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Reinventing the wheel for chronic disease management

Move more, eat less.

We have all heard it before. These health messages have been widely propagated but have proven to be quite ineffective1. As practitioners, we keep preaching to patients’ things they already know, and then bang our heads against the wall when they haven’t done as we advise. And we wonder why obesity and chronic disease continue to sky rocket2. Something has got to change…

As a pharmacist, I have not once met a patient who wants to take medications, nor have I met someone who wants to live with a chronic disease. A majority of the patients I come across know what they need to do but have a hard time doing it, and I’m sure this resonates with most of you. I also find that many don’t fully understand their condition or appreciate how healing healthy behaviours can be (often more so than any blockbuster drug).

Recently, I met with an aspiring cardiologist, Dr Edo Paz, while travelling in New York City. He and his colleagues have opened clinics across New York, which promote the prevention of cardiovascular disease. They have a cardiologist specifically assigned to provide education to patients and are always available to answer their questions. They also offer innovative services like Central Park runs with a cardiologist, meditation and lessons on how to use and interpret wearable smart devices.

Whilst the American healthcare system is very different to ours in Australia, both Australia and America have had chronic disease epidemics for decades and the numbers continually exceed our estimates3. Clearly, what we are doing isn’t working, but therein presents opportunity for innovation. An entrepreneur is essentially someone who seizes opportunity, shows initiative and takes a risk. Not surprisingly, we are seeing a growing number of entrepreneurs in the healthcare industry and I think it’s only smart to stay tuned to what’s happening elsewhere to get ideas and inspiration.

I recently started a diabetes clinic at one of the general practices I work with in Adelaide and was amazed at the participation rate when I explained that it would be holistic, with a focus on lifestyle and behaviour change. These patients were crying out for help, not for basic information they can get on the internet but for support and guidance from a trusted health professional to make healthier decisions.

Our practice is participating in the Health Care Homes trial, which gives us more flexibility and freedom in how we manage patients; removing the Medicare fee for service model. Essentially, I use one-on-one visits, group sessions and phone calls (which ever the patient prefers), to impart knowledge and skills, to help them understand and manage their diabetes and health. We have a multi-disciplinary team and this year we will be offering group exercise classes, walking groups and cooking presentations. The Health Care Home may not be the answer, but the concept is definitely a step in the right direction.

In addition to this clinic, I am setting up my own independent diabetes and health clinic which will offer various health programs and services with a focus on the root cause of disease and behaviour change. It will be accessible to patients anywhere in Australia and across the world. I am looking at a subscription type model where patients have ongoing and open access to their health care team. I plan to create a community where my patients feel well supported to manage their health in an open, non-judgemental environment.

Lifestyle Medicine fills the massive void we have had in healthcare for decades and I am so excited to be a part of the movement. It holds the key to change and by uniting ambitious, like-minded practitioners like yourself I believe we have a far better chance at overcoming the growing wave of chronic disease.

  1. Gill, T.P. and Boylan, S, 2012, ‘Public Health Messages: Why Are They Ineffective and What Can Be Done?’, Current Obesity Reports , Vol. 1, Issue 1, pp. 50-58 https://doi.org/10.1007/s13679-011-0003-6
  2. The World Health Organisation nd, The global burden of chronic, Geneva, https://www.who.int/nutrition/topics/2_background/en/, viewed 29 January 2019.
  3. Lin, J, Thompson, T.J., Cheng, Y.J., Zhuo, X., Zhang, P., Gregg, E. and Rolka, D.B, 2018, ‘Projection of the future diabetes burden in the United States through 2060’, Population Health Metrics, Vol. 16, Issue 9, pp. 1-9 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6003101/pdf/12963_2018_Article_166.pdf

This article has been written for the Australasian Society of Lifestyle Medicine (ASLM) by the documented original author. The views and opinions expressed in this article are solely those of the original author and do not necessarily represent the views and opinions of the ASLM or its Board.

Juliet Richards is a Consultant Pharmacist, Credentialed Diabetes Educator and an ASLM-Certified Practitioner in Lifestyle Medicine.

By | 2019-02-21T11:03:36+00:00 January 30th, 2019|1 Comment

About the Author:

Juliet Richards
Juliet Richards is a consultant pharmacist, credentialed diabetes educator and an ASLM certified practitioner in Lifestyle Medicine. After working in large tertiary hospitals as a clinical pharmacist she started her own business called MyMedsHealth which provides clinical pharmacy, chronic disease management and other support services to general practices in SA. Juliet is passionate about health and nutrition and while appreciating the role of medications in chronic disease, she could see how they would simply mask or temporarily manage the underlying pathology. This meant progression was inevitable, translating into more medications. She felt she could offer so much more to her patients. With a special in diabetes she started a diabetes clinic with a focus on the root cause and behaviour change. She is also moving into workforce health with her other side business, Workforce Health Assessors. Lastly, Juliet works for the University of South Australia and loves teaching and inspiring young pharmacists.

One Comment

  1. John Bobbin February 5, 2019 at 11:45 am

    In 1957 I topped my sixth class half yearly, I was ecstatic for a few weeks, then my father took a heart attack at 43 years of age, and never worked again. After third year I was forced to leave school, and go to work to support the family. I commenced my study of lifestyle medicine at this point. I asked the elders about family mortality, cause of death, age at death, and what sort of lifestyle they led. I became convinced that lifestyle caused a lot of the diseases, not genetics. I took the only option opened to me and commenced studying in privately owned complimentary medicine colleges. I finished with 4 certificates, 6 diplomas, including one in Nutritional Science, and a Bachelor Degree in Naturopathy, after 1995. By 1992 I was working in my own Naturopathic Clinic. Finally in 2009 I read about Lifestyle Medicine. In 2010 I was accepted into the Southern Cross University in a Master of Clinical Science Degree – Lifestyle Medicine where Gary Egger was the Professor. I graduated in 2013 at 67 years of age. For the past six years I have thoroughly enjoyed my role in clinical practice. Lifestyle Medicine is going to re shape the way health is delivered world wide. I am coming up to my 73rd birthday so this will probably be my last year but I have no regrets at all, apart from my age when I finally got into lifestyle medicine. John Bobbin BNat, MClinSc-Lifestyle Medicine

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