The Secret I Tell All My Patients by Alex McDonald, MD

06 Oct 2021

When I meet a new patient, I often take a moment to get to know them, and I tell them about myself and my personal and professional philosophy and guiding principles as their new family physician. As part of this initial visit, I always tell them, “I have a medical secret. It might not quite be a fountain of youth, but it will do more for you than any pill or medical procedure ever could.”

Patients often give me an inquisitive (or maybe sceptical) look as if I’m about to sell them some crazy pyramid scheme. I allow the suspense to build for a moment, and then I say, “Lifestyle medicine — a healthy, plant-based diet; 30 minutes a day of physical activity; daily stress reduction; and 8 hours sleep each night — will do more for you than any medication or treatment in the world.” This releases any tension and helps me create a great rapport with my new patients

Don’t get me wrong. I certainly prescribe traditional medication when indicated. However, I also tell patients that if they make the right changes, they may be able to stop taking insulin or blood pressure medication.

So, what exactly is lifestyle medicine? Lifestyle medicine centres on a whole-food, plant-based diet; physical activity; adequate rest and recovery; and stress management and social connection to not only promote health but also to treat and reverse disease.

Health spending is on an unsustainable trajectory, and we are headed for disaster unless the incentives and messaging aimed at patients dramatically changes. This is where I see lifestyle medicine as part of the solution.

There are huge structural and institutional hurdles to overcome to achieve ideal lifestyles for all. Individual counselling and motivational interviewing are important; however, we ultimately need health and institutional policies that make the healthy choice the easy choice. For example, we could design buildings — and even communities — in a way that would encourage physical activity such as walking or taking the stairs.

My favourite part of lifestyle medicine is that it is truly patient-centred. It puts the ball in patients’ court to truly take ownership of their health. Lifestyle medicine is not a panacea and it’s not a replacement for all medications or procedures. However, it can get us a lot closer to the triple aim of improved health, reduced costs, and improved patient satisfaction.

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