I gave a talk today to try and inspire some of my patients onto a healthier lifestyle. I remember communicating with Steven Devries, an integrative cardiologist who tries to get his pre-cardiac stent patients to make a lifestyle change before going to bypass. I used to think the concept of integrative preventive medicine was only limited to primary care doctors since my specialty couldn't bill for hospital based procedures -thus the only tool at our disposal was prescription medicine or life-coaching. With the 15 minute visit not being adequate time to educate .....our only go to was the prescription pad. Fast, powerful, easy to swallow and most important......paid for by insurance!!! But wait.....what if a patient asks about diet and exercise? "Well John, I can send you to a registered dietitian for 60minutes of education, design, empowerment.....oh.....but your diagnosis of increase weight, high cholesterol, high blood pressure and prediabetes doesn't cover the visit with her". We have to wait until your heart attack occurs or you are a full blown diabetic before giving you the education to reverse disease. Doesn't make sense!!! But has a hired doctor for a large corporation, I have to be productive compared to other docs.
Or do I?
I thought instead of seeing different patients individually then repeating the same answers.....why not have them all come at the same time!!!! (of course they have to kinda resemble each other as far as type of medical disease) But aren't the most common diagnosis all rooted in the same problems-nutrition/stress/immobility? I decided to see a group of patients at the same time, teach healthy eating and "fire off" answers to the questions that resonated from the group - How to Design the Change in Life and Where to Start. At the fellowship of Integrative Medicine with Andy Weil, doctors are essentially given the permission to spend 2 years reading and learning about using nutrition, mind body medicine, and parts of ancient whole healing systems (like yoga an Chinese medicine) to take care of the imbalances most people are suffering from. These imbalances are driving the per capita spending from $5000.00 per person about 5 yrs ago to $8000.00 more recently. So I was able to get some good education across (I think?) and design good take home points that all could use for their individual medical problems. I called it Weight Loss and Lowering Cholesterol. I should have called it Weight Loss/Lowering Cholesterol/Reversing Prediabetes/Improving Obesity/Reducing Blood Pressure Medicine/Helping Menopause/Caring for Metabolic Syndrome/Fighting Cancer. That wouldn't fit on the first slide. Not only was I able to give more in depth info, I was able to introduce a personal trainer/nutritionist to our group and have her chime in additional "real world" pointers to each person in attendance!
Pouring this information into someones cup will only work if the cup is held with the open side up. If I have someone that doesn't want a "refill", I don't give it. Since taking over this primary care practice in Jan 2015, I have found most people didn't want to change getting their refills every 4-6months and some were not ready or willing to start experimenting with cooking more, buying from the farmers market, going gluten-free, enrolling in an exercise place. In fact some people got angry and offended that I would suggest conservative options instead of medicines (see the angry review on www.vitals.com). This is because the trusted way people have been interpreting "being healthy"- is to take a prescription. Their thinking is if I suggest exercise, counseling and food prep then take the prescription drugs away and ......that would bring on disease!!! I feel that other doctors are DISEMPOWERING patients by puffing up the value of prescription fixes and not mentioning natural ways to reverse disease with eating and movement. So back to my original intention....I used to think it was just the primary care doctors role to advise lifestyle change since we had no procedure training and couldn't do stents or bypass or irradiation of tumors or insulin pump insertion.....but....I heard Steven Devries speak of Dark Leafy Greens and exercise and the diet used during the Lyon Heart Study. Now it isn't just primary care, the concept of healthy lifestyle and evidence based change has trickled down into the specialists fields!!! (there's hope after all....)
One of my old patients (an open heart surgery patient) came to the group visit today. He and his wife are living proof of lifestyle change leading to positive results. He was told by his cardiologist if he didn't have another surgical procedure, he would be dead in 4 years. (-threat incentive) I remember seeing his cardiac numbers a few yrs ago and was a bit worried that going conservative may not reverse his disease in time. We pushed on, I watched him while his cardiologist continued to give the obligatory finger pointing saying that once the heart muscle is damaged it can never be retrained to beat healthy. First we did supplements to feel better, then supplements to fix deficiencies on blood testing, then exercise to take advantage of the supplement positive effects, then nutrition to remove the need for supplements. Now at 72, he has been deemed a miracle according to the cardiologist, he inspires people 1/2 his age (and out-exercises a lot of them!!!) He has dropped down to a healthy weight even lower than what he was in high school. I asked to see muscle size and this is what this 72 yr old open heart patient showed me:
Even at the age of 72 where some people are accepting death, John is making changes to live a healthy life, has thrown away all his cardiac medicines and (....the clincher) avoided the high risk procedure he was told would get him past the 3 yr deadline given by cardiologist. He looks good, feels good, is helping his wife get healthy and is living proof that change is worth it.....it's never too late.
Or do I?
I thought instead of seeing different patients individually then repeating the same answers.....why not have them all come at the same time!!!! (of course they have to kinda resemble each other as far as type of medical disease) But aren't the most common diagnosis all rooted in the same problems-nutrition/stress/immobility? I decided to see a group of patients at the same time, teach healthy eating and "fire off" answers to the questions that resonated from the group - How to Design the Change in Life and Where to Start. At the fellowship of Integrative Medicine with Andy Weil, doctors are essentially given the permission to spend 2 years reading and learning about using nutrition, mind body medicine, and parts of ancient whole healing systems (like yoga an Chinese medicine) to take care of the imbalances most people are suffering from. These imbalances are driving the per capita spending from $5000.00 per person about 5 yrs ago to $8000.00 more recently. So I was able to get some good education across (I think?) and design good take home points that all could use for their individual medical problems. I called it Weight Loss and Lowering Cholesterol. I should have called it Weight Loss/Lowering Cholesterol/Reversing Prediabetes/Improving Obesity/Reducing Blood Pressure Medicine/Helping Menopause/Caring for Metabolic Syndrome/Fighting Cancer. That wouldn't fit on the first slide. Not only was I able to give more in depth info, I was able to introduce a personal trainer/nutritionist to our group and have her chime in additional "real world" pointers to each person in attendance!
Pouring this information into someones cup will only work if the cup is held with the open side up. If I have someone that doesn't want a "refill", I don't give it. Since taking over this primary care practice in Jan 2015, I have found most people didn't want to change getting their refills every 4-6months and some were not ready or willing to start experimenting with cooking more, buying from the farmers market, going gluten-free, enrolling in an exercise place. In fact some people got angry and offended that I would suggest conservative options instead of medicines (see the angry review on www.vitals.com). This is because the trusted way people have been interpreting "being healthy"- is to take a prescription. Their thinking is if I suggest exercise, counseling and food prep then take the prescription drugs away and ......that would bring on disease!!! I feel that other doctors are DISEMPOWERING patients by puffing up the value of prescription fixes and not mentioning natural ways to reverse disease with eating and movement. So back to my original intention....I used to think it was just the primary care doctors role to advise lifestyle change since we had no procedure training and couldn't do stents or bypass or irradiation of tumors or insulin pump insertion.....but....I heard Steven Devries speak of Dark Leafy Greens and exercise and the diet used during the Lyon Heart Study. Now it isn't just primary care, the concept of healthy lifestyle and evidence based change has trickled down into the specialists fields!!! (there's hope after all....)
One of my old patients (an open heart surgery patient) came to the group visit today. He and his wife are living proof of lifestyle change leading to positive results. He was told by his cardiologist if he didn't have another surgical procedure, he would be dead in 4 years. (-threat incentive) I remember seeing his cardiac numbers a few yrs ago and was a bit worried that going conservative may not reverse his disease in time. We pushed on, I watched him while his cardiologist continued to give the obligatory finger pointing saying that once the heart muscle is damaged it can never be retrained to beat healthy. First we did supplements to feel better, then supplements to fix deficiencies on blood testing, then exercise to take advantage of the supplement positive effects, then nutrition to remove the need for supplements. Now at 72, he has been deemed a miracle according to the cardiologist, he inspires people 1/2 his age (and out-exercises a lot of them!!!) He has dropped down to a healthy weight even lower than what he was in high school. I asked to see muscle size and this is what this 72 yr old open heart patient showed me:
Even at the age of 72 where some people are accepting death, John is making changes to live a healthy life, has thrown away all his cardiac medicines and (....the clincher) avoided the high risk procedure he was told would get him past the 3 yr deadline given by cardiologist. He looks good, feels good, is helping his wife get healthy and is living proof that change is worth it.....it's never too late.
