Lifestyle Medicine Practice Models: Optimizing Lifestyle Medicine Clinical Practice 

Prices per Course NOTE: ACLM members receive an exclusive $200 discount. 
Nonmember - $100
Member - $80

Credits
2 CME/CNE/CE Credits
0.50 CPE Credits
(Full Accreditation information listed below)

Learning Objectives 

  • List various practice models that Lifestyle Medicine providers and professionals are using in clinical practice. 
  • Distinguish the differences between the delivery of each practice model and what settings each might be applied in. 
  • Describe the key elements and action steps for the implementation of the highlighted practice models. 
  • Describe the tools and resources needed and available to implement the highlighted practice models.
  • Determine which practice models would be appropriate to apply in a practice setting.
  • Formulate a plan to implement one or more of these practice models in a practice setting.
  • Prepare to apply one or more practice model in his or her own clinical practice.
Segments 

The ACLM's Provider Network is seeking to deliver a consistent, best practice of Lifestyle Medicine across diverse practices throughout the United States. To accomplish this, we have initiated the "LM Framework", a standardized set of best practices that we train our member practices in. We capture a minimum set of metrics about each patient experience to ensure that best practices were followed, and to measure outcomes. Our plan is to develop a practice model that permits practitioners to do their signature LM programs and counseling, while delivering common LM best practices and real outcomes, that we can sell to employers and brokers. 

Learning Objectives 

  • Discuss the risks of ad-hoc Lifestyle Medicine. 
  • Design a system for your Lifestyle Medicine practice, that delivers measurable outcomes. 
  • Implement the cultural change in your practice necessary to transform your practice into a measurable outcome-generating machine. 

Speakers 
David Donohue, MD, FACP, DipABLM  – Chief Medical Officer, Progressive Health of Delaware

David Donohue, MD FACP is a primary care internist practicing in Wilmington, Delaware since 2000. He received his masters of Molecular Biology from Stanford in 1993, medical training at Baylor College of Medicine and residency in primary care internal medicine at George Washington University. He was certified by the American Board of Lifestyle Medicine in November 2017. His practice, Progressive Health of Delaware, is the only lifestyle medicine practice in its region. From 2000 to 2016, he was a full-time IT architect and software developer for the DuPont company. Since 2018 he has been the chair of ACLM's Provider Network. He is passionate about transforming health care in the United States to focus on standardized, protocol-driven best practices of lifestyle medicine.

In this presentation, Dr. Serna will share her expertise and experiences of the intersection between LM and Concierge Medicine. After a breif justification of why an LM provider might be interested in practicing concierge medicine, she will review key considerations and steps to delivering LM in a concierge practice. The audience can expect to walk away with a clear understanding of what it takes to deliver LM in a concierge model of practice and how to get started. 

Learning Objectives 

  • Discuss concierge medicine and why it might be used to sustainably deliver Lifestyle Medicine. 
  • Describe methods used to efficiently and effectively conduct LM practice within a concierge delivery model. 
  • Summarize at least 3 key steps needed to start or enhance a concierge LM practice. 

Speakers 
Dorothy C. Serna, MD, CWP, FACP, DipABLM  – Owner and Founder, North Cypress Internal Medicine and Wellness 

Dorothy Cohen Serna, MD, CWP, FACP has been in private practice since 1998. She founded North Cypress Internal Medicine and Wellness, with the mission of providing superior, attentive and thoughtful care with a strong focus on Lifestyle Medicine and Wellness. Dr. Serna is certified as a Diplomate of the American Board of Lifestyle Medicine, part of the first group of medical professionals to earn this distinction. Dr. Serna attended medical school at the University of South Florida and completed her Internal Medicine residency at Baylor College of Medicine in the Texas Medical Center in 1997. Dr. Serna is Board Certified by the American Board of Internal Medicine, she has attained Fellowship with the American College of Physicians and also is a Certified Wellness Practitioner. She is also proud to serve as Chief Wellness Officer at North Cypress Medical Center Hospital, as a member of the Go Houston Task Force and as an active participant on the Community Health Improvement and Communications Committee of the Harris County Medical Society. Dr. Serna has four children. She enjoys fitness activities, reading and trying to keep up with her children! She aims to be an excellent role model for the healthy lifestyles that are promoted in her medical practice. 

Lifestyle Medical is a two clinic primary care practice in Southern California that is built on Lifestyle Medicine principles. The financial model that Lifestyle Medical uses is value based. This means that we are reimbursed in a capitated or per member per month (PMPM) fashion for all of our patients. Reimbursement occurs in four different ways: 

  1. Medicare Advantage (Medicare C or Medicare HMO) - this is our best reimbursement, especially in contracts where we take risk
  2. Medicare B - we take advantage of CMS sponsored chronic care management (CCM) and remote patient monitoring (RPM) programs to get paid monthly for these patients - but we also bill old-fashioned fee for service (FFS) for them
  3. Commercial PPO and HMO - for non-Medicare patients who have an insurance who we can either bill FFS or get a PMPM payment, we charge an additional $18/mo to cover our extra LM services and interventions
  4. Direct Primary Care - for individuals who do not have insurance, have a very high deductible, or have an insurance we cannot bill (ie, Kaiser), we charge $78/mo for both our primary care and LM services. 
    We did not arrive at our current financially strong place easily. We tried a variety of approaches, but over the course of five years have found what works well for us, and what we believe would work well for many Lifestyle Medicine flavored primary care practices. 

Learning Objectives 

  • Identify why a value based practice approach is uniquely suited for Lifestyle Medicine. 
  • Explain why Medicare Advantage is a unique reimbursement opportunity for a primary care Lifestyle Medicine practice. 
  • Discuss how an additional monthly fee allows a primary care practice to provide full Lifestyle Medicine services to commercial patients. 

Speakers 
Wayne S. Dysinger, MD, MPH, FACLM, FACPM, DipABLM  – Medical Director and Chair, Lifestyle Medical 

Dr. Dysinger is a lifestyle and primary care physician who currently serves as Medical Director of Lifestyle Medical, a set of new model primary care clinics in southern California that are built around the principals of Lifestyle Medicine. He is also Chair of the American Board of Lifestyle Medicine and the International Board of Lifestyle Medicine. He is an active faculty at Loma Linda University and consults, teaches and participates in research on Lifestyle Medicine issues around the world. Dr. Dysinger was previously Chair, Department of Preventive Medicine, Loma Linda University as well as the Medical Director of the Complete Health Improvement Program (CHIP). He is a past President of the American College of Lifestyle Medicine, and has been on the board of the American College of Preventive Medicine and the Association for Prevention Teaching and Research. He has worked in various capacities with the American Medical Association and the American Academy of Family Physicians. Dr. Dysinger earned his M.D. degree from Loma Linda University School of Medicine (1986), and his MPH from Loma Linda University School of Public Health (1990). He has previously worked in Guam, Atlanta and Dartmouth. His board certification is in Family Medicine and Preventive Medicine. 

In this session, we will define the direct primary care model and how it supports successful lifestyle medicine in clinical practice. We will then discuss the widespread success of this model in improving patient satisfaction, physician satisfaction, improved patient outcomes and value for patients and employers. We will reflect on how Direct Primary Care specifically supports the Lifestyle Medicine Core Competencies.  

Learning Objectives 

  • Define Direct Primary Care. 
  • Review the widespread success of this model in improving patient satisfaction, physician satisfaction, improved patient outcomes and value for patients and employers by employing the Lifestyle in Medicine model. 
  • Discuss how the DPC model supports LM independent practices and the Lifestyle Medicine Core Competencies. 

Speakers 
Amy Mechley, MD, DipABLM – CEO, Co-Founder and Volunteer Adjunct Professor, Integrative Family Care 

Dr. Mechley is a practicing Direct Primary Care family medicine physician, entrepreneur, clinical consultant and teacher. Her career as a physician is grounded on servant led principles and she takes innovative approaches to some of the most challenging concerns in healthcare today. As a recognized physician executive in primary care, she has had the successful opportunity to lead transformation in an Advanced Payment Model working with the Center for Medicare and Medicaid Innovation and the State of Ohio governor’s task force. She has also completed a certificate in Design Thinking from Xavier University. Dr Mechley is double boarded in Lifestyle and Family Medicine. She is actively involved in teaching medical students and family medicine residents. It is her interest in aligning her focus of Lifestyle Medicine principals within the practice of primary care that has led her to open IFC Direct Primary Care in Cincinnati, Ohio. She has subsequently created TRI-DPC, a network of Independant DPC practices contracting directly with employers.

Will your specialty practice have to close its doors during these tough times? America continues spending significantly more on health care than other countries, without a great return on that investment. The old models of managing the disease are outdated, and the future of healthcare will need to go beyond the roles of traditional hospitals and medical practices. As the overall health of Americans get worse, there exists the need for leadership in medicine which can strengthen our commitment health, wholeness, and therefore hope. 
 
The COVID 19 pandemic has caused many practices and businesses to close due to the inability to adapt to our country’s evolving landscape. The population of people in a town or city have no real sustainable ideas to get them through the crisis. As the Coronavirus crisis passes, our country will be looking to forward-thinking practices to help rebuild and find solutions to the health of our communities, and our nation. 
 
Our cardiology practice has been consistently able to get our patients off their hypertensive and diabetic meds even during the pandemic. This has been achieved by focusing on the interconnectedness of our health to the neighborhoods and communities around us who are facing the crisis. Cardiology practices are keenly positioned to focus on improving and strengthening the community via a 21st century preventative strategy leveraging the core principles of Lifestyle Medicine. 
 
What are the secrets needed to create a viable preventative practice that is designed to make an impact? Our model can improve the health of individuals and communities, and in turn, make care more affordable. We believe that preventative cardiology practices can have an even bigger impact as part of a strong and prevention-minded health system.  

Learning Objectives 

  • Define the Social Determinants of Health (SDH). 
  • Discuss the role of a specialty practice in leveraging the core principles of Lifestyle Medicine to address the Social Determinants of Health. 
  • Explain how a specialty practice focused on Lifestyle Medicine can make a decisive impact and lead communities to recovery. 

Speakers 
Clifford Morris, MD – President, Morris Cardiovascular & Risk Reduction Center 

Dr. Cliff Morris is a highly regarded board certified cardiologist whose unique approach takes into account the physical, psychological, cultural, and social aspects of heart disease. The Morris Cardiovascular and Risk Reduction Center, which he founded, has the first Medical Fitness Program of its kind, which reverses heart disease and diabetes through comprehensive lifestyle change. Educated at The University of North Carolina at Chapel Hill, he received his BS degree in biology while playing basketball for the legendary Coach Dean Smith and UNC Tarheels. His former teammates included greats such as Michael Jordan, Kenny Smith, and Brad Daugherty. His life work has earned him many prestigious honors over the 25+ years he has been practicing medicine. A few of these include recognition for his humanitarian efforts including the 2008 Planetree Physicians’ Award for compassion oriented patient care. In 2009 he was the first physician at John Randolph Medical Center to be honored with the HCA Frist Humanitarian Award. He once again was honored to receive this award again in 2019. In 2014 he was honored with Richmond Virginia's top award for Best Bedside Manner by Our Health Magazine. Dr. Morris has four children and lives with his loving wife Fran and their dog Dusty. He enjoys daily meditation, Tai Chi, and performing acts of service in the community. His motto is "All Doctors Are Not The Same", and he is deeply grateful for any opportunity to grow and contribute to the world.

In our attempt to fix the broken healthcare system, integrating lifestyle medicine principles within a healthcare system is fundamental. While we all agree that there needs to be a radical change in healthcare delivery, how do we make a case for LM that convinces hospital administrators? Learn how Midland Health started its LM journey and what keeps the healthcare system committed in its mission to support its Lifestyle Medicine Program. 

Learning Objectives 

  • Identify reasons that make a case for LM in a healthcare system. 
  • Discuss cost-saving initiatives and programs that center around LM. 
  • Describe the role of LM in changing reimbursement models for a healthcare system. 

Speakers 
Padmaja M. Patel, MD, DipABLM – Medical Director, Midland Health 

Dr. Padmaja Patel has been a practicing internist in Midland, TX for nearly two decades. She completed her E.N.T. training in India and Internal Medicine residency at the University of Missouri, Columbia. She currently serves as the Medical Director of the Lifestyle Medicine Center at Midland Health and has been an advocate for offering a variety of comprehensive lifestyle intervention programs under physician supervision. In her private practice, she strives to offer high-quality, evidence-based care that incorporates the core principles of lifestyle medicine. Dr. Patel’s passion for health and wellness fueled her desire to co-found Healthy City, a non-profit organization, to raise awareness of the benefits of plant-based nutrition within her community. She also serves as Vice President of the Midland Quality Alliance, a clinically integrated network of physicians, and is on the Health and Wellness committee of Priority Midland, a local community initiative.

Discuss the current burden of cardiovascular risk factors and related risk factors, followed by how we can make an effort to "flip the pyramid." Show case the work that is being done at the James A Haley VA Medical Center in Tampa, FL. 

Learning Objectives 

  • Define the current cardiovascular disease burden. 
  • Demonstrate that the majority of the current burden is related to diseases that are preventable. 
  • List the methods and programs being undertaken at a VA hospital to prevent treat and potentially reverse chronic disease. 

Speakers 
Koushik Reddy, MD, DipABLM – Director, Interventional Cardiology, James A Haley VA Medical Center 

Dr. Reddy is the director of interventional cardiology at the James A Haley VA Medical Center in Tampa, FL. He completed his general and interventional cardiology fellowship training at Winthrop University Hospital in Long Island, NY. After practicing interventional cardiology for ten years, he changed his focus towards cardiovascular health promotion and disease prevention, using lifestyle and nutrition based strategies. He is a member of American College of Cardiology’s working group on nutrition and lifestyle. In addition, he serves as a board of director and the treasurer for the American College of Lifestyle Medicine. He is the founding Co-Chair of Veterans Health Administration/Department of Defense member interest group and the Cardiology member interest group under the American College of Lifestyle Medicine. Dr. Reddy is board certified in Cardiology, Interventional Cardiology and Lifestyle Medicine He is closely involved with the department of Whole Health at the Tampa VA hospital. Working in partnership with the local Whole Health leadership, he established two preventive cardiology clinics. HEAL – Healthy Eating and Living – Introductory Program. CALM – Comprehensive Approach to Lifestyle Medicine – 6 weeks of multidisciplinary program. He is passionate and is committed to the idea of health promotion and disease prevention, using lifestyle and nutrition related tools. It is with this passion and commitment, he boldly challenges his patients by saying – “I have a carrot and a stent, you pick!”

There is an epidemic of chronic disease in our country, the majority of which is largely preventable and reversible. These diseases affect millions of Americans, costing billions of dollars yearly for treatments that slow the progression of disease but do not address the root cause of illness. The vast majority of our health care costs are related to treating chronic diseases such as diabetes, heart disease, stroke, hypertension, cancer and COPD. Research has demonstrated that 80% of these chronic diseases could be prevented if Americans followed four lifestyle behaviors - not smoking, maintaining a healthy weight, eating a diet rich in fruits, vegetables, legumes and whole grains, and exercising moderately for at least 30 minutes daily. Unfortunately, only 3% of Americans adhere to all four of these lifestyle behaviors. If lifestyle choices have such a dramatic impact on our health and wellbeing, why do we have such a dismally low percentage of people actively engaged in healthy habits? It turns out that lifestyle choices are contagious, in a similar way to a virus. We are likely to pursue the same habits and activities as the family, friends and co-workers that surround us. To effectively curb the high cost of health care and improve the vitality of our patients we must treat the cause of health problems rather than just treating the symptoms with medications and procedures. Studies have indicated that only 20% of our health outcomes in the US are related to the clinical care we receive – the quality of the healthcare professionals and medical facilities we can access – the remaining 80% is directly related to our own health behaviors, socioeconomic factors and the impact of our physical environment. It is time to embrace multi-component, community-based strategies supporting improved access to fresh fruits and vegetables, school/neighborhood gardens, interactive whole food, plant-based cooking classes, exercise opportunities, intensive therapeutic lifestyle change programs and increased social connectivity as part of our healthcare toolkit. The power to achieve a long “healthspan” and a long lifespan full of vitality and purpose is within our own hands. We do not need to wait for a new wonder-drug or high-tech medical procedure. The power is in the relationships that we nurture, the food that we eat, the way that we move and sleep, the community culture that we create and the social nudges with which we surround ourselves. By working together with a diverse coalition of community partners we can make the Healthy Choice the Easy Choice within our families and our neighborhoods. 

Learning Objectives 

  • Upon completion, participant will be able to discuss multi-component strategies to increase fruit, vegetable and other whole food, plant-based meal consumption in the community, specifically targeted for areas of food insecurity. 
  • Upon completion, participants will be able to summarize relevant research regarding the impact of health behaviors, socioeconomic factors, physical environment and social norms in health outcomes. 
  • Upon completion, participant will be able to summarize a roadmap for creating innovative lifestyle medicine initiatives in their community, including Food as Medicine and food access initiatives, healthy lifestyle educational workshops, community/school garden programs, neighborhood cooking classes and intensive therapeutic lifestyle change programs. 

Speakers 
Meagan L. Grega, MD, DipABLM – Co-Founder, Chief Medical Officer, Kellyn Foundation 

Meagan L. Grega, MD, is the Co-Founder and Chief Medical Officer of Kellyn Foundation (www.kellyn.org), a 501(c)3 non-profit dedicated to making the Healthy Choice the Easy Choice. Kellyn provides school-based healthy lifestyle education and “Garden as a Classroom” programs; supports access to nutrient-dense produce via the Eat Real Food Mobile Market and Lehigh Valley Corner Store Initiative; engages participants in hands-on, plant-based cooking classes in community settings and offers intensive therapeutic lifestyle change interventions for individuals and families. She is a summa cum laude graduate of Bucknell University with a B.S. in Biochemistry/Cell Biology and earned her MD degree from the University of Pennsylvania Medical School. Dr. Grega spent several years as a medical officer in the United States Navy, attaining the rank of Lieutenant Commander before resigning from active duty service. She has been a staff Family Physician at Hunterdon Medical Center, the Director of Women's Health Services at Lafayette College and is currently the Managing Director of Llantrisant Retreat and Wellness Center (www.llantrisantretreat.com), the home of Kellyn Foundation. She is honored to serve as adjunct faculty for the St. Luke’s University Health Network Anderson Campus Family Medicine and Internal Medicine Residency programs and as a faculty advisor for the Lewis Katz School of Medicine at Temple University/SLUHN medical student Lifestyle Medicine Interest Group (LMIG). She is a member of the ACLM Speaker’s Bureau, a member of the True Health Initiative Council of Directors and serves on several national task force groups dedicated to the expansion of evidence-based lifestyle medicine services. Dr. Grega is a member of the American Academy of Family Physicians, a Fellow of the American College of Lifestyle Medicine and is board certified in both Family Medicine and Lifestyle Medicine.

Format 
LM2020 On Demand is hosted online via the ACLM Learning Management System and consists of 16 sessions all of which include a title, description, learning objectives, speaker information, video recording, presentation slides in PDF format, an assessment and survey evaluation.

Duration 
2 hours

Specifications 
This content can be viewed on a desktop, tablet or mobile device. Speakers or headphones are required. 

Term of Approval 
February 22, 2021 – February 22, 2023 

Enrollment 
Access to course: access to online material is granted through the term of approval which ends February 22, 2023.  

Accreditation Statement 
In support of patient care, Rush University Medical Center is accredited by the American Nurses Credentialing Center (ANCC), the Accreditation Council for Pharmacy Education (ACPE), and the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing education for the healthcare team. 
 
Rush University Medical Center designates this enduring material for a maximum of 2 AMA PRA Category 1 Credit(s)™. Physicians should claim only credit commensurate with the extent of their participation in the activity. 
 
ANCC Credit Designation – Nurses The maximum number of hours awarded for this CE activity is 2 contact hours. This activity is being presented without bias and without commercial support. 
 
Rush University Medical Center designates this knowledge based CPE activity for 0.50 contact hours for pharmacists. 
 
Rush University is an approved provider for physical therapy (216.000272), occupational therapy, respiratory therapy, social work (159.001203), nutrition, speech-audiology, and psychology by the Illinois Department of Professional Regulation. Rush University designates this live activity for 2 Continuing Education credit(s)
 
The Commission on Dietetic Registration accepts self-study programs approved through the ACCME.

ABLM MOC 
The American Board of Lifestyle Medicine has approved 2 maintenance of certification credits for this learning activity. 

AAFP Prescribed Credits 
The AAFP has reviewed LM2020 On Demand: Health Restored Virtual Conference, and deemed it acceptable for AAFP credit. Term of approval is from 02/22/2021 to 02/22/2022. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Credit approval includes the following session: 2.00 Enduring Materials, Self-Study AAFP Prescribed Credit(s) - Lifestyle Medicine Practice Models: Optimizing Lifestyle Medicine Clinical Practice

The National Board for Health and Wellness Coaching (NBHWC) has approved 2 continuing education credits for NBC-HWCs upon successful completion of the LM2020 On Demand Health Restored Virtual Conference. 

Faculty Disclosures 
It is the policy of the Rush University Office of Interprofessional continuing Education to ensure that its CE activities are independent, free of commercial bias and beyond the control of persons or organizations with an economic interest in influencing the content of CE.  Everyone who is in a position to control the content of an educational activity must disclose all relevant financial relationships with any commercial interest (including but not limited to pharmaceutical companies, biomedical device manufacturers, or other corporations whose products or services are related to the subject matter of the presentation topic) within the preceding 12 months. 

Unapproved Uses of Drugs/Devices:  In accordance with requirements of the FDA, the audience is advised that information presented in this continuing medical education activity may contain references to unlabeled or unapproved uses of drugs or devices.  Please refer to the FDA approved package insert for each drug/device for full prescribing/utilization information. 

The course directors, planners and faculty of this activity have stated they have no relevant financial disclosures.