SPRINGFIELD, Vt. — Among the obstacles to making America’s healthcare system more accessible, affordable and sustainable is a less discussed, perhaps uncomfortable truth: that so many diseases being treated today are considered preventable.
Eighty percent of America’s healthcare spending is on people with chronic conditions — from diabetes, cardiovascular diseases, high blood pressure, cancers, depression and anxiety to dementia — which could be prevented or sometimes arrested through a healthier lifestyle, said Dr. Scott Durgin, Director of Lifestyle Medicine at Springfield Medical Care Systems.
“One of the few things we know, from evidence-based study, is that changing our diet, exercising, managing our sleep, reducing our toxins and maintaining social relationships, is the most effective approach to prevent, and even reverse chronic diseases,” Durgin sai.
While this information may sound like what many people call “common sense,” getting people to practice it is another matter. According to the Center for Disease Control (CDC), seven of every 10 deaths in America each year are from chronic diseases. A 2005 study by the CDC found that 133 million Americans, or one out of every two adults had at least one chronic disease.
The CDC also reports that while America outspends every nation in healthcare, and have tripled our expenditures since 1990, America’s life expectancy rate remains far below many nations whose annual health care spending is less.
Stress is the underlying cause, Durgin said.
“Prolonged stress on our bodies taxes our system and inflammation that causes [internal damage],” Durgin said on Thursday, during an interview with Springfield’s Lifestyle Medicine team. “More often than not, what’s stressing our body is lack of sleep, poor diet, lack of exercise, toxins from smoking, lack of social interaction. Too much damage to systems in our body causes them to break down.”
A new field of medicine
Human behavior does not instinctively abide by what’s reasonable. Even when a person wants to change, actively breaking habits is difficult and often requires support.
“It takes a whole team,” Durgin said.
Just last year Durgin approached Josh Dufresne, CEO of Springfield Medical Care Systems, to create a robust, team-centered lifestyle health program in the Springfield region.
On Thursday Durgin and members of the lifestyle medicine team held a regular team meeting in Springfield. Team members in attendance included Durgin; Russ Payne, registered nurse; Laura Jensen, care program coordinator; and Adam Ameele, psychologist.
The program provides a unique but much needed patient service to the area, one which team members hope will grow in time.
Traditionally, physicians have limited resources for preventative medical practice, team member said. They can prescribe medications, write referrals and recommend a regimen of lifestyle changes, but the burden falls on the patient to implement changes once exiting the office.
The Lifestyle Medicine program works with each patient to map out an individualized wellness vision, target achievable goals and implement action.
Ameele said that the team can help the patient to make the goal specific and realistic, but that the patient must choose the goal.
“We are not telling anyone what to do,” Ameele said. “They are making the decisions.”
When it comes to change the brain is resistant to direction from others, Ameele said. The individual must want to do something to have the best chance for success.
Each patient’s goals are individualized. Ameele said examples could vary from wanting to get back into the woods, being able to weed the garden again, or try one new food every week.
As an example of the program’s hands-on support to patients, Payne said that he once brought his vegetable steamer from home to teach a patient how to steam broccoli.
“It’s important to realize that people change, so our team changes with the patient,” Durgin said. “We don’t push. With change we see patients wanting to try something new that they didn’t at the beginning.“
Sharing from personal experience
Though growing in national recognition, lifestyle medicine is still a relatively new medical field. Durgin is only one of three licensed lifestyle medicine doctors in Vermont.
Durgin said that his own personal health struggle and newfound well-being through change brought him down this path. A native of the New Hampshire North Country, Durgin said that he was not very active in childhood. He studied medicine after high school, studying at the University of New Hampshire, Dartmouth College and Brown University.
“When I finished my emergency medical training I was five years into a path of depression, diabetes and high blood pressure,” Durgin said.
Over the following 10-to 15 years, Durgin took to an exercise regimen of running, swimming and cycling. He lost 50 pounds and eventually began to compete in triathlons and Iron Man competitions. His interest shifted toward physical fitness. He shifted focus to bodybuilding before finding a new path that let him merge his focus on healthy lifestyle with medicine.
“The biggest reward is getting to watch the people we work with come alive,” Durgin said. “Seeing them happy and energized.”
Ameele said that at one time he was 40 pounds overweight, which he lost through introducing more structured exercise and eating into his life.
The Lifestyle Medicine program currently provides services at Springfield Health Center and Ludlow Health Center. Their patients are sometimes referred, though referrals are not necessary.
Additionally, patients do not need to be in critical condition to receive help, that the person may want early signs of condition from becoming more serious.
“The ideal patient is someone who wants to make those changes,” Durgin said.