Lifestyle MedicineEducation

Concentration

Graduate Medical EducationLoma Linda University

Wayne Dysinger, MD, MPHCourse Director

80% of health care costsworldwidecome from

chronicdiseases

that are fullytreatable with

lifestyle

Did youknow that…

A report by the S

ecretary General on the prevention and control of non-com

municable disease A

/66/83. Septem

ber, 2011,;

… only 52% of obese patients who already have obesity-related co-morbidities are counseled to lose weight

Did you know that…

Stafford RS, Farhat JH, Misra B, Schoenfeld DA. National patterns of physician activities related to obesity management. Arch Fam Med. 2000;9:631-638.

Do you know that…

…most doctors have never written a nutrition prescrip- tion because they don’t know how to?

Dysinger WS. Lifestyle medicine: an overview. Primary Care Reports. 2010;16(5),1-12.

…lifestyle medicine is a financially viable foundation for future practice?

Did you know that…

Centers for Medicaid and Medicare Services. Decision Memo for Intensive Behavioral Therapy for Obesity (CAG-00423N). November, 2011

Three Core Activities

1) Completion of twelve podcastsa. 60 minute didactic

b. Includes an interactive component and a quiz

2) Achievement of a personal lifestyle medicine application

3) Participation in presentation of an Intensive Therapeutic Lifestyle Change (ITLC) interventiona. pre-intervention ITLC review

b. Intervention participation / hands on experience

JAMA, July 14, 2010

Podcasts based on the JAMA Lifestyle Medicine competencies.

Lifestyle Medicine Podcasts1. Introduction to Lifestyle Medicine (LMC #1)

2. Making it Personal – Short and Long Term Considerations (LMC #2)

3. A Review of the Evidence – What Science Says (LMC #3)

4. Health Behavior Change – Ways to Make it Happen (LMC #4)

5. Health Risk Assessment – Where is the Patient At? (LMC #5 & 6)

6. Health Risk Assessment – Learning about Health Habits (LMC #7)

7. Establishing Ongoing Therapeutic Relationships with Patients (LMC #9)

8. Creating LM Treatment Maps for your Patients (LMC #8)

9. Developing Specific Action Plans (LMC #10)

10. Accessing Inter-disciplinary and Community Resources (LMC #12 & 15)

11. Applying Technology and Resources for Maintenance (LMC #11 & 13)

12. Ongoing Measurement and Improvements (LMC #14)

LMC – Lifestyle Medicine Competency number as listed in the 7/14/10 JAMA article.

Intensive Therapeutic Lifestyle Change (ITLC) Intervention

1. Introduction- review of typical components of an ITLC- presented in summer and fall quarters – attendance at 1 is required

2. Participation- 20 sessions over three months, each 90 minutes in length- attendance and participation in at least 6 sessions is required- participation may include: a) educational presentations, b) patient interactions, and/or c) logistical coordination- may occur during the fall, winter or spring quarters (after attending the introductory session)

Personal Lifestyle Improvement1. Plan Creation

- by the end of August each resident will create a personal improvement plan that implements a lifestyle change enhancing their own life balance using the Wholeness Portal

2. Ongoing Log/Journal- participants will support each other via on-line logs/journals

3. Summary- by the end of June each resident will create a written summary of their successes, failures, and what they learned

July August September October November December January February March April May June

Podcasts

#1 ---

Introduc-tion to LM

(LMC #1)

#2---

Making LM Personal(LMC #2)

#3---

A Reviewof the Evidence

(LMC #3)

#4---

HealthBehaviorChange

(LMC #4)

#5---

Readiness to Change

(LMC #5&6)

#6---

Health Risk Assessmnt(LMC #7)

#7---

Establishing Therapeutic

Relations(LMC #9)

#8---

Creating LM Treat-ment Maps

(LMC #8)

#9---

Developing Specific Ac-tion

Plans (LMC #10)

#10---

Community Resources

(LMC #12 & 15)

#11---

Technology and Other Resources(LMC #11 & 13)

#12---

Measure-ment & Im-provement

(LMC #14)

Completion of all twelve is required including: 1) thorough engagement in the interactive portion, and

2) passing scores on the end of podcast quiz.

PersonalLifestyle Activity

Participation in a personal application of a balanced lifestyle.

IntensiveThera-peutic

Lifestyle Change

Inter-vention(ITLC)

Introductory Seminar -Preparing for the ITLC

(1 hour)

Introductory Seminar -Preparing for the ITLC

(1 hour)

ITLC InterventionIntro, 13 sessions, Conclusion

(90 min each session)

ITLC InterventionIntro, 13 sessions, Conclusion

(90 min each session)

Attendance at one or the other is required.Participation in the intro, all 13 sessions and conclusion is encouraged.

Participation in at least six of the sessions is required. This is to include patient Interactions, educational lectures, logistics coordination.

LIFESTYLE MECICINE EDUCATION CONCENTRATION TIMELINE

• LMC’s are the Lifestyle Medicine Competencies published in JAMA, July 14, 2010.

Faculty1. Director

Wayne Dysinger, MD, MPH – Course DirectorChair of Preventive Medicine, Loma Linda UniversityPresident of the American College of Lifestyle Medicine

2. Core FacultyMark Debay, MD, PhDHans Diehl, DrPH, MPHWarren Peters, MDMichael Orlich, MD, MPH, PhD © Serena Tonstad, MD, MPH, PhD

3. Other FacultyA variety of other faculty specializing in lifestyle medicine from either the nutrition, physical activity, rest, spirituality and/or health behavior change components will also participate

Evaluation

1. Lifestyle Medicine Knowledge (25%)A quiz will be given at the end of each pod-cast

2. Presentation Quality (25%)The quality of the resident’s presentation in the ITLC intervention will be evaluated. A variety of other faculty specializing in lifestyle medicine from either the nutrition, physical activity, rest, spirituality and/or health behavior change components will also participate

3. Participation (50%)Full participation in each of the 3 core activities is required:a. Podcasts (must be done in a timely manner)b. ITLC (ITLC intro, 6 ITLC session)c. Personal improvement plan

Do you wish you…

…were able to treat the actual causes of your patients’ diseases?

(not just the symptoms)

…could effectively reverse disease naturally with minimal use of medications?

Do you wish you…

Do you wish you…

…knew how to competently talk with your patients about nutrition?

Do you wish you…

…had a healthy, balanced lifestyle yourself?

Summary Requirements

1) Completion of twelve podcastsa. 60 minute didactic

b. interactive component

c. quiz

2) Achievement of a personal lifestyle medicine application

3) Participation in presentation of an Intensive Therapeutic Lifestyle Change (ITLC) intervention