Healthcare has reached what Shawn Martin from the American Academy of Family Physicians calls an "inflection point" unlike any other. Joining us at the American College of Lifestyle Medicine Conference, Martin shares how our system's overwhelming focus on late-stage disease intervention has created a financial and clinical disconnect that's pushing us toward a breaking point.
The conversation reveals a startling truth: our healthcare system wasn't built to help people become healthy. Instead, as Martin explains, interventions have historically been designed "to save a hospital money, to save the employer money, to save the insurer money" rather than helping patients live better lives. This misalignment of incentives has created what one host calls our collective "Wile E. Coyote moment" - we've run off the cliff of sustainability and haven't yet looked down.
But within this crisis lies unprecedented opportunity. Lifestyle medicine emerges as a catalyst for transformation, offering physicians tools to not just manage chronic disease but potentially reverse it. For the 130,000 family physicians represented by AAFP across 95% of US counties, this approach reconnects them with the type of care they envisioned providing when entering medicine. It's not about expensive technology or complicated protocols - it's about returning to foundations of health that have been overlooked in our complex system.
Listen now to understand how combining lifestyle medicine with emerging value-based payment models could finally align financial incentives with patient outcomes and rebuild healthcare on a foundation of health rather than disease.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Justin Politti (00:02):
Welcome to the Reverse Mullet Healthcare
Podcast.
We are live at the ACLMConference, the American College
of Lifestyle Medicine.
Ellen Brown (00:11):
He did it.
Yeah, there you go 2024,orlando, florida.
Justin Politti (00:16):
I'm Justin Politti, I'm Dave Pavlik.
I'm Alan Brown.
Ellen Brown (00:20):
I'm Justin Politti.
I'm Mullet man, but we're herewith Sean Martin and I'm super
excited because I think yourorganization is integral to
what's happening today.
You know we had Susan Benegason yesterday and she used the
term catalyst for transformation.
Sean Martin (00:34):
Yeah.
Ellen Brown (00:34):
And you have been in this uphill battle with
family practice for the AFP ofhow do you enable family
practice, primary care, tofulfill what it's capable of
fulfilling, right, and it's sucha challenge with the RVU model
and a fee-for-service model andjust what we've been up against,
and you know we've been comingat it from a payment
(00:55):
transformation perspective.
And how do we getoutcomes-based models?
You know value-based caremodels, all these things in
place, and I feel like lifestylemedicine is truly this catalyst
to transformation, because it'sa tool to allow success, you
know.
So I'm really glad you joined.
Well, thank you for having me sotell us about AAFP and tell us
about your work and lifestyle,medicine and linkage, et cetera.
Sean Martin (01:17):
Sure.
So the American Academy ofFamily Physicians is founded in
1947 as the American Academy ofGeneral Practice.
We became AAFP in 1971 for avariety of reasons.
Part of it was atransformational movement around
the practice and the scope andcommunity-based care and
community health centers.
Lots of things were happeningin the United States and kind of
(01:38):
the post-Medicarecommunity-based care models were
emerging.
Community-based care modelswere emerging but family
medicine kind of came out ofthat community-based movement to
connect health and healthprofessionals at the community
level in response to kind of avery hospital-centric time
period around Medicare, whichstill exists today in many ways.
We represent 130,000 familyphysicians and medical residents
(01:59):
across the country.
We have a member at least thelast time we counted in 95% of
US counties.
They move around a little bitbut we have a very robust
footprint across the country and, more likely than not, if
there's people living in acommunity there's probably a
family physician somewherenearby.
We're an organization.
We're a professionalorganization.
We really do three things.
We do member support.
We have a very robust educationapparatus, helping members be
(02:23):
successful both in clinicalpractice but also in their
careers and profession, and thenwe're a big advocacy
organization and doing all thework that you just talked about
at the beginning A little.
You know, it was a littledepressing to hear all the
things that we got to work onSorry.
Justin Politti (02:39):
Well, we're energized about it so.
Sean Martin (02:41):
But you know it's a wonderful organization.
You know people come to FamilyMedicine for all the right
reasons.
So, but, um, you know it's awonderful organization.
When you know people come tofamily medicine for all the
right reasons and you know it'sjust a opportunity, I really
appreciate the opportunity totry to help make their world
better so they can make otherpeople's world better, and
that's why I'm here at lifestylemedicine and I think we're just
it's a continued pursuit.
Ellen Brown (02:59):
Yeah, so you guys want to.
I'm always the yapper, yeah,now what do you find the biggest
?
Justin Politti (03:05):
barriers to moving it forward.
Sean Martin (03:08):
Just the concepts of primary care or lifestyle
medicine.
Justin Politti (03:10):
Lifestyle medicine.
Sean Martin (03:11):
I think the barriers to the concepts of
primary health care in theUnited States are the same for
lifestyle medicine is the sameas it was for health promotion,
disease prevention and like allthese concepts have faced the
same headwinds in the UnitedStates and it's because we have
built a healthcare system from abenefits and financing
perspective that is heavilyfocused on late stage
(03:31):
intervention of disease we don'tfocus with, except for children
, you know, and like there'sthis moment in time with
children who were very healthand prevention focused but by
the time they reach, you know,young adolescents, we've moved
away from that.
But we're a healthcare systemlargely focused on late
intervention of disease.
And how do we not ignore peoplethat need intervention to live
(03:53):
a better life because of theirdisease state, but kind of pivot
backwards earlier in thelifespan to start creating a
more healthy population movingforward?
And I say this all the time it,you know, it upsets people, but
we're never going to solve ourproblems if we're trying to
solve it at plus 50 years old.
I mean we, just we can't.
I mean that's like swimmingagainst the strongest current.
(04:13):
You know we're going to have toget way upstream and try to
create healthier populations inthe future, which, in results,
you know could lower theeconomic pressure on our
healthcare system andindividuals and create a
healthier population.
Ellen Brown (04:25):
But it's interesting because I feel like
we're coming into this magicmoment where, because we're
spending 2 trillion, so it'skind of like the creep.
Right, healthcare used to be toyour point.
Like we did.
We built this very, I say, sickcare, which is a bit draconian
statement, but people understandthat.
Right, we built this system forkeeping you alive, right?
You're really sick.
We treat you, we keep you alive, we treat you.
(04:46):
And I think now, with the rapid, exponential growth of
lifestyle disease,cardiometabolic disease syndrome
you know we're spending 2trillion on that it's it's
really largely bankrupting a lotof folks.
And now all of a sudden, peoplesee that and so I almost feel
like we're at this magic momentwhere we don't even have to
debate about quote unquotewellness and prevention, which I
a hundred percent agree withyour point about we need to keep
(05:09):
moving down is we have thishuge opportunity in front of us.
I mean, I've been shocked atthe number of people that have
said, even at late stage in yoursixties, right, that lifestyle
medicine can truly reversedisease.
You know, and it's like wait,we have this tool that we can
put in our toolkit that couldactually give an option to
reverse disease, not just treatit right.
(05:30):
And as that takes hold and weshow success, we could then say,
okay, now we can keep movingdown right.
We can use it as a tool toimprove the health overall and
not get to the point we've beengetting to you know.
Justin Politti (05:44):
Well, yeah, we've collectively lost our
minds, it's true.
Ellen Brown (05:49):
No, you said this yesterday and it was so true.
Justin Politti (05:53):
And we have a common sense solution in front
of us and we just need toadvertise it.
But we are, we're full,delusional, and now we have a
common sense solution in frontof us and we just need to
advertise it, like I I mean like.
But we are, we're in, like,we're full delusional and now,
like, we're awake.
You know what I'm saying thisis an epiphany.
Sean Martin (06:05):
He actually had t-shirt ideas now it's um, so I,
I, I actually agree with thatas um.
Those aren't the words.
I would have um in myprofessional role.
But I do think this concept ofwe've lured ourselves into this
(06:26):
false optimism about whatactually is important in the
healthcare system and I thinkit's a real disconnect.
You've made the point.
It's a financial disconnect toindividuals, it's a healthcare
disconnect to individuals.
It's a healthcare disconnect toindividuals.
Like people want to livehealthier lives, and I mean, if
you engage them and you givephysicians and care teams the
resources to help people see adifferent alternative, more
(06:46):
often than not they take thatalternative.
And the healthcare system isn'tdesigned and I made this
comment yesterday in my talkhere the healthcare system is
not designed from a benefit andfinancing structure for these
conversations to take place.
They actually disincentivizethose conversations from taking
place and I think we just, youknow, we just we have to align
the outcomes we want with thecare that we're asking people to
(07:09):
provide and I think right nowthe care that we're providing is
aligned with, you know, all thewrong things in many respects.
Ellen Brown (07:20):
But I do think and that's why I say it's.
This moment is I do actuallyget very optimistic when I look
at all of the value-basedpayment models that we have
accessible to us through bothCMMI, through direct-to-employer
, through commercial, all ofthose different Medicaid.
I get hopeful because I think alot of people have been
uncomfortable to jump into thosemodels because they've been
doing chronic care management.
Justin Politti (07:41):
Again manage.
Ellen Brown (07:42):
It's like let's just manage the person, let's
try and just avoid a readmission, whatever.
We're not reversing anythingright, we're not focusing on
changing behavior.
And I look at this and I say,wait a minute.
Okay, if we could just deploylifestyle medicine with cohorts
of people, to your point, thatactually want to get healthy.
There are millions of peoplethat do want to get healthy and
(08:03):
we give them the intervention tosay here now we have an
outcomes-based model to reinvest, to actually reinvest those
dollars for a health system.
They make a lot more margin onsharing 50% of the savings of a
diabetic patient that just saved$30,000 in the year than they
did on the margin of a stay.
Sean Martin (08:21):
You know what I'm saying.
Ellen Brown (08:22):
And I'm not talking about all of a sudden just like
yanking all the inpatientadmissions out it's.
There's a real opportunity hereto leverage the payment models
that we have and align them withthe practice of medicine, using
such simple tools as lifestylemedicine.
Justin Politti (08:37):
You know what if we're all healthy?
What if we're all healthy?
Sean Martin (08:39):
Well, I mean that's true, right.
Like I mean that's the conceptof just prolonging the onset of
disease by a week, a month, ayear.
Like I mean just the impactthat has at scale in a
population like this.
But I have two comments because, like I think you're making an
excellent point, we, you know,for a long time, interventions
(09:01):
in or demonstration projects orinnovation, particularly in
primary care, were all designedto produce an outcome from
someone other than the patient.
So it was to save a hospitalmoney, to save the employer
money, to save the insurer money.
There was never a systemdesigned to help the patient be
healthier and live a better life.
And I think, to CMMI's creditand to a lot of people in the
marketplace, that has changed.
(09:21):
People are becoming much morefocused on this concept of whole
person care, helping peoplelive their best healthy life, no
matter what state they may findthemselves in at the time.
So I think that conversationhas changed a little bit, which
gives us a new opportunity toalign financing models and care
models around.
You know some of these newconcepts and I think that's why
lifestyle medicine is having amoment.
(09:43):
I think that's why you'reseeing the appropriate like how
does it get incorporated intomore comprehensive care models
so that it's not a niche, youknow, practice model.
I think that's where, at AFP,lifestyle medicine should
reemerge as a component ofcomprehensive primary care right
Everybody should be doing thisyou know, and you should be
(10:04):
doing it for children.
You know, these approaches tothis concept of care do not have
an age limit or anything else.
I mean these are just a goodapproach to better patient care.
Ellen Brown (10:09):
Yeah, they don't have to be concierge, they don't
have to be only for the rich,and I think that's it, like just
we've lost our minds Like it'show to live healthy.
It's like just we've lost ourminds like it's how to live
healthy.
It's like you don't have to gobuy some special implement.
Or it's like just sleep moreand move your body and eat
healthy and right.
Justin Politti (10:24):
It's like no, and I haven't shared.
I haven't shared this.
I've been thinking all weeklike oh boy, oh boy, wait, no,
this, this is the roadrunnerwiley coyote kind of moment.
Uh, wiley coyote runs off thecliff and all of a sudden
crashes down because guess what?
It's unsustainable, the wholesystem, the way we're funding
everything.
And we've hit that momentcollectively, as society.
Ellen Brown (10:43):
Yeah, we're running , we're like really close.
Justin Politti (10:45):
Right.
So, honey, I'll have the Acmepillow ready for us.
Ellen Brown (10:50):
Justin's underneath .
Is there going to be an anvilfalling on?
Justin Politti (10:53):
us, or is there a pillow, an Acme pillow?
Yeah, I don't know, we'll findout.
Ellen Brown (10:57):
Well, we know you have to get on with the day, and
we know this is always a tighttime frame.
We really appreciate youjoining us.
Sean Martin (11:04):
Yeah, thanks for being here.
Thank you guys for having me.
I mean, we've got Roadrunner.
Justin Politti (11:08):
Yeah, we go everywhere Like it's like a pain
.
Ellen Brown (11:13):
And feel free to jump in against the Roadrunner
there?
Justin Politti (11:15):
I didn't I wanted to give you an out.
I wanted to give you an out, sothank you for having me and
you're welcome on for a fulldiscussion.
Sean Martin (11:29):
I would actually welcome that.
Now, my mind I'll be betterprepared mentally for what I'm
getting into you think so?
But thank you for having me,thanks for the opportunity to
share a few thoughts, and I lookforward to the next time.
This is not grandpa's podcast.
Ellen Brown (11:46):
No, but we do have a lot of people don't understand
it's party in the front,business in the back but, you
make it too boring and peopleare like, yeah, I get enough of
that at work every day but youmake it too silly and it's not
helpful, and so our goal is tohopefully kind of balance the
two.
Weave it in, yeah, so thank you.
Sean Martin (12:01):
And I don't want to be.
I want to say one last thingyeah, please.
I think I've been at this a longtime.
I think we are at an inflectionpoint that is different than
any other time that I canremember, and I think COVID
created that in many respectsoriented to essential kind of
false truths that exist.
One, it reoriented peoplearound the fact that they do
want to be healthy.
(12:22):
I mean, you started to see kindof a refocus of the population
on wanting to be healthy.
And two, it reoriented thehealthcare system that it wasn't
actually doing a good job.
It was not, you know, preparedto really meet the moment, and
not the people inside thehealthcare system, but the
structure of the system itselfwas not really designed to meet
that moment.
And you know, now it's.
(12:42):
You know, do we how fast can webuild?
Can we stack bricks fast enoughto build something different,
or do we just kind of fall backinto the routine?
Ellen Brown (12:49):
And it's interesting you say that,
because I was really at aninflection point myself in my
career a year and a half ago.
We all were, and lifestylemedicine to me is.
I don't know, justin will comeup with a good analogy.
You might.
You seem like a good analogyperson.
I'm not Is.
Sean Martin (13:06):
I feel like lifestyle medicine.
Ellen Brown (13:06):
Maybe it's like the speed drying mortar, that that
it's like you can take we have.
We have certain elements in thecare system that we built today
, right, that can be deployed,like all of the primary care
physicians that we have.
But now, all of a sudden, wegive them lifestyle medicine as
a board certification on top andanother way to practice
medicine for the patients thatwant to reverse disease.
Right, and now all of a sudden,it's like boom, boom, boom,
boom, boom, boom, boom.
Because you're not, you don'thave to recreate the wheel.
(13:28):
I guess, that's it Right.
It's like a tool to you know,super pump up what you already
have, or like retool it withoutrebuilding.
Justin Politti (13:36):
Yeah, and it's something that you electrify it.
Ellen Brown (13:38):
Thank, you, I'm thinking of Greece Electrified.
Justin Politti (13:41):
Yeah, electrified, Just electrified.
Ellen Brown (13:43):
I was like really I was trying to make a point and
now I'm seeing OliviaNewton-John.
Justin Politti (13:47):
Exactly John Travolta.
Sean Martin (13:50):
So I think the uniqueness is I was thinking
about this yesterday of, formost physicians particularly
primary care physicians, I think, people that are
community-based physicians theconcept of lifestyle medicine is
probably very well orientedwith their worldview of the type
of care they wanted to providewhen they went into medicine.
So it's inviting them back tothis concept of patient care
(14:11):
that I think they probably sawat the beginning.
That's been taken away fromthem by a variety of factors
over many years, and so there'sa lot of optimism around it.
And it's not a you know it's.
It's not an EHR, it's not adigital health tool Like it's
something they can do everysingle day with every single
patient, and it has a kind oftactical feel to it, right, like
they can touch it and feel itevery day and it's a
(14:32):
relationship.
Ellen Brown (14:33):
That's what we've heard over and over again, is
the relationship that they can,they can build with the
simplicity of this yeah right,it's like back to basics, so
anyways, all right awesome.
Justin Politti (14:42):
Thank you for your time.
Thank you.
Welcome to the Reverse Mullet Healthcare
Podcast.
We are live at the ACLMConference, the American College
of Lifestyle Medicine.
Ellen Brown (00:11):
He did it.
Yeah, there you go 2024,orlando, florida.
Justin Politti (00:16):
I'm Justin Politti, I'm Dave Pavlik.
I'm Alan Brown.
Ellen Brown (00:20):
I'm Justin Politti.
I'm Mullet man, but we're herewith Sean Martin and I'm super
excited because I think yourorganization is integral to
what's happening today.
You know we had Susan Benegason yesterday and she used the
term catalyst for transformation.
Sean Martin (00:34):
Yeah.
Ellen Brown (00:34):
And you have been in this uphill battle with
family practice for the AFP ofhow do you enable family
practice, primary care, tofulfill what it's capable of
fulfilling, right, and it's sucha challenge with the RVU model
and a fee-for-service model andjust what we've been up against,
and you know we've been comingat it from a payment
(00:55):
transformation perspective.
And how do we getoutcomes-based models?
You know value-based caremodels, all these things in
place, and I feel like lifestylemedicine is truly this catalyst
to transformation, because it'sa tool to allow success, you
know.
So I'm really glad you joined.
Well, thank you for having me sotell us about AAFP and tell us
about your work and lifestyle,medicine and linkage, et cetera.
Sean Martin (01:17):
Sure.
So the American Academy ofFamily Physicians is founded in
1947 as the American Academy ofGeneral Practice.
We became AAFP in 1971 for avariety of reasons.
Part of it was atransformational movement around
the practice and the scope andcommunity-based care and
community health centers.
Lots of things were happeningin the United States and kind of
(01:38):
the post-Medicarecommunity-based care models were
emerging.
Community-based care modelswere emerging but family
medicine kind of came out ofthat community-based movement to
connect health and healthprofessionals at the community
level in response to kind of avery hospital-centric time
period around Medicare, whichstill exists today in many ways.
We represent 130,000 familyphysicians and medical residents
(01:59):
across the country.
We have a member at least thelast time we counted in 95% of
US counties.
They move around a little bitbut we have a very robust
footprint across the country and, more likely than not, if
there's people living in acommunity there's probably a
family physician somewherenearby.
We're an organization.
We're a professionalorganization.
We really do three things.
We do member support.
We have a very robust educationapparatus, helping members be
(02:23):
successful both in clinicalpractice but also in their
careers and profession, and thenwe're a big advocacy
organization and doing all thework that you just talked about
at the beginning A little.
You know, it was a littledepressing to hear all the
things that we got to work onSorry.
Justin Politti (02:39):
Well, we're energized about it so.
Sean Martin (02:41):
But you know it's a wonderful organization.
You know people come to FamilyMedicine for all the right
reasons.
So, but, um, you know it's awonderful organization.
When you know people come tofamily medicine for all the
right reasons and you know it'sjust a opportunity, I really
appreciate the opportunity totry to help make their world
better so they can make otherpeople's world better, and
that's why I'm here at lifestylemedicine and I think we're just
it's a continued pursuit.
Ellen Brown (02:59):
Yeah, so you guys want to.
I'm always the yapper, yeah,now what do you find the biggest
?
Justin Politti (03:05):
barriers to moving it forward.
Sean Martin (03:08):
Just the concepts of primary care or lifestyle
medicine.
Justin Politti (03:10):
Lifestyle medicine.
Sean Martin (03:11):
I think the barriers to the concepts of
primary health care in theUnited States are the same for
lifestyle medicine is the sameas it was for health promotion,
disease prevention and like allthese concepts have faced the
same headwinds in the UnitedStates and it's because we have
built a healthcare system from abenefits and financing
perspective that is heavilyfocused on late stage
(03:31):
intervention of disease we don'tfocus with, except for children
, you know, and like there'sthis moment in time with
children who were very healthand prevention focused but by
the time they reach, you know,young adolescents, we've moved
away from that.
But we're a healthcare systemlargely focused on late
intervention of disease.
And how do we not ignore peoplethat need intervention to live
(03:53):
a better life because of theirdisease state, but kind of pivot
backwards earlier in thelifespan to start creating a
more healthy population movingforward?
And I say this all the time it,you know, it upsets people, but
we're never going to solve ourproblems if we're trying to
solve it at plus 50 years old.
I mean we, just we can't.
I mean that's like swimmingagainst the strongest current.
(04:13):
You know we're going to have toget way upstream and try to
create healthier populations inthe future, which, in results,
you know could lower theeconomic pressure on our
healthcare system andindividuals and create a
healthier population.
Ellen Brown (04:25):
But it's interesting because I feel like
we're coming into this magicmoment where, because we're
spending 2 trillion, so it'skind of like the creep.
Right, healthcare used to be toyour point.
Like we did.
We built this very, I say, sickcare, which is a bit draconian
statement, but people understandthat.
Right, we built this system forkeeping you alive, right?
You're really sick.
We treat you, we keep you alive, we treat you.
(04:46):
And I think now, with the rapid, exponential growth of
lifestyle disease,cardiometabolic disease syndrome
you know we're spending 2trillion on that it's it's
really largely bankrupting a lotof folks.
And now all of a sudden, peoplesee that and so I almost feel
like we're at this magic momentwhere we don't even have to
debate about quote unquotewellness and prevention, which I
a hundred percent agree withyour point about we need to keep
(05:09):
moving down is we have thishuge opportunity in front of us.
I mean, I've been shocked atthe number of people that have
said, even at late stage in yoursixties, right, that lifestyle
medicine can truly reversedisease.
You know, and it's like wait,we have this tool that we can
put in our toolkit that couldactually give an option to
reverse disease, not just treatit right.
(05:30):
And as that takes hold and weshow success, we could then say,
okay, now we can keep movingdown right.
We can use it as a tool toimprove the health overall and
not get to the point we've beengetting to you know.
Justin Politti (05:44):
Well, yeah, we've collectively lost our
minds, it's true.
Ellen Brown (05:49):
No, you said this yesterday and it was so true.
Justin Politti (05:53):
And we have a common sense solution in front
of us and we just need toadvertise it.
But we are, we're full,delusional, and now we have a
common sense solution in frontof us and we just need to
advertise it, like I I mean like.
But we are, we're in, like,we're full delusional and now,
like, we're awake.
You know what I'm saying thisis an epiphany.
Sean Martin (06:05):
He actually had t-shirt ideas now it's um, so I,
I, I actually agree with thatas um.
Those aren't the words.
I would have um in myprofessional role.
But I do think this concept ofwe've lured ourselves into this
(06:26):
false optimism about whatactually is important in the
healthcare system and I thinkit's a real disconnect.
You've made the point.
It's a financial disconnect toindividuals, it's a healthcare
disconnect to individuals.
It's a healthcare disconnect toindividuals.
Like people want to livehealthier lives, and I mean, if
you engage them and you givephysicians and care teams the
resources to help people see adifferent alternative, more
(06:46):
often than not they take thatalternative.
And the healthcare system isn'tdesigned and I made this
comment yesterday in my talkhere the healthcare system is
not designed from a benefit andfinancing structure for these
conversations to take place.
They actually disincentivizethose conversations from taking
place and I think we just, youknow, we just we have to align
the outcomes we want with thecare that we're asking people to
(07:09):
provide and I think right nowthe care that we're providing is
aligned with, you know, all thewrong things in many respects.
Ellen Brown (07:20):
But I do think and that's why I say it's.
This moment is I do actuallyget very optimistic when I look
at all of the value-basedpayment models that we have
accessible to us through bothCMMI, through direct-to-employer
, through commercial, all ofthose different Medicaid.
I get hopeful because I think alot of people have been
uncomfortable to jump into thosemodels because they've been
doing chronic care management.
Justin Politti (07:41):
Again manage.
Ellen Brown (07:42):
It's like let's just manage the person, let's
try and just avoid a readmission, whatever.
We're not reversing anythingright, we're not focusing on
changing behavior.
And I look at this and I say,wait a minute.
Okay, if we could just deploylifestyle medicine with cohorts
of people, to your point, thatactually want to get healthy.
There are millions of peoplethat do want to get healthy and
(08:03):
we give them the intervention tosay here now we have an
outcomes-based model to reinvest, to actually reinvest those
dollars for a health system.
They make a lot more margin onsharing 50% of the savings of a
diabetic patient that just saved$30,000 in the year than they
did on the margin of a stay.
Sean Martin (08:21):
You know what I'm saying.
Ellen Brown (08:22):
And I'm not talking about all of a sudden just like
yanking all the inpatientadmissions out it's.
There's a real opportunity hereto leverage the payment models
that we have and align them withthe practice of medicine, using
such simple tools as lifestylemedicine.
Justin Politti (08:37):
You know what if we're all healthy?
What if we're all healthy?
Sean Martin (08:39):
Well, I mean that's true, right.
Like I mean that's the conceptof just prolonging the onset of
disease by a week, a month, ayear.
Like I mean just the impactthat has at scale in a
population like this.
But I have two comments because, like I think you're making an
excellent point, we, you know,for a long time, interventions
(09:01):
in or demonstration projects orinnovation, particularly in
primary care, were all designedto produce an outcome from
someone other than the patient.
So it was to save a hospitalmoney, to save the employer
money, to save the insurer money.
There was never a systemdesigned to help the patient be
healthier and live a better life.
And I think, to CMMI's creditand to a lot of people in the
marketplace, that has changed.
(09:21):
People are becoming much morefocused on this concept of whole
person care, helping peoplelive their best healthy life, no
matter what state they may findthemselves in at the time.
So I think that conversationhas changed a little bit, which
gives us a new opportunity toalign financing models and care
models around.
You know some of these newconcepts and I think that's why
lifestyle medicine is having amoment.
(09:43):
I think that's why you'reseeing the appropriate like how
does it get incorporated intomore comprehensive care models
so that it's not a niche, youknow, practice model.
I think that's where, at AFP,lifestyle medicine should
reemerge as a component ofcomprehensive primary care right
Everybody should be doing thisyou know, and you should be
(10:04):
doing it for children.
You know, these approaches tothis concept of care do not have
an age limit or anything else.
I mean these are just a goodapproach to better patient care.
Ellen Brown (10:09):
Yeah, they don't have to be concierge, they don't
have to be only for the rich,and I think that's it, like just
we've lost our minds Like it'show to live healthy.
It's like just we've lost ourminds like it's how to live
healthy.
It's like you don't have to gobuy some special implement.
Or it's like just sleep moreand move your body and eat
healthy and right.
Justin Politti (10:24):
It's like no, and I haven't shared.
I haven't shared this.
I've been thinking all weeklike oh boy, oh boy, wait, no,
this, this is the roadrunnerwiley coyote kind of moment.
Uh, wiley coyote runs off thecliff and all of a sudden
crashes down because guess what?
It's unsustainable, the wholesystem, the way we're funding
everything.
And we've hit that momentcollectively, as society.
Ellen Brown (10:43):
Yeah, we're running , we're like really close.
Justin Politti (10:45):
Right.
So, honey, I'll have the Acmepillow ready for us.
Ellen Brown (10:50):
Justin's underneath .
Is there going to be an anvilfalling on?
Justin Politti (10:53):
us, or is there a pillow, an Acme pillow?
Yeah, I don't know, we'll findout.
Ellen Brown (10:57):
Well, we know you have to get on with the day, and
we know this is always a tighttime frame.
We really appreciate youjoining us.
Sean Martin (11:04):
Yeah, thanks for being here.
Thank you guys for having me.
I mean, we've got Roadrunner.
Justin Politti (11:08):
Yeah, we go everywhere Like it's like a pain
.
Ellen Brown (11:13):
And feel free to jump in against the Roadrunner
there?
Justin Politti (11:15):
I didn't I wanted to give you an out.
I wanted to give you an out, sothank you for having me and
you're welcome on for a fulldiscussion.
Sean Martin (11:29):
I would actually welcome that.
Now, my mind I'll be betterprepared mentally for what I'm
getting into you think so?
But thank you for having me,thanks for the opportunity to
share a few thoughts, and I lookforward to the next time.
This is not grandpa's podcast.
Ellen Brown (11:46):
No, but we do have a lot of people don't understand
it's party in the front,business in the back but, you
make it too boring and peopleare like, yeah, I get enough of
that at work every day but youmake it too silly and it's not
helpful, and so our goal is tohopefully kind of balance the
two.
Weave it in, yeah, so thank you.
Sean Martin (12:01):
And I don't want to be.
I want to say one last thingyeah, please.
I think I've been at this a longtime.
I think we are at an inflectionpoint that is different than
any other time that I canremember, and I think COVID
created that in many respectsoriented to essential kind of
false truths that exist.
One, it reoriented peoplearound the fact that they do
want to be healthy.
(12:22):
I mean, you started to see kindof a refocus of the population
on wanting to be healthy.
And two, it reoriented thehealthcare system that it wasn't
actually doing a good job.
It was not, you know, preparedto really meet the moment, and
not the people inside thehealthcare system, but the
structure of the system itselfwas not really designed to meet
that moment.
And you know, now it's.
(12:42):
You know, do we how fast can webuild?
Can we stack bricks fast enoughto build something different,
or do we just kind of fall backinto the routine?
Ellen Brown (12:49):
And it's interesting you say that,
because I was really at aninflection point myself in my
career a year and a half ago.
We all were, and lifestylemedicine to me is.
I don't know, justin will comeup with a good analogy.
You might.
You seem like a good analogyperson.
I'm not Is.
Sean Martin (13:06):
I feel like lifestyle medicine.
Ellen Brown (13:06):
Maybe it's like the speed drying mortar, that that
it's like you can take we have.
We have certain elements in thecare system that we built today
, right, that can be deployed,like all of the primary care
physicians that we have.
But now, all of a sudden, wegive them lifestyle medicine as
a board certification on top andanother way to practice
medicine for the patients thatwant to reverse disease.
Right, and now all of a sudden,it's like boom, boom, boom,
boom, boom, boom, boom.
Because you're not, you don'thave to recreate the wheel.
(13:28):
I guess, that's it Right.
It's like a tool to you know,super pump up what you already
have, or like retool it withoutrebuilding.
Justin Politti (13:36):
Yeah, and it's something that you electrify it.
Ellen Brown (13:38):
Thank, you, I'm thinking of Greece Electrified.
Justin Politti (13:41):
Yeah, electrified, Just electrified.
Ellen Brown (13:43):
I was like really I was trying to make a point and
now I'm seeing OliviaNewton-John.
Justin Politti (13:47):
Exactly John Travolta.
Sean Martin (13:50):
So I think the uniqueness is I was thinking
about this yesterday of, formost physicians particularly
primary care physicians, I think, people that are
community-based physicians theconcept of lifestyle medicine is
probably very well orientedwith their worldview of the type
of care they wanted to providewhen they went into medicine.
So it's inviting them back tothis concept of patient care
(14:11):
that I think they probably sawat the beginning.
That's been taken away fromthem by a variety of factors
over many years, and so there'sa lot of optimism around it.
And it's not a you know it's.
It's not an EHR, it's not adigital health tool Like it's
something they can do everysingle day with every single
patient, and it has a kind oftactical feel to it, right, like
they can touch it and feel itevery day and it's a
(14:32):
relationship.
Ellen Brown (14:33):
That's what we've heard over and over again, is
the relationship that they can,they can build with the
simplicity of this yeah right,it's like back to basics, so
anyways, all right awesome.
Justin Politti (14:42):
Thank you for your time.
Thank you.
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