lifestyle medicine


Is This Chelmsford Doctor A Model For The Nation?

Dr. Damian Folch runs his first half-marathon.

Dr. Damian Folch runs his first half-marathon.

Do you think Dr. Damian Folch, a primary care doctor in Chelmsford, is a model for the nation? You can vote on that here at The Los Angeles Times.

Oh, wait, you want to know how he might be a model? Well, he definitely has my vote when it comes to practicing “Lifestyle Medicine,” tackling his patients’ unhealthy lifestyles and getting them to exercise more. (Check out that story from earlier this year here.) But now The Los Angeles Times features Dr. Folch in “A shift in how care is paid for.” It’s an excellent explanatory piece about the shift away from “fee for service” medicine — paying doctors for each bit of care — and toward “global payments” that pay doctors for a patient’s overall care — and rewards them for keeping the patient healthier and costs lower. That shift is happening more systematically here in Massachusetts than anywhere else, the piece says.

It begins:

CHELMSFORD, Mass. — It’s hard work being one of Dr. Damian Folch’s diabetic patients.

If a lab test shows high cholesterol, Folch is quick to call or email. No patient can leave the office without scheduling an annual eye exam, a key preventive test. A missed exam or an appointment leads to another call.

“We are a real pain in their necks,” joked Folch, a primary care physician in suburban Boston. “We track them down.”

That kind of attention has always been good medicine. For Folch, 59, it’s now good business. He is among thousands of physicians in Massachusetts whose pay depends on how their patients fare, not just on how many times they see them. If patients stay healthy and avoid costly medical care, he gets more money. Continue reading

Why To Exercise Today: Inactivity As A Disease, And One $17 Treatment

standing desk

My standing desk: Laptop on a cheap little pink table

Sometimes a single well-turned phrase can change you forever. That’s what happened to me a few months ago when I heard the director of the Institute of Lifestyle Medicine, Dr. Eddie Phillips, say, “Sitting is a disease state.”

He was speaking to a lunchtime symposium of Harvard medical students about “Lifestyle Medicine,” a field that aims to get doctors to tackle the bad diet and exercise habits that underlie so many of their patients’ diseases. And he was explaining why the students were invited either to sit on big balls or to walk around the seminar table.

The phrase reverberated in my mind when I got my new desk in the WBUR newsroom, to the point that I bought this $17 table and now spend about half my time with my laptop perched on it, standing and shifting my weight as I type. (Two of my colleagues were already doing the same, improvising with piles of books or boxes beneath their keyboards.)

And I thought of it again when I saw this NPR post: “Should lack of exercise be considered a medical condition?” It frames the disease state a bit more broadly than sitting, as inactivity in general. And it asks whether doctors should literally diagnose “deconditioning” or “inactivity” in their patients who don’t exercise, to help them understand what a reliable precursor of disease it is. Continue reading