Archives for April 2018

“Whole Health Learning” is part of a broad societal response to the intractable presence of overwhelming conditions of ill-health faced across America; conditions that have thus far outrun conventional medicine’s – and society’s — ability to redress them, notably:

• Obesity, especially in childhood, that sets the population onto the path of chronic illness
• The debilitating opioid addiction epidemic
• Pervasive and complex social determinants of health — Adverse Childhood Experiences (ACEs), trauma, poor nutrition, lack of healthcare  — that wrack too many American neighborhoods

The costs of dealing with these and chronic pain are plundering the reserves of vitality, prosperity and productivity that lie at the core of the American self-assurance, to say nothing of public treasuries.  Everyone feels the costs of dealing with these conditions.

But medicine and the healthcare professions have started to respond to these circumstances by pushing the boundaries of their own specialty training, by understanding human health in its broadest context, informed by advances in genomics and personalized medicine, and by partnering with the skilled practitioners of once-scorned and derided healing modalities (meditation and acupuncture among them).  All of which is leading to a revised view of the patient: from someone with discrete illness or problem to a person-in-full: a “whole person.”

Lifestyles

This growing view of a patient as a whole person has naturally brought greater emphasis to the importance of true prevention and support for wellbeing.  In October 2017, Andrew Weil, MD, for decades one of the nation’s leading advocates for health promotion and prevention, observed during his presentation at the Global Wellness Summit:

“To help people make better and not make worse lifestyle choices the first thing I can do is to educate them….  If you can get people information, they can understand and connect with their own experience, and they will move in the right direction.”

Weil speaks of the education that he and physician colleagues — through new approaches to lifestyle medicine – provide to their adult patients in order to undo the debilitating effects of years of health-compromising lifestyle.

In fact “lifestyle” has become a vibrant corner in medicine for educating conventionally-trained medical professionals with the tools to work with (rather than “treat”) the whole person.  The American College of Lifestyle Medicine put it this way:

Lifestyle Medicine involves the use of evidence-based lifestyle therapeutic approaches, such as a predominantly whole food, plant-based diet, regular physical activity, adequate sleep, stress management, avoidance of risky substance use, and other non-drug modalities, to prevent, treat, and, oftentimes, reverse the lifestyle-related, chronic disease that’s all too prevalent. 

Cynics may wonder why this “answer” wasn’t always part of basic doctor training in the first place.  The reality is that it just wasn’t.  In the years ahead physicians and patients alike are going to face a profusion of whole-health-based care options provided by the adherents of lifestyle, functional, integrative, holistic and naturopathic medicine, chiropractic, and acupuncture and oriental medicine.   The new forms of shared, inter-professional team experiences that are in formation now don’t yet constitute a trend, but their orientation to the whole person and the root causes of disease ultimately will change the care culture.

Whole Health Care for Kids

Closer to elementary schools, and therefore the focus of  WholeHealthED, many pediatricians especially have undertaken a more expansive, supportive role for the whole health and wellbeing for their young patients and their families.

In this video, Nimali Fernando, MD who serves families in Spotsylvania County, VA, has taken a serious step into whole health learning by demonstrating to her families the foundations for good health that lie in informed food and diet choices.  Her clinical practice, Yum Pediatrics now includes a teaching kitchen supported by a nutritionist and the produce of a vegetable garden outside her office.

Serving a population in which some 30% of children are overweight or obese, Fernando made a point of providing recipes and nutrition information on her clinic’s web site, which was merely a beginning: “When I started to see how empowering that was to families,” she says, “I decided to teach cooking classes.”

Many other examples of such imagination-driven initiatives can be found all across the nation.  As their advantages become more widely known and understood, the continued funding by Medicare and Medicaid for improvements in electronic health records and other administrative capacity, will make the choices for directing those funds that much starker.

Meanwhile, attending to those discouraging conditions outlined above has clearly taken on an urgency that has inspired innovations like Dr. Fernando’s pediatric teaching kitchen. And as Dr. Weil put it: “If you can get people information, they can understand and connect with their own experience, and they will move in the right direction.”

The WholeHealthED variation: Let’s start this information delivery when people are 4 and sustain it until they’re 18.