Original Article can be found here. Thank you, Kat Quinn for taking time to get to know us.
Lifestyle Medicine Solutions with Dr. Wayne Dysinger
Dr. Wayne Dysinger, founder of Lifestyle Medicine Solutions, is a newly minted Direct Primary Care doctor who recently launched his DPC practice in Riverside, California. His unique style of primary care delivery involves Lifestyle Medicine as preventative medicine to optimize health outcomes.
Lifestyle medicine is an approach to decrease disease risk and illness by utilizing lifestyle interventions such as nutrition, physical activity, stress reduction, smoking cessation, avoidance of alcohol abuse, and rest. Lifestyle medicine contributes to population health management by offering wellness and nutrition programs to take a proactive approach to one’s own health and wellness.
Lifestyle Medicine Solutions is a membership-based primary care team that focuses on relationships, health and root causes of illness; they do this with primary care to nutrition to wellness classes. The “direct primary care” form of care re-establishes the physician-patient relationship that is so important in the delivery of healthcare.
Dr. Dysinger shares his story on why Lifestyle Medicine makes sense in Direct Primary Care:
Q1: What inspired you to become a primary care physician? How long have you been practicing?
I recognized that I loved working with patients 1:1, and that my first love was to deal with patients who were early in a disease process so that I could help them reverse that process and regain full health.
I graduated from medical school in 1986, and completed my Family Medicine Residency in 1989.
Q2: Why did you choose Lifestyle Medicine as your primary focus in delivering primary care?
We have a global chronic disease epidemic facing our world. As examples, there are now close to 30 million US diabetics, or almost 10% of the population. Worldwide there are almost 400 million diabetics, and this is predicted to be close to 600 million in 20 years. Around 35% of the US population has fatty liver disease. Type 2 diabetes and fatty liver disease are primarily food borne illnesses that affected less than 1% of the population as recently as 55 years ago.
There are many things we need to do to reverse these trends, but at least part of it involves physicians practicing differently. Doctors are not currently effectively trained to write nutrition prescriptions and successfully support patients through the health behavior changes needed to reverse diabetes and fatty liver disease. As a result, patients are not frequently given the information or resources needed to deal with these diseases from a health care perspective. Lifestyle Medicine is addressing these deficits.
Q3: What is Lifestyle Medicine and what makes it unique and special? How are you educating your patients on how to live a healthy lifestyle into your business model?
Lifestyle Medicine is the evidence based prevention, treatment and reversal of disease using nutrition, physical activity, stress management and social support systems. It is a low cost, virtually risk free approach to chronic disease care that is consistently effective short term and rivals medication use as far as long term adherence. Lifestyle Medicine is the recommended first choice treatment approach for almost all chronic diseases including diabetes, hyperlipidemia, and hypertension. It is estimated that 80% of chronic disease is lifestyle related. If the disease is caused by lifestyle, shouldn’t the treatment also focus on lifestyle?
We educate our patients by first clarifying for them that their chronic disease can be treated and frequently reversed by lifestyle choices. We thoroughly evaluate them using a wholistic optimal health approach, including a comprehensive understanding of their current lifestyle and health risk behaviors. We assist them in creating health goals, and write lifestyle prescriptions, prescribe group treatment approaches, and other evidence based interventions that will help them reach those goals. We create a healthy living accountability community and atmosphere that help to make the healthy choice the easy choice. And we celebrate our successes.
Q4: How did you discover Direct Primary Care and decide you wanted to convert to a direct-pay, valued-based model?
I was given a unique opportunity to create a Lifestyle Medicine based primary care practice. Most of my professional career I have been an academic physician. I’ve watched my medical students and residents complete their training knowledgeable and passionate about Lifestyle Medicine, but when they went to find a job there was nothing out there that reimbursed them appropriately to practice Lifestyle Medicine. I knew for Lifestyle Medicine to really achieve its’ potential it needed a different reimbursement mechanism.
When we were give this unique opportunity, my partner, Cono Badalamenti, MD, MHSA, and I quickly identified the natural synergies between the Direct Primary Care (DPC) movement and the Lifestyle Medicine movement. Direct Primary Care is typically a membership arrangement. Physicians are reimbursed for comprehensively caring for a whole patient, and doing so in flexible and low cost ways. Lifestyle Medicine is best practiced when both the patient and the physician see their relationship focusing on achieving wellness, not putting bandaids and medications towards illness. That’s something that many people are happy to buy into, and the DPC financial models allows that to happen in a low cost, value-based way.
Q5: What strategy did you use to convert to Direct Primary Care?
We actually are not a conversion practice. We are primarily a start-up practice, although our particular situation is actually way more complicated than that. We have been privileged to work with a nationally recognized consultant in the DPC arena. He has given us valuable insights and connections. Most of what we’re doing, however, is DIY.
Q6: What would you have done differently?
We feel our biggest challenge has been letting people know that we exist. What we offer is valuable and sought after, but the four million or so people within our market area, which is the Inland Empire region of Southern California, don’t really know who we are, what we do, and how we can help them. We’ve spent a lot of time trying to understand and master getting that message out. So, having a clear, proven, cost effective approach to informing individuals and businesses of our existence is the thing we have wished for the most.
Q7: How would you rate your patients’ satisfaction and health outcomes, after implementing Direct Primary Care plus Lifestyle Medicine Solutions compared to your previous practice?
Patients love the atmosphere that we’ve created. Our practice is in a historic old Victorian house that feels very cosy and family like. They also very much enjoy being able to interact with us 24/7 via text, phone, and email. They want the comprehensive health evaluation that we do, and the appreciate our wholistic approach to health care. People tell us all the time that we’re the kind of doctors they’ve been looking for, and they can’t imagine themselves going any where else.
Q8: What is your main goal and mission as a DPC Docpreneur?
I know this is ostentatious, but our goal is to reverse the chronic disease epidemic. To us, it’s unacceptable to have 400 million people suffering from a food borne disease that doesn’t need to exist and basically didn’t exist just 55 years ago.
Q9: Where do you see your business 5 and 10 years from now?
Our vision is to develop a model that offers any primary care physician who is passionate about Lifestyle Medicine an opportunity to practice their craft and make a reasonable living doing so. We also want any patient to be able to choose a Lifestyle Medicine credentialed primary care physician if they so desire.
Q10: What kind of EHR/EMR software did you implement into your DPC?
We use the Elation EMR and the linked Hint Health billing software.
Q11: What HIT software do you use and love most?
We’re very happy with Elation. Beyond that we use standard programs from google, microsoft, etc. My partner has created our own health optimization software that is still developing, but is promising. I use myhealthfinder.gov, and subscribe to the Nutrition Action Healthletter from the Center for Science in the Public Interest. I’m a passionate member of the American College of Lifestyle Medicine, so use their newsletter and website as well.
Q12: What advice would you give to primary care physicians, just out of residency, wanting to go into Direct Primary Care?
Understand your goals, learn from those out there already doing it successfully, be serious about how to let people know about you (ie, marketing), and find a second income stream as you build your initial practice.
Q13: Please share your analogy about primary care needing a new vehicle and that new vehicle being Direct Primary Care?
One hundred and twenty years ago there was more and more traffic going back and forth across the Atlantic Ocean, between Europe and the United States. All the shipping companies were vying for business by trying to offer the quickest, safest, most comfortable, most economical ships. Their engineers and designers were creating bigger engines, more streamlined hulls, adding sail power to engine power, and a variety of other ways to assure that they were gaining market share.
Around the same time two brothers were experimenting in their garage in Dayton, Ohio, and eventually at Kitty Hawk, North Carolina. After much hard work, and multiple failures, they eventually developed a vehicle that could fly. Within a few decades, anyone wanting to travel across the Atlantic stopped even thinking about calling a shipping company. Everyone calls an airline now. Ships are still used for cargo and other things, but transportation of people is done by airlines.
The point of the story is that when a new type of transportation was developed, everything changed. We believe that Direct Primary Care is the new type of transportation within health care. Hospitals, like ships, will still exist for a variety of reasons, but a few decades from now no one will think about going to a hospital based physician for their primary care needs.
This story was originally told by Rushika Fernandopulle, MD from Iora Health.
About the Author:
Kat Quinn is a digital health start-up specialist with a focus in HealthIT(mHealth) and Direct Primary Care start-ups and co-founder of SheepGuru.com, one of social media’s leading DPC voices.
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