ACLM Leadership Spotlight: Wayne S. Dysinger, MD, MPH
Wayne S. Dysinger, MD, MPH
Director, Loma Linda University Lifestyle Medicine Institute
Program Director, Lifestyle Medicine Residency
Loma Linda University Medical Center (LLUMC), Loma Linda, CA
Wayne
S. Dysinger grew up planning to be a doctor. As a student teacher
during his college years, he experienced the joy of education and was
then torn between two valuable careers. Upon realizing that his goal of
medicine did not have to preclude teaching, his dream of being a doctor
prevailed and his desire for teaching within the context of medicine
has transpired, tenfold.
His
father, also a physician with a prominent career in preventive medicine
and public health--locally and globally, influenced his life and
career. "It is a huge privilege to be a doctor," says Dr. Dysinger. I
have always thought that what makes life worth living is being of
service to others. It's always amazing to me, how you walk into a
patient's room and they tell you significant information about
themselves; information that they wouldn't share a fraction of
otherwise yet they feel safe with their physician. It is a privilege
that people put their lives in our hands--physically, emotionally,
mentally and/or spiritually."
As
he completed his medical school at Loma Linda University Dr. Dysinger
knew during residency training that he wanted to do something 'big
picture;"more than tending to the individual patient and even to the
community. "I wanted to be effective in the 'process' of medicine, such
as the ways that medicine is perceived and taught and administered, so
I created my own track of Family Medicine and Preventive Medicine. I
didn't call it 'Lifestyle Medicine' at the time, but that is what I was
searching for and creating all along."
"Eventually
I got involved in teaching both disciplines, and helped to create a
combined residency at Dartmouth. While teaching, I also did family
practice. I was the main doctor in a town of several thousand people so
I did home visits, 'hospice' work, delivered babies. Those will always
be some of my best memories."
An Invitation to Innovate
In
2003, upon invitation to be Chair of the Department of Preventive
Medicine at Loma Linda University Medical Center in Loma Linda,
California, Dysinger moved west. "Soon after my arrival, at a
department visioning meeting, it became clear that the Loma
Linda University Prevetive Medicine Department wanted to be known for
it's Lifestyle Medicine strengths and activities. In fact, for that
meeting we listed 20-30 different potential tracks/issues/ideas on
which our department could focus. As the group prioritized that list,
the top three were consistent and clear: outpatient LM, Community LM
and In patient LM. This meeting determined our focus for a Residency
Program, Clinical Work and Education respectively. Our unanimous focus
was like a laser."
"Developing
residency programs--family medicine residencies and preventive medicine
residencies, has been a significant focus of my career. In our process
of development here at Loma Linda, we had two senior students that we
hoped would be interested in doing a Family and Preventive residency
with exposure to Lifestyle Medicine. Neither student said yes to our
initial sketchy proposal. At that point John Kelly, MD, MPH who was
doing research in the Department of Nutrition at Loma Linda and I knew
then that if we were going to attract students to this combined
program, then we must offer a true Lifestyle Medicine program."
To
achieve this, Dr. Dysinger sought participation for the idea from the
Internal Medicine as well as the Family Medicine Departments at Loma
Linda. "It was the Family Medicine Department that had the interest and
passion to move forward with us," says Dysinger. "Over the next year,
we received certification from the American Board of Family Medicine,
American Board of Preventive Medicine and the Residency Review
Committee of each of those Boards. Our first year we had four students
interested. Three of them (one did not stay in the program) are now
fourth year residents. In 2010 they will graduate as our first group of
Family and Preventive Medicine residents, also known as Lifestyle
Medicine residents."
"Over
the last four years we have seen an increasing strength in quality and
quantity of applicants for this program; medical students from across
the country want to do rotations with us. It sparks the passions in a
lot of people pursuing a medical career, so much so that we have to
turn people down.The Residency's Vision 'to create a worldwide health
epidemic' is accompanied by their Mission to train physicians in Family
and Preventive Medicine, focusing on:
- An atmosphere that promotes leadership, innovation, spirituality and service
- Knowledge and skills that meet the primary and preventive health care needs of individuals and communities
- Leadership tracks in lifestyle medicine and global health
Lifestyle Medicine Residency: An Evolving Discipline
Loma
Linda's unique program includes a full spectrum of primary care
experiences through the Loma Linda University Family Medicine Residency
Program, and a comprehensive exposure to population-based care and
health-care systems through the Loma Linda University Preventive
Medicine Residency Program. This innovative program is for students who
"want to impact the health of individuals, as well as communities and
populations, and who are called to excellence, compassion and
wholeness," Dysinger explains.
"We combine the years of clinical
training in a Family Medicine Residency and the three years of
population-based training in a Preventive Medicine Residency into an
integrated four-year educational program. At the end of their four
years, residents will have completed an MPH at the Loma Linda
University School of Public Health with a focus on Lifestyle Medicine
and will be board eligible in both Family Medicine and Preventive
Medicine. Our innovative training approach has led us to be designated
as one of the fourteen P4 residencies recognized nationally as a
program of the future by residency educators."
"We have learned
which rotations work, and which ones don't. Our residency program has
been evolving; it's been adaptable, flexible, able to adjust with
change," explains Dysinger, "in order to make it the most vital and
viable of programs for our students. Upon completion of their training,
residents will be board eligible in family medicine and preventive
medicine (we are the first and only four-year curriculum that is
formally approved by both the American Board of Family Medicine and the
American Board of Preventive Medicine). They will be well positioned to
lead in the provision of new models of chronic disease care such as
obesity and diabetes, as well as global health challenges such as
maternal child health and smoking cessation."
The residency currently accepts four residents per year through the National Resident Match Program.
The
Family & Preventive Medicine Residency is also considered to be a
Lifestyle Medicine Residency, although not 'formally.' Dr. Dysinger
elaborated: "Residency's have to be certified, and at this time there
isn't a 'certifying body' for our program to 'be certified' as
Lifestyle Medicine. We are working hard on securing certification but
it's a long process. In the meantime, it is important to reference our
program for what it is, which is indeed Lifestyle Medicine. We have
built on Loma Linda University's 100 year history of leadership in the
Lifestyle Medicine movement to create a focused training program that
ensures our residents will be experts at lifestyle change in multiple
settings."
"Besides
an MPH in Lifestyle Medicine, rotations in the second through fourth
years incorporate lifestyle medicine training experiences in inpatient,
outpatient, community and residential settings. Continuity clinics
provide residents with hands-on skills in individual and group
lifestyle medicine interventions and expose them to tools and resources
that maximize their success in facilitating healthy behavior change."
A Good Mix: 20.30.30.20
Dr.
Dysinger's responsibilities as Chair of Preventive Medicine and
Director of Family and Preventive Residency are delineated, ideally,
into 20% of his time at Loma Linda's Center for Health Promotion doing
lifestyle medicine clinical work, 30% teaching the medical students,
30% teaching in the residency program and 20% administration. "It's a
good mix for me," proclaims Dr. Dysinger.
"For
over two decades the Center for Health Promotion has been providing
preventive specialty care and primary medical services to the Southern
California community. Our goal has always been to provide quality
health care and a close working relationship between the client,
medical practitioner, health educator, and preventive care specialist.
The Center is associated with the Loma Linda University Schools of
Medicine and Public Health and has been chosen to offer the highest
level of ambulatory care to our University student body through Student
Health Service. The Center offers a variety of services such as
preventive specialty care/Primary medical care, executive health -
comprehensive health evaluation and intervention, weight management,
nutrition and dietetic counseling, international travel clinic and
fitness testing."
ACLM Leadership
In 2004
Dr. Dysinger was one of the founding members of ACLM. He served two
terms on the ACLM board, and was chosen as President elect in 2008. He
moved into the role of President in November 2009.
