Lifestyle Medicine: An Emerging Medical Specialty
It's becoming more likely that fitness professionals will partner with physicians who understand, embrace and prescribe exercise as medicine.
Fitness and wellness professionals know the importance of building a strong referral program with allied health professionals, such as physicians, but making connections is not always easy. Personal trainers, for example, have worked hard to gain trust from the medical community. Sometimes, however, an “old guard” mentality stands in the way of healthy cooperation, potentially putting clients and patients at higher risk. The fitness and wellness community already knows that exercise is medicine. Wouldn’t it be great to refer your clients to physicians who are on the same page as you?
Seeking support from wellness-oriented doctors is now much easier thanks to a burgeoning movement called lifestyle medicine (LM), which is led by physicians who believe positive lifestyle changes should be the first line of defense—and offense—against chronic, lifestyle-related disease. Read on to find out more about how LM proponents advocate what fitness professionals already laud.
What Is Lifestyle Medicine?
LM is a clinical specialty for physicians who treat chronic conditions like heart disease, diabetes and high blood pressure. LM specialists may prescribe behavioral modifications for two reasons: to reduce the risk of future problems, or to treat and/or reverse existing disease. Recommendations usually include plant-based nutrition, exercise plans, stress management and smoking cessation techniques, and other nondrug approaches. However, LM is not “alternative” medicine; LM-trained physicians may use traditional allopathic approaches (such as medication) as well. It’s important to note, though, that owing to the lifestyle intervention focus, patients often need a lower dosage of medications (ACLM 2011).
It’s well known that positive lifestyle changes help manage many illnesses. But often physicians do not actively prescribe behavior modifications to their patients (Lianov & Johnson 2010). Besides being pressed for time, doctors have cited lack of confidence, lack of knowledge, and lack of skill as major barriers to offering lifestyle counseling. Mark Hyman, MD, says this type of oversight costs society: “Personalized lifestyle medicine is a high-science, high-touch, low-tech, low-cost treatment that is more effective for the top 5 chronic diseases than our current approaches.“ In fact, this treatment, if applied to all the patients with cardiovascular disease, diabetes, metabolic syndrome (obesity), prostate cancer, and breast cancer could reduce net health care expenditures $930 billion over 5 years and result in dramatically better health and quality of life” (Hyman, Ornish & Roizen 2009).
Organizations have formed to help lead forward-thinking physicians toward practicing LM. The American College of Lifestyle Medicine, formed in 2004, is a national medical-specialty society (not a place of study). ACLM membership is primarily composed of physicians, although it also includes researchers, nutritionists and other healthcare professionals. “The ACLM is dedicated to changing the face of medicine and treating the cause of 80% of all preventable deaths, which is lifestyle behaviors,” says researcher and ACLM spokesperson (and former personal trainer) Mark D. Faries, MS, PhD.
The ACLM’s offerings include an annual conference (the 2014 headliners included Dean Ornish, MD), an official journal (American Journal of Lifestyle Medicine), an online directory of affiliated physicians, and other educational and networking opportunities. The organization also strives to help physicians overcome concerns about practicing LM. LM-trained doctors “have an important perspective and expertise to prevent and treat disease with the same lifestyle behaviors that the fitness professional works with every single day,” says Faries.
Part of the ACLM’s work is to help lifestyle medicine become a “board-certifiable” specialty for doctors through the American Board of Medical Specialties. In the United States, board certification is voluntary and indicates that a doctor has met additional educational requirements in a specific area of professional expertise. Prominent board-certification-eligible specialties include family medicine, pediatrics and dermatology. In the future, LM might be an ABMS-recognized medical specialty too. Note that other board-certifiable medical specialties typically have their own colleges. Thus, for example, a board-certified pediatrician might belong to the American College of Pediatricians. The ACLM fulfills this role for wellness-oriented physicians.
Other organizations that focus on promoting lifestyle medicine include the European Society of Lifestyle Medicine, the Australian Lifestyle Medicine Association and the Institute of Lifestyle Medicine.
The Fitness Connection
The ACLM supports a multipronged approach to client wellness. “The physician’s trusted relationship with the patient, with the support of the family, the interdisciplinary team (including the fitness professional), and the community is key to improving health behaviors and outcomes,” Faries says. “As highlighted in the ACLM physician competencies, fitness professionals are viewed as an important, key member of the lifestyle medicine team.”
To network with lifestyle-savvy docs, visit the ACLM website (www.lifestylemedicine.org) and search for providers in your area, recommends Faries. “This is the perfect time for fitness professionals to get involved and team up with all the medical providers dedicated to lifestyle medicine,” he says.
Here are additional tips that will help you develop a strong professional network with like-minded physicians:
- Always stay within your scope of practice. Keep a list of preapproved physicians on hand so that you can refer clients as needed.
- Send regular progress reports to your client’s physician (with your client’s approval, of course), and ask for input.
- Stay current with your certifications and continuing education credits so that physicians can see that you are well-trained and serious about your profession.
- Become familiar with standardized healthcare communication protocols, such as SBAR (situation, background, assessment and recommendation), and use them when interfacing with physicians. For example, when speaking with a client’s doctor, state the situation, offer background on your experience with the client, give your assessment and ask for a recommendation.
Now, more than ever, the fitness and medical communities need to find a common link that will ultimately help patients and clients become and stay healthy. Lifestyle medicine is positioned to partner with the fitness industry in new and extraordinary ways that may reshape the future of health and wellness.
ACLM (American College of Lifestyle Medicine). 2011. What is lifestyle medicine? Accessed Dec. 2014. www.lifestylemedicine.org/define.
Hyman, M., Ornish, D., & Roizen, M. 2009. Lifestyle medicine: Treating the causes of disease. Alternative Therapies, 15 (6), 12-14. http://drhyman.com/downloads/Lifestyle-Medicine.pdf
Lianov, L., & Johnson, M. 2010. Physician competencies for prescribing lifestyle medicine. Journal of the American Medical Association, 304 (2), 202-203. http://www.jama.jamanetwork.com/article.aspx?articleid=186192