERS RECEIVE KEY BENEFITS INCLUDING:

  • Discounts on conferences
  • Discounts on practice management support services
  • Subscription to The American Journal of Lifestyle Medicine (regular memberships) 
  • ACLM list serve for direct communication with all other members
  • Free Lifestyle Medicine classifieds postings on website and in monthly newsletter
  • Listing on ACLM's website: www.lifestylemedicine.org Identity as part of the new professional field of Lifestyle Medicine
  • Advocacy for you and your interests 
Importantly, ACLM membership empowers the Lifestyle Medicine movement, advancing healthcare that "treats the cause".
Calendar
 
Obesity in America

October 14-15, 2011

Stanford, CA

 

Active Lives

November 11-12, 2011
Waltham, MA

Group Visits/Shared Medical Appointment Symposium
November 3-4, 2011
Cambridge, MA

Nutrition as Core Medicine

November 16-19
Morristown, NJ

 

February 22-25, 2011
Orlando, FL 

Greetings!

WELCOME to the October 2011 issue of  

Lifestyle Medicine in Action!    


In keeping with our mission of advancing the field of Lifestyle Medicine, we offer you five key perspectives on how changes underway in healthcare are creating opportunities in Lifestyle Medicine. 


Dr. Wayne Dysinger shares his experience at the recent Lifestyle Medicine Practice Management Workshop and invites you to consider the ways our collective stories serve to energize and inspire one another.     


The field of Lifestyle Medicine is moving confidently forward.  Our intent is to continue to serve and support you and your practice.  With that in mind, we're actively exploring an ACLM "Lifestyle Medicine 2012" conference in the fall...further announcements to come.   

To your well-being and successful practice!

 

      
President's Desk
Wayne Dysinger

The first annual ACLM Practice Management Workshop was an incredible success. Over 50 participants gained practical tools around the incorporation of group visits, exploration of the retainer model of medicine, billing for nutrition counseling, and many other real life opportunities to make lifestyle medicine work financially in our practices. Spending four days in an inspirational setting with lifestyle medicine visionaries from literally around the world was both energizing and thought-provoking. What I took away from the meeting, however, was not just a toolbox of functional methods for improving my practice. I also left with a joint camaraderie and understanding of the importance of working together to nurture and grow our passion.

 

The opening session of the workshop was given by John Principe, MD, who told a story familiar to many of us - one of frustration and disillusionment with the traditional medical system into which we've been trained and a-cultured. There was a sense of being stuck. Through a series of connections and decisions, Dr. Principe has moved beyond that discontent and into a new, creative, innovative Lifestyle Medicine practice.   His journey inspired many of us to reconnect to our own stories and our own passions. Each of us has a Lifestyle Medicine story. It is in the depths of those stories that we can find our energy to continue to support each other in our journeys forward.

 

My own story is deeply connected to the death of my 13 year old son from cancer in 2006. Remembering his courageous battle and wishing for ways to make that less likely to occur for others is the foundation of my Lifestyle Medicine activities. What is your story?

 

At the end of the Practice Management Workshop, Dr. Braman shared a video clip of Derek Redmond and his 400 meter race in the Barcelona Olympics. The video clip can be viewed here or by searching "powerful inspirational true story...don't give up!"  

 

Working together, using practical tools, built on the foundations of our collective stories, we can and will continue to take the Lifestyle Medicine movement forward.

 

Sincerely,

 

 

Wayne Dysinger, MD, MPH
President


Spotlight:  Changes in Healthcare 

Opportunities in Lifestyle Medicine      

  

With change comes opportunity.  The best minds in the business of healthcare gathered at the first-ever Lifestyle Medicine Practice Management Workshop to guide Lifestyle Medicine providers in positioning themselves and their practices for success.  We asked several of these thought leaders to share their perspective on what they see as critical changes underway in healthcare and how practitioners of Lifestyle Medicine can make the most of these opportunities.

 

Sandra LawsonSandra Lawson, MBA, Executive Director of the Institute of Lifestyle Medicine provides perspective on the changes occurring through healthcare reform, and through increased transparency for all providers - the ability of payers and consumers to understand the value they're receiving, quality that will be measured in numbers.  

 

"Capitation failed because it was perceived as rationing care.  There was no mechanism to quantify quality, no identification of measures of quality.  Under new reimbursement models, such as ACO's, this will change.  There will be value and quality metrics and providers will be paid based upon quality.  This changes the game as far as how providers are paid."   She describes the Patient Centered Medical Home as a model of care that will measure and require patient engagement as a key component.  "This was not measured before and was not considered a metric for how providers perform.  Patient engagement is critical within Lifestyle Medicine - a key competency and an area where Lifestyle Medicine providers may outperform other providers."  She also points to the Medicare Annual Wellness Visit as a recent change and potential revenue stream, with 46 million patients now able to schedule a visit strictly to discuss prevention and wellness.  "These are new modes of reimbursement.  To be successful, providers must be competent in wellness and prevention and must be able to engage patients."  

 

She goes on to describe how transparency measures such as those currently imposed upon healthcare institutions will affect physicians.  "As of yet physicians have not been affected; however, Medicare's voluntary Physician Quality Reporting System (PQRS), which offers physician's bonuses for reporting quality measures, will become mandatory with bonuses tied to outcome and will be published on Medicare's Physician Compare website.  Physicians must choose measures relevant to their specialty and to their patient population and with that, consumers and payers will be able to assess the value received."  She describes how insurers will tie measures to reimbursement, offering the example of the Medicare Advantage star rating that now gives insurers bonuses. Members of plans are asked questions such as whether their physician spoke with them about exercise.  "This is very relevant to Lifestyle Medicine competencies.  We are going to see these measures built into physician ratings and reimbursement.  This puts Lifestyle Medicine, especially within the primary care context, in a good position to negotiate favorable contracts with insurers for the Medicare Advantage Plan.  Keeping people healthy instead of focusing on treating illness will drive how physicians contract with insurers.   

Lifestyle Medicine physicians are uniquely positioned to achieve good health outcomes. But keep in mind that we've not truly measured Lifestyle Medicine efficacy as of yet. Through transparency, we'll be able to study and measure the efficacy of Lifestyle Medicine." 

 

Sandra Lawson sees opportunities in both primary care and specialty practices.  "Lifestyle Medicine offered within the primary care context will be able to perform well within the ACO and PCMH systems.  And there will be opportunities as well for specialists to contract with ACO's, especially those specialists who can take on high-risk patients and achieve behavior change."  She envisions opportunities for marketing based on successful outcomes.  "As we see numbers - quality measures on true outcomes - we'll then see marketing opportunities for physician practices to highlight strong ratings in the way that hospitals now use Hospital Compare ratings.   

With coming changes, the ability to track outcomes will become paramount for success.   "Physicians must prepare themselves to collect information electronically. Information technology will be critical to performance.  When sorting out how they will deliver care, physicians must also be prepared to collect and report clinical data.  Data management will drive performance."   


The Institute of Lifestyle Medicine helps clinicians get patients healthier. The mission to transform clinical care is achieved through professional education, research, and advocacy.  For more information on the ILM, visit:
http://www.instituteoflifestylemedicine.org/index.php

Edward NoffsingerEdward Noffsinger, PhD, pioneer of group medical visits and originator of the Drop-in Group Medical Appointment (DIGMA) and the Physicals Shared Medical Appointment (PSMA) models offers his views on key changes that will impact healthcare.  "First, we now have an aging population with baby boomers emerging from the pipeline in increasing numbers as the sickest, most multi-morbid, sedentary, obese generation in our nation's history. Second, we have the most sedentary, obese, and unhealthy pediatric population reaching adulthood - one in which type 2 diabetes is rapidly on the increase. Third, we have fewer medical students choosing primary care while seasoned and experienced internal medicine/family practice/geriatricians are moving into retirement and are not being adequately replaced. And fourth, under the Affordable Healthcare Act, we'll have an additional twenty to forty million previously uninsured patients with coverage, all of which raise the question of who is going to take care of these patients?  We're also seeing a shift in the last century from acute to chronic care with the vast majority of our nation's healthcare dollars going into the care of chronic conditions, almost all of which have a significant lifestyle component."  


Dr. Noffsinger sees Lifestyle Medicine as particularly well-suited to address the root causes of chronic disease and sees Lifestyle Medicine practitioners as ideally-suited to deliver healthcare in group settings, maintaining that the root causes of chronic disease can often be best addressed in group medical visits.   

 

 Read the full article     

CME Opportunity: Obesity in America

Stanford School of Medicine presentsStanford CME Conference

 

Obesity in America

 

October 14-15, 2011 

Stanford, California    

More information   

  

CME Opportunity: Active Lives: Transforming Ourselves and Our Patients 

Man on treadmill (ILM)

Active Lives:

Transforming Ourselves and Our Patients

  

November 11-12, 2011 Friday-Saturday

The Conference Center at Waltham Woods, Waltham, MA

        More information

 

CME Opportunity: The Emergence of Nutrition as Core Medicine  

Nutrition as Core Medicine ConferenceThe American College of Nutrition presents

 

The Emergence of Nutrition  

as Core Medicine 

  

November 16-19, 2011
Morristown, New Jersey

 

More information 

 

CME Opportunity:
Preventive Medicine 2012/Lifestyle Medicine Track

The American College of Lifestyle MedicinePreventive Medicine 2012
is pleased to co-sponsor the Lifestyle Medicine track 
 

 

Preventive Medicine 2012

Lifestyle Medicine Track

February 22-25, 2011
Orlando, Florida 

 

More information

 

 

CME Opportunity: Group Visits/Shared Medical Appointment Symposium

Harvard Vanguard Medical Associates presents

 

      Group Visits/
Shared Medical Appointment Symposium

November 3-4, 2011
Cambridge, Massachusetts
 
   

More information  

 

CME Opportunity: LM Practice Management Online Course  

American College of Lifestyle Medicine and     Doctor with Patient 

American College of Preventive Medicine present

 

Coming soon:

Lifestyle Medicine 

Practice Management Workshop

Online CME Course 

    
 More information  

 

CME Opportunity:
Lifestyle Medicine/Preventive Medicine 2011

The American College of Preventive Medicine offers online access to the recorded Lifestyle Medicine sessions and speaker slides from the 2011 annual meeting,

 

Lifestyle Medicine/Preventive Medicine 2011

 

This content is accessible through ACPM's e-Portal. To view the presentations, click on the  

2011 conference proceedings link located on the left side.    

 

More information  

 

EVENT:  
Food Day, October 24th, 2011

Center for Science in the Public Interest presents: apple

 

Food Day, October 24th, 2011  

Transforming the American Diet  

  

Join national leaders Caldwell Esselstyn, M.D., Colin Campbell, PhD, David Katz, MD, Walter Willett, M.D.,Dean Ornish, MD, and other Food Day Advisory Board members in inspiring a broad movement to promote a healthier way of eating that is also affordable, sustainable, and humane.   

 

More information

 

CNN: The Last Heart Attack  





Sanjay Gupta, MD interviews Bill Clinton

 

The Last Heart Attack

 

More information  

Lifestyle Medicine Career Listings    


POSTED: March 24, 2011
I am excited to place the following offer to either a Nurse Practitioner or Physician versed in Integrative/Functional Medicine to join our growing practice. With the basis of teaching patients lifestyle medicine, we are growing an active and vibrant practice. Our practice houses a 2400 square foot functional movement center and a teaching kitchen. We have had a wellness-based course in place for 2 years with the group medical visit model in place; we have brought 200 graduates through our program and have been witness to wonderful life transforming stories.
For further information, please contact me by office phone (708-448-9450) or via email Wellness@wellbeingmd.com.
John R. Principe, MD

POSTED: October 12, 2011
Health and Wellness Consultant at a new medical practice in Ocala, Florida. Part-time position with opportunities to work or travel in the medical missionary field.
For further information including the full job description, please contact Dr. McEachrane-Gross at eachrane@centurylink.net or 352-857-7524.
 


About Employment Opportunities Listings: To post an employment opportunity or for rate information, please contact admin@lifestylemedicine.org
ACLM members may post career opportunities or job seeking announcements at no charge.

Research Summaries  

The following presented by Diabetes in Control


Even small changes in A1c and BP could significantly reduce the risk of CVD complications in people with type 2 diabetes.

Collectively, lifestyle factors, including not smoking, regular physical activity, healthy diet, moderate alcohol consumption, and normal body weight, are associated with a substantially decreased risk of developing diabetes, according to new research findings.
 
The following presented by Medpage

Men receiving vitamin E supplements in a large randomized trial showed a slight but statistically significant increase in prostate cancer diagnoses, researchers said.

Stepped Approach to Weight Loss Works

Stepping up the intensity of a weight-loss intervention only for those patients who fail to reach their goal may be a viable alternative to standard lifestyle approaches, a randomized trial showed.

Some Diabetes Teaching Programs Better than Others 

Individual education and behavioral intervention were superior to both group and individual standard education, according to three randomized controlled trials reported in Archives of Internal Medicine.

Extra Calcium of Little Benefit for Mom or Baby
Calcium supplementation offers a protective benefit against pre-eclampsia and hypertension in pregnant women, but offers no other maternal or fetal advantages, according to a Cochrane review.

Previous research has shown that people who have used indoor tanning are at 75% higher risk for melanoma, the most deadly form of skin cancer, and indoor tanning raises the risk of other types of skin cancer as well.
Chocolate appears to reduce women's risk of strokes, with a bigger impact on hemorrhagic than ischemic strokes, a population-based study indicated.

In postmenopausal women, the use of several common vitamin and mineral supplements was associated with an increased risk of death, researchers found.

School Lunches Healthier than Homemade
Meals offered by the National School Lunch Program appear to be healthier with more fruits and vegetables than those packed at home, a study of second graders showed.

Even as rates of overweight and obesity rise, primary care physicians appear to be cutting back on weight counseling for their adult patients, researchers found.

Mothers of young children get less exercise than women who do not have children at home, researchers found.

Depressed Spouse Affects Heart Failure Patient, Too
Heart failure patients' quality of life suffers most when both they and their caregivers are depressed, researchers reported.

Heart failure death occurred two to three times more often in people with vitamin D insufficiency or deficiency compared with those who had normal levels of the vitamin, according to data from a government survey.

In obese children, vigorous exercise decreased body fat while increasing bone formation and insulin sensitivity, as reported at the American Society for Bone and Mineral Research meeting.

Diabetes Predicts 10-Year Fracture Risk
Diabetes is a significant predictor of fracture risk, independent of conventional risk factors, Canadian researchers report.

Diabetes Estimate Now 366 Million
About 366 million people worldwide have diabetes, according to the latest figures from the International Diabetes Federation (IDF), released in advance of a United Nations summit on non-communicable diseases.

 

 

The following from ABC World News

 

Comparing Weight Watchers to Standard Physician Advice  

Participants in a Weight Watchers plan lost more weight than those receiving weight loss advice and guidelines for treatment from their family physicians.

 

Harvard Researchers Unveil New Healthy Eating Plate 

Harvard School of Public Health researchers contend that the USDA MyPlate doesn't provide adequate information on whole grains, healthy fats and other food choices.

   


The following presented by NIH Research Matters

Gene Linked to Optimism and Self-Esteem
Three of the most widely studied psychological resources-optimism, self-esteem and mastery-are good predictors of a person's physical and psychological health. Study links these traits with OXTR gene.

The following presented by Web MD


Draft guidelines from the U.S. Preventive Services Task Force advise against common prostate cancer screening test.
Study: Aerobic Exercise Better Than Weight Training to Reduce Unhealthy Abdominal Fat.

Drinking several cups a day is linked with a lower risk of depression in women, according to a new study published in the Archives of Internal Medicine; mental health expert urges caution.

The XMRV virus probably not a cause of chronic fatigue syndrome; original study partially retracted.
 
 
Executives rate patient satisfaction higher than improved health outcomes when evaluating complementary medicine programs.

Medicare Tests Monthly Incentives for Innovative Primary Care  

Participating practices will receive an average of about $20 per patient per month to coordinate quality care for Medicare and private patients.

Group appointments can serve both patients and practices

Shared medical appointments are a small but growing part of primary care and a key component of the patient-centered medical home model. 
   
The following presented by NIH News

Physicians often fail to counsel their young adult patients about excessive alcohol use.

In a new study, a widely used herbal dietary supplement called saw palmetto was no better than placebo in reducing urinary problems caused by prostate enlargement.

 


Links to Opinion Articles, Practice Advice and Patient Handouts
The following presented by Diabetes in Control

The Centers for Medicare and Medicaid Services (CMS) has announced a plan to strengthen primary care and put a price tag on the medical-home concept and how it will pay for services.

Understanding Shared Medical Appointments
The complex needs of today's patients present a challenge to medical group physicians who try to meet patients' needs within the constraints of the traditional office visit.

   

The following presented by Medscape Today

 

Medscape interview on the prevention and control of non-communicable diseases.

 

The following presented by the U.S. Department of Health and Human Services

The Centers for Medicare and Medicaid Services (CMS) propose covering intensive behavioral therapy for obesity for Medicare beneficiaries when provided by a qualified primary care physician or other primary care practitioner and in a primary setting.

Public comments on this proposed determination are requested.  After considering public comments, the CMS will make a final determination and issue a final decision memorandum.  

 

  

The following presented by Mayo Clinic

There's no proven prostate cancer prevention strategy. But you may reduce your risk of prostate cancer by making healthy choices, such as exercising and eating a healthy diet.

Senior Health: How to Prevent and Detect Malnutrition
Malnutrition is a serious senior health issue. Know the warning signs and how to help an older loved one avoid poor nutrition.

Discover if you're at risk of job burnout - and what you can do when your job begins to affect your health and happiness.
Only ten percent of the variation in people's reports of happiness can be explained by differences in circumstances. The bulk of what determines happiness is personality, thoughts, behaviors.

 
The following presented by Berkeley Wellness Alerts

Running requires more strenuous movement and raises heart rate more, all of which burn extra calories.

The Link Between Erectile Dysfunction and Heart Disease
Erectile dysfunction can be a sign of elevated risk for cardiovascular disease. Lifestyle changes can benefit both conditions.

Can Interval Training Give Your Workouts a Boost?
Studies have found that interval training can improve endurance and fitness better than moderate-intensity workouts at a steady pace, and in less time. And it can help improve blood sugar control, lower blood pressure and raise HDL cholesterol.

Napping May Improve Memory
As if we needed another reason to enjoy a midday snooze, a growing body of research suggests that napping helps improve memory.

Green Exercise: A Walk in the Woods
Exercise is good for your body and mind. But exercising in nature can be especially restorative, recent research shows.
 


contact us: admin@lifestylemedicine.org
Contributing writers:
Marc Braman
Wayne Dysinger
Kathy Cater
Kathleen Jones

American College of Lifestyle Medicine
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fax: 971-983-5384

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