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Lifestyle Medicine Meets Obamacare

News  |  By MedPage Today  
   April 14, 2016

Diet, exercise, stress management, and other lifestyle medicine interventions can have a powerful effect on disease, but how are new models of care changing the clinical incentives for offering them? From MedPage Today.

This article first appeared on MedPage Today April 4, 2016.

In this video, long-time proponent Dean Ornish, MD, provides a perspective on how lifestyle medicine might find its place in the changing healthcare landscape.

A transcript follows:

"We all know that lifestyle factors play a role in helping to prevent disease. But lifestyle medicine is about using lifestyle interventions to treat disease, and often to reverse it, either in combinations with drugs and surgery, or often as an alternative to them.

"You know, we tend to think of advances in medicine as being a new drug, a new laser, or something really high-tech and expensive. And we often have a hard time believing that the simple choices that we and our patients make in our lives each day -- like what we eat, how we respond to stress, how much exercise we get, and, perhaps most important, how much love and support we have -- that these simple changes can make such a powerful difference, but they often do.

"And in 39 years of research, my colleagues and I at the non-profit Preventive Medicine Research Institute published in all the leading peer-reviewed journals have been able to show that these simple choices that we make -- what we eat, how we respond to stress, how much exercise we get, and how much love and support -- can actually reverse the progression of severe coronary heart disease, of Type 2 diabetes, can slow, stop, or reverse the progression of men with early-stage prostate cancer, and by extension breast cancer, can actually change our genes, up-regulating the genes that protect us, turning off or down-regulating the genes that cause prostate, breast and colon cancer -- the ras oncogenes, over 500 genes in only 3 months. And in our latest research, we found that these same lifestyle changes may lengthen telomeres, the ends of our chromosomes that cause aging, in a sense, beginning to reverse aging at a cellular level.

"And as we move into the era of Obamacare, whatever people think about it, it's really turning all the incentives on their ear. In a fee-for-service environment, the more operations and drugs and hospitalizations, the more revenue is generated. But in the bundled payments of accountable care organizations and integrated delivery networks, there's 'X' amount of dollars to take care of somebody and you get to keep what's left over: The fewer procedures, the more revenue that's generated. And Medicare is now covering our program for reversing heart disease and others like it, and so it's really creating a new sustainable model that allows physicians to provide people the information and the time that they need in order to make sustainable changes. It's a whole new era, and it's one that I find terribly exciting."


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