Incorporating Lifestyle Medicine Into Your Academic Institution and Hospital Setting: The Key is Connection

“By starting lifestyle medicine group visits, you can bring therapeutic lifestyle medicine counseling into your hospital.”

The key to spreading lifestyle medicine is connection: connection with colleagues, connection with research, connection with CME, connection with students, and connection with community.

The American College of Lifestyle Medicine (ACLM) is making it as easy as possible for you to introduce, develop, and incorporate lifestyle medicine programs in your academic institutions and hospital settings. One of the first opportunities to share is the free “Introduction to Lifestyle Medicine and Food is Medicine Essentials” CME/CE course bundle which provides 5.5 credits for physicians and health professionals. This Essentials bundle includes our “Introduction to Lifestyle Medicine,” “Food As Medicine: Nutrition for Prevention and Longevity,” and “Food As Medicine: Nutrition for Treatment and Risk Reduction” courses. By connecting with your colleagues and team members at your medical or healthcare professional schools and sharing this resource with them, you make friends and create opportunities to discuss the power of lifestyle and food and nutrition prescriptions. Sharing this resource in an email or as an announcement during Grand Rounds, division meetings, or presentations helps you to bring lifestyle medicine into the room and the conversation with your co-workers. As a reminder, here’s the link - White House | Lifestyle Medicine Free CME/CE.

Getting involved with CME/CE courses locally helps to bring lifestyle medicine into your academic institution and hospital setting. If there is a CME/CE course on a topic related to lifestyle medicine, you can attend and mingle with other physicians and healthcare providers describing what you do and learning about what they do. Working to find connections and future collaborations will help propel lifestyle medicine forward.

Connecting lifestyle medicine to one’s own self-care and thriving during chaotic times is key.

Research from two decades ago revealed that physicians who exercise are more likely to counsel their patients on exercise. And, specifically, physicians who do strength training counsel on it. Those who do not do strength training do not counsel on it. The same type of association holds for aerobic activity as well. I performed this study with colleagues as a resident at Spaulding Rehabilitation Hospital. ¹ For this reason and many others, helping our colleagues to participate in physical activity by signing up for a 5K or 10K walk or run is another way to incorporate lifestyle medicine into your academic or hospital setting. Bringing a Walk with a Doc or Future Doc chapter to your workplace is another way to infuse lifestyle medicine into the fabric of your community.

A relatively new approach to incorporating lifestyle medicine into the academic hospital setting is to include wellbeing into the formal career mentoring meetings that are held for each faculty member. During these meetings, research, clinical practice, and teaching are addressed individually and a plan for promotion is often put into place. It depends on the goals of the faculty member which area is emphasized. What is missing in these sessions? A discussion of wellbeing and the six pillars of lifestyle medicine.

In 2021, the Department of Surgery at Massachusetts General Hospital piloted a new style of mentoring that including the traditional components and added a wellbeing component. As the Director of Lifestyle Medicine and Wellness for the Department of Surgery, I was invited to attend the mentoring meetings for the early career faculty. The goal was to remind these young faculty members to take care of themselves physically and mentally, to learn how to cultivate high-quality connections at work and at home, and to be able to discuss their work-life harmony. ² This new mentoring system was well received by mentees and mentors, and it continues to this day.

Another option for including lifestyle medicine into your academic institution or hospital setting is to give lunch time talks, presentations, or grand rounds at your hospital and others around you. Many times, the person in charge of Grand Rounds is seeking novel topics to bring to the hospital. This is a great way to introduce lifestyle medicine and can lead to lectures on all the six pillars. In 2009, I experimented with this strategy and gave Grand Rounds on health coaching and behavior change. This evolved to include other aspects of lifestyle medicine and at many other hospitals in Boston including Mass General Hospital, Cambridge Alliance Hospital, Beth Israel, Brigham Women’s Hospital, McLean Hospital, and others. One presentation can lead to another and another. After years of delivering Grand Rounds, in 2022, I was able to work with the Wellbeing Committee at Spaulding Rehabilitation Hospital to start the first “Wellbeing Rounds,” which are held six times throughout the year during Grand Rounds for CME credits with a focus on lifestyle medicine topics including social connection and thriving at work with a strong sense of purpose and meaning.

Convening colleagues around research with Journal Clubs is another way to bring lifestyle medicine into your academic institution or hospital setting through a traditional medical activity. In 2022, I started the first Harvard Medical School-wide Lifestyle Medicine Journal Club to bring physicians and healthcare providers together around research in the six pillars of physical activity, nutrition, sleep, stress resiliency, social connection, and avoidance of risky substances. We meet six times in the year. Through a grant with Ardmore Institute of Health, we were able to secure CME credits for the Journal Club. Our first topic was nutrition with Dr. Walter Willett, and another one was counseling on alcohol use moderation and elimination with Dr. Joji Suzuki. These Journal Clubs bring together colleagues who are new to lifestyle medicine and others who are ABLM diplomates practicing in different hospitals in the Harvard system. It also allows medical students, residents, practicing physicians, nurses, health coaches and other members of the lifestyle medicine team to share time together outside the clinic or hospital. Lifestyle Medicine Journal Club is an opportunity to learn together on a regular schedule and gather around research, a topic of great interest and passion for many physicians and healthcare providers. The routine time and day of Journal Club helps to keep connections alive between colleagues and keeps attendance up.

As for educating students, lifestyle medicine clinicians can teach at medical schools and other healthcare professional groups through a parallel curriculum. ³ With a parallel curriculum, there is no need to go through the red tape and bureaucracy of the core curriculum committee. If your organization doesn’t already have one establish a Lifestyle Medicine Interest Group (LMIG). An LMIG consists of a group of students with a faculty advisor who explore the six pillars of lifestyle medicine during educational and experiential events. The LMIG can help students, faculty, and the local community build healthy habits through involvement with activities like school gardens, goat yoga, 5K runs to support local food pantries, teaching the Teen Lifestyle Medicine Curriculum to local teens at middle schools, high schools or programs like Big Brothers and Sisters or kickball games. The options for providing exposure to lifestyle medicine activities are endless with LMIGs. Inviting colleagues to speak to the students or creating a panel of lifestyle medicine clinicians to speak with the students are great ways to involve other faculty and friends. The ACLM has an LMIG Tool Kit that is available on the website. https://connect.lifestylemedicine.org/lmigtoolkit/home.

By establishing or supporting an LMIG, you are inspiring the next generation of leaders in lifestyle medicine. If you are looking to start an LMIG, consider applying for the Donald A Pegg Award Student Leadership Award https://lifestylemedicine.org/project/dap-student-scholarship/to support student activities and for the leader of the group to attend the annual ACLM conference. Pegg Award winners publish a paper in the education column of AJLM that outlines their accomplishments.^4-7 You can also apply for Taste of Lifestyle Medicine micro-grantto fund a plant-based meal or snack to be served at an LMIG event.

Students are hungry for lifestyle medicine information, and they are searching for ways to thrive during medical school. Lifestyle medicine practices and principles can help them. At Harvard Medical School, the students created a wellbeing community during COVID when they were home during the peak of the pandemic. This wellbeing community revolved around the six pillars of lifestyle medicine. After hearing about lifestyle medicine during one of the school’s official wellbeing workshops that I led, the students approached me to create a special weekly offering in the evenings to help them stay socially connected and reduce stress. We created a 12-week curriculum which turned into a supportive group for the students throughout the year. They called the experience WholeHeartedMD and published a paper titled “WholeheartedMD: Medical Students Embracing Vulnerability and Finding Fulfillment,” so that other schools could replicate the program. ⁸

Publishing case studies is another way to share lifestyle medicine with your colleagues. You can write up case studies that describe each team member’s role in the lifestyle medicine team. ⁹ This helps to create respect and understanding about each team member’s role. By working together on a project such as a journal article, the authors have the opportunity to develop closer connections. The overall outcome is to spread lifestyle medicine information. Publishing a case study of your own can also help you spread the word and connect with colleagues, as you can share the article with your division, or department, and perhaps use it to teach medical students and residents. ¹⁰ Teaching students through cases is engaging and helps them to feel connected to the material in a concrete way.

Another opportunity to reach residents is available through the Lifestyle Medicine Residency Curriculum (LMRC). In my case, implementing the LMRC connected me to new colleagues at the TH Chan School of Public Health in the Department of Environmental Medicine. The LMRC connects faculty to residents and to fellow faculty interested in lifestyle medicine. Upon completion of the LMRC, residents qualify to sit for the American Board of Lifestyle Medicine certification exam. If you are interested in the LMRC, there is more information on the ACLM website https://lifestylemedicine.org/project/lifestyle-medicine-residency-curriculum/. When working with residents, you can connect them to the LMIG in their medical school affiliate.

In addition, residents often enjoy teaching and they can teach lifestyle medicine concepts to the community by using the LM 101 Curriculum, which is a free ACLM resource available on the website https://lifestylemedicine.org/project/lm-101/. Residents can download the PowerPoints and teach them to fellow residents, medical students, or members of the community. The PM&R residents at Spaulding created a series of classes on lifestyle medicine for high school students in Charlestown by using the ACLM Teen Curriculum available free for download here https://connect.lifestylemedicine.org/viewdocument/teen-curriculum?CommunityKey=a76509bf-15f4-4136-bd19-b7b82c4bbbbf&tab=librarydocuments. The students loved it and the residents felt fulfilled and joyful after providing the lifestyle medicine presentations. This ACLM Teen Curriculum resource is a great tool to help healthcare providers share lifestyle medicine with middle schools and high schools. ¹¹

By starting lifestyle medicine group visits, you can bring therapeutic lifestyle medicine counseling into your hospital. In 2012, I piloted group lifestyle medicine interventions at Spaulding Rehabilitation Hospital for stroke survivors and their caregivers. In 2013, I co-authored a paper on this topic with colleagues around the country to bring awareness of its value and impact. ¹² ACLM provided the first workshop on group visits in 2016 when Dr. Wayne Dysinger, Dr. Deepa Sannidhi, Dr. Beth Motley, and I shared our experiences. Our article, “The Art and Science of Group Visits in Lifestyle Medicine,” can be used as a guide for those interested in starting a group at their hospital or outpatient clinic. ¹³ These groups can be run with funds for research, as Dr. Jeff Krauss did at the Palo Alto VA ¹⁴ or through philanthropy as Dr. Amy Comander does at Massachusetts General Hospital, ¹⁵ or through shared medical appointments billing through CPT codes as Dr. Jacob Mirsky, Dr. Liz Lincoln, Katie Engels, Loren Winters, and Carol Sullivan are doing at Massachusetts General Hospital.

There are so many creative ways to bring lifestyle medicine into your institutions. It just takes a little time and a lot of passion to get it going and to keep it going. ACLM is here to fuel that passion and keep you connected.