COMMUNITY CONNECTIONS

Date: Wednesday, December 4, 2024, 7:00 - 10:00 AM

Location: Vue 17 - A Modern Broadcast & Event Center

Address: 1034 S Brentwood Blvd., 17th Floor, St. Louis, MO 63117​​

 ​

The Midwest Health Initiative (MHI) continued its Community Connections series with a December 4th event, Stopping Chronic Disease Where It Starts, examining lifestyle medicine as a driver of improved patient health, clinician fulfillment, and lower health care costs. Keynote speaker, Dr. Padmaja Patel, president of the American College of Lifestyle Medicine (ACLM), made both the clinical and economic case for lifestyle medicine in primary care and shared innovative practical strategies to integrate lifestyle medicine into clinical practice. A reaction panel of local health professionals weighed in on the topic and highlighted the work their practices are already doing to provide integrated, advanced patient care. The event concluded with an interactive group discussion where participants identified the greatest enabling factors or focus areas for the successful implementation of lifestyle medicine in St. Louis.

​

Lifestyle medicine, the practice of focusing on healthy behaviors like nutrition, physical activity, sleep, and stress management to treat disease, is a topic with growing interest in the St. Louis region. Employers, faced with ever-rising health care costs largely due to preventable chronic conditions, strive to stop disease at the source to ensure healthier employee populations. At the same time, clinicians disillusioned by our current health care systems are looking to break the mold and rediscover the joy in effective preventative patient care.

​

Employers are feeling the immense burden of chronic disease, especially as high-priced specialty drugs and GLP-1s continue to rise in popularity. Driving individuals to make healthier lifestyle choices is not just an option, but an imperative for companies looking to mitigate health care spending growth and build a healthier workforce. Employers are finding, however, that incentives and messaging fall flat if patients are not receiving lifestyle coaching from their doctors.​

​

John Ziegler, of Arch Resources, Inc., spoke to Community Connections attendees about the challenges he has faced trying to move his employee population to better health. “We provide employees and their families with gym memberships - we hand them out like gumdrops. It has not moved the needle.” Ziegler shared the strategies his company has implemented to increase employee health, including wellness incentives and the creation of near-site clinics with flexible hours, but stressed that clinicians must deliver lifestyle medicine interventions for meaningful change to occur.

​

Dr. Padmaja Patel, a primary care physician turned lifestyle medicine pioneer based in Midland Texas, has worked throughout her career to bridge the gap between primary care delivery and lifestyle medicine. As the keynote speaker at Community Connections, Dr. Patel emphasized the role that lifestyle medicine must play in effective primary care, pointing out that over 80% of chronic health conditions in the US are related to lifestyle behaviors, and over $700 billion of health care expenditures stem from tobacco or alcohol use, physical inactivity, and poor nutrition. Lifestyle medicine aims to attack chronic disease where it starts by using evidence-based, prescriptive lifestyle change to treat and reverse chronic conditions.

​

Dr. Patel also reviewed strategies she has used to integrate lifestyle medicine into clinical practice in both fee-for-service and value-based settings, including shared medical appointments and a collaborative care model that combines primary care expertise with behavioral health and psychiatric care. Lifestyle Medicine Shared Medical Appointments (LMSMAs) allow clinicians to interact with multiple patients simultaneously in a group setting. LMSMAs offer not only increased clinical efficiency as education and counseling are administered in a group environment but also enable interdisciplinary care teams to interact with patients for care addressing physical, mental, and social health. Stressing the importance of a whole-person approach to patient care that blends physical and mental health, Dr. Patel stated, “Almost 30% of patients with chronic disease have a mental health disorder and 70% of patients with a mental health condition have physical comorbidities.”

​

Practicing lifestyle medicine can also be beneficial for clinicians. Once herself a traditional practitioner, Dr. Patel expressed that she would have retired from the industry altogether had she not discovered lifestyle medicine. For her, prescribing lifestyle interventions to guide patients in adopting healthier diets and routines – and then witnessing the profound effects like diabetes reversal – is invigorating. To help patients achieve whole-person health and reach a place where they don’t depend on medications and procedures is what medicine should be about.

​

Following Dr. Patel’s presentation, a reaction panel of local health care professionals whose work intersects primary care and lifestyle medicine reflected on the keynote and offered their perspectives. Jordanna Riebel, a behavioral health consultant and clinical psychologist for Family Care Health Centers, provides integrated behavioral health services to the practices’ primary care patients. Thomas Landholt, a family medicine doctor with SSM Health, focuses on delivering personalized health care solutions for his patients. Devyani Hunt, a professor at WashU medicine and medical director for the WashU Living Well Center, provides integrative lifestyle medicine  focusing primarily on orthopedic patients. Each clinician highlighted their practice’s efforts to influence patient behaviors and explained the time and resource challenges they must overcome to affect healthy patient lifestyles. Outside factors often present a barrier to successful behavior change, including limited access to healthy foods, patient economic resources, and misaligned primary care payment structures. For the clinicians at Community Connections, it was important the audience understand that primary care is not ignorant of lifestyle medicine. “The importance of patient lifestyle is part of primary care training, and many physicians work hard to treat patients wholistically and avoid medications when possible.”

 

Key Focus Areas to Advance Lifestyle Medicine in St. Louis

• Motivation/personal desire

• Money

• Healthy Food Access / Diet

• Social support/community strategy

• Clinician Training

• Social Determinants of Health

​

Community Connections concluded with its signature interactive session, where attendees shuffled around the room trading ideas, shared reflections, and competed in a drawing competition. Eric Armbrecht, professor and senior advisor at Saint Louis University and event emcee, asked the audience to consider the biggest key factors for advancing lifestyle medicine in St. Louis primary care and led a crowd-sourcing exercise to identify major themes. While the group’s answers were not altogether surprising, they illuminated clear areas of focus moving forward. Perhaps more importantly, the results demonstrated that stakeholders from all corners of St. Louis and different sides of the health care industry recognize the same issues and paths to a healthier community.