June 6, 2025 • 21 mins
"I would have retired from healthcare if I hadn't found lifestyle medicine." These powerful words from Dr. Patel capture the transformative potential not just for patients, but for burned-out healthcare professionals seeking meaning in their work.
Speaking with us at the American College of Lifestyle Medicine Conference, Dr. Patel shares the remarkable journey that led her from traditional internal medicine to becoming a champion of lifestyle medicine approaches. Her patients' transformations were so dramatic that after just three months, some were unrecognizable - completely weaning off insulin, reversing diabetes, normalizing cholesterol levels, and losing significant weight. These weren't incremental improvements but complete health transformations.
What makes Dr. Patel's story particularly compelling is her strategic approach to integrating lifestyle medicine into healthcare systems. Rather than starting with idealism, she targeted specific pain points for her health system. As a self-insured entity spending $3 million over budget on employee healthcare annually, the system was receptive when her intensive therapeutic lifestyle change program for 150 employees demonstrated exactly $3 million in cost savings within a year. This perfect ROI opened doors for expansion, allowing her to build comprehensive programs incorporating health coaches, registered dietitians, and community-based interventions.
The pandemic forced Dr. Patel to transition her in-person programs to virtual platforms, yielding a surprising discovery: virtual lifestyle medicine programs produce identical clinical and biometric outcomes to in-person interventions. This breakthrough has enormous implications for scaling these solutions nationwide without capital-intensive facility investments, potentially addressing both clinician shortages and healthcare access issues simultaneously.
Ready to transform your approach to healthcare? Explore how lifestyle medicine can revitalize your practice, improve patient outcomes, and create sustainable healthcare models that address both clinical and economic challenges. The revolution in healthcare isn't coming - it's already here.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Dave Pavlik (00:02):
Welcome to the Reverse Mullet Healthcare
Podcast by BP2 Health.
We're here at the ACLMConference in Orlando, Florida
2024.
Justin Politti (00:10):
Sunny Florida 20th anniversary.
Right.
Who are you?
I'm Dave Pavlik the Mullet.
Ellen Brown (00:16):
Man.
Justin Politti (00:16):
I'm the Mullet man today.
Ellen Brown (00:17):
And I am Ellen Brown.
Justin Politti (00:18):
And I'm Justin Politti.
Ellen Brown (00:20):
And we're here with one of my favorite ACLM people,
dr Patel, and, yeah, americanCollege of Lifestyle Medicine
Annual Conference and superexcited to be here.
I think what's so exciting iswe have our little unicorn on
the table of always searchingfor the unicorns of healthcare,
and what's so amazing to meabout ACLM is like the whole
(00:40):
function of ACLM is a unicornright.
So not only is it likethousands of unicorns walking
around, it's also an entire youknow board certification.
That really is unicorn statusin terms of healthcare.
Justin Politti (00:54):
So I can't tell you how many people that I've
talked to that you know that.
Well, what are you doing?
What's the podcast about?
And I explained it to them andtell them what we do is BP2.
And they go yeah, I'm almostboard certified, I'm sitting for
the exam next month.
I can't wait.
It's like like I literally yeah, four or five different people
that I talked to just kind ofrandomly- yeah, there's a lot of
people sitting right now.
Ellen Brown (01:13):
There's a lot of buzz.
Justin Politti (01:13):
Yeah, I know they're supposed to be studying,
but instead they're here, yeah.
Dave Pavlik (01:25):
So it's actually part of attending this
conference.
Very nice, oh, I thought yousaid getting in front of BP2
Health was part of it.
Justin Politti (01:29):
It should be.
Dave Pavlik (01:30):
It's a new part of the curriculum Hold on a second.
Ellen Brown (01:37):
We just talked to the no nevermind Carry on yeah,
you're not going to remember wetalked to get that on the
curriculum.
Justin Politti (01:43):
Oh, brenda, brenda, yes, brenda, we need to
get.
Let Brenda know that we're anew part of a couple of CMEs,
for maybe one.
Ellen Brown (01:51):
Yeah, just one half .
Justin Politti (01:52):
Yeah, you just have to.
Ellen Brown (01:54):
Yeah, anyways, without further ado Dr.
Patel, so glad you're here.
Justin Politti (01:58):
Yes.
Ellen Brown (02:06):
You're a very find.
Padmaja Patel (02:06):
Oh no, maybe I can find you, but I can't
extract you to get you into thebooth.
So yeah, so tell us aboutyourself.
Oh, happy to be here, alan.
You.
You've been someone that I'vebeen following too, so, uh, on a
social media, and that's how Ifound you, but uh, she's not on
social media come on I haven'tseen one lot of her posts are
actually getting viral, as Ihear, she has a huge fan
following there, so I'm one ofthose.
(02:27):
But no, I think more about howI find that what you actually
write on your post on socialmedia and LinkedIn is something
I resonate so much with, andit's like, wow, someone is
exactly writing what I'mthinking, right, and so you
articulate so well and with somuch humor and fun, and so, yeah
(02:50):
, I think we're kindred spiritshere.
Ellen Brown (02:52):
We are kindred spirits, yeah, and you're the
same, and Ellen was ACLM beforeshe knew what ACLM was.
Justin Politti (02:58):
Yes, I was, I've been living an ACL dream.
Ellen Brown (03:00):
It's just like my husband and I took a year and a
half RV trip before there wasvan life and before there was
blogging, like it's right.
It's like Brenda with hercommitment to ACLM before most
people.
Justin Politti (03:12):
She's Forrest Gump, oh I am.
Dave Pavlik (03:14):
I'm like Forrest.
Ellen Brown (03:14):
Gump.
Justin Politti (03:15):
Trendsetter yeah .
Ellen Brown (03:16):
Didn't even know it , so yeah.
So tell us about what you'reworking on, what you're
passionate about yeah.
Padmaja Patel (03:22):
So so anyway, but I'm an internal medicine
trained clinician and thencertified in lifestyle medicine,
obviously.
So I've had fortunate, you know, as a primary care clinician.
We all go through the same, uh,sort of journey of, you know,
getting tired of doing this moreof the same, and fortunately I
found lifestyle medicine thatliterally changed my personal
(03:46):
and professional trajectory.
Um, I would have retired fromhealthcare if I had not found
lifestyle medicine and I don'tthink I'm the only one saying
that.
there are so many clinicianshere either are they are burned
out, you know from doing whatthey do, or they're looking for
another revenue to uh find howcan they deliver meaningful care
and find purpose and meaningalong the way, right?
(04:08):
So this is what LifestyleMedicine delivers, and I'm so
delighted that I had theopportunity of delivering and
establishing a program at alocal health system in Midland
Texas where I developed many ofthis intensive therapeutic
lifestyle program, and whatreally changed me the most was
(04:29):
more around the transformationsthat I actually witnessed.
You know I saw people like someof my patients are related.
You know they came back as afollow-up and I didn't even
recognize them.
Ellen Brown (04:40):
It was like that kind of a transformation?
After what period of time?
In three months?
Justin Politti (04:46):
Three months Wow , yeah, it was like that kind of
a transformation.
Padmaja Patel (04:48):
After what period of time?
In three months, three months,wow, yeah, three months.
Patients completely getting offtheir medications If they were
on insulin, reversing theirdiabetes, reversing their
cholesterol hyperlipidemia andthings like.
So this is not what we had seenor at least I had seen in my
traditional primary carepractice, right?
So that's brought me all thepassion and excitement, what we
had seen or at least I had seenin my traditional family care
practice, right?
So that's that's brought me allthe passion and excitement.
(05:09):
Wow, can we do this?
How can I do this?
And more of it, right, like Ididn't want to just practice my
own clinic, I wanted to actuallyhave that impact, bigger impact
.
So I aligned with the localhealth system and then now I'm
so excited to be part of thisbigger community here at ACLM
and in my leadership role I wantto replicate more of the
(05:33):
success that I've actually seenin my private practice and with
health systems to really see howwe can do this on a bigger
scale.
So that's my big agenda even asI step into my leadership role
within ACLM is to reallydemonstrate the value
proposition of lifestylemedicine across different
(05:56):
payment models.
Ellen Brown (05:57):
Do I hug you?
Do I hug you?
I think this is the first timeI've ever hugged a guest.
Justin Politti (06:01):
She does.
She usually gives a fist pump.
Ellen Brown (06:04):
But that was just hug-worthy right there.
Justin Politti (06:06):
this is why we are meant to be friends in in
your example I'm sure there aremany of of a patient that you
know came back three monthslater and you didn't recognize
them.
What are the?
What are the um interventionsyou're deploying, that that are
lifestyle medicine related?
All of them, some of them?
What?
What works the best?
Padmaja Patel (06:23):
You know, so early in my private practice I
didn't have the resources toreally bring in team-based care.
You know, in your privatepractice you don't have the
resources, you can't afford itin fee-for-service payment
models.
So a lot of that relied on justeducating them, providing them
some pamphlets, educationalmaterial or websites, so you
(06:45):
know.
So I had actually aprescription that we would give
them.
So you know, watch this video,look at this website.
Here are the recipes.
You know all these stuff thatwe gave and they go home.
And you know those who werereally motivated would continue,
but there was no support systemearly on.
Clearly, then I realized thatthere needs to be a very
structured program and we neededto integrate health coaching,
(07:09):
bringing into behavioral aspectand also bringing nutritional
counseling with a registereddietitian, and so that's why I
joined a health system to bringaround this entire
interdisciplinary team-basedcare as part of our approach.
But I have seen so, for example, in my community I co-founded
(07:30):
another non-profit called OurHealthy City.
So our biggest mission there isto more around educating
community around the benefits ofwhole food plant, predominant
dietary pattern and lifestylemedicine.
We would conduct and we stilldo annual food as medicine event
and we would have about 500members from our community just
(07:54):
come listen to one day seminar.
We would invite all these bigprofessionals and speakers from
around the world sometimes, butthe key is that they just
learned, they heard about it,they watched some presentations
and then they go home and we'veseen people losing 70 pounds, 80
pounds on their own right,without any further.
Justin Politti (08:18):
They just got motivated from a one-day event.
Padmaja Patel (08:20):
Yeah, that's what I'm saying.
So there are many ways to thinkabout this.
It's not everyone needs to havea structured medical program.
This community element isequally important for support
and education, and so all ofthese pieces have to be plugged
in together, even for doctors,many of our intensive programs,
(08:40):
yes, we can demonstrate goodoutcomes, but if we don't have
an ongoing support in thecommunity, it's very hard to
sustain.
Justin Politti (08:48):
that Keeps coming up.
Padmaja Patel (08:50):
Community.
Ellen Brown (08:50):
Community yeah.
Padmaja Patel (08:52):
That's the key here is to talk about lifestyle.
Analysis is not just whathappens in an office setting.
Ellen Brown (08:58):
Yeah.
Padmaja Patel (08:59):
It's much more than that, and you can see it
here, right.
Dave Pavlik (09:03):
Very much so.
Padmaja Patel (09:04):
The models that we see it's across, and so my
passion and excitement comesfrom it's not just I mean
predominantly primary care.
We want to integrate lifestylemedicine across the board, but
we also have it in specialtycare.
Ellen Brown (09:17):
Which is amazing.
Padmaja Patel (09:18):
We have it in different settings Yep Right,
inpatient, outpatient, you andme, yep and across different
payment models, so it's likeubiquitous, it can be anywhere,
yep Right, and so that's thebeauty of this foundational care
that we talk about.
Dave Pavlik (09:34):
So what are some of your thoughts on?
You mentioned scale a littleearlier.
What are some of your thoughtson how you can scale this across
the country?
Padmaja Patel (09:43):
Yeah, so when COVID-19 happened, during the
pandemic, I had a program whichwas, you know, in-person,
intensive group program, andobviously we couldn't gather
right, so I had to put thatprogram on a virtual platform
and I had no idea how that wouldwork.
Dave Pavlik (09:58):
I was actually very nervous.
I was like how?
Padmaja Patel (10:00):
are we gonna?
How do we, how do you motivate?
And you know all of that.
And then, first group I saw Imean there was this person, one
of my patients, who lost like 40pounds in 10 weeks.
His hemoglobin A1C dropped from7.9 to like 6.2.
Wow, it's just a dramaticchange.
(10:21):
And he convinced me thatvirtual model can be equally
effective.
And then I continued doingin-person groups versus virtual
groups and eventually publishedthe study as well that the
outcomes clinical as well asbiometrics, all of them exactly
same.
There's no difference.
So that gives me hope thatlifestyle medicine is really,
(10:44):
you know, it doesn't have to belimited within.
Ellen Brown (10:46):
Yeah, there's a huge confidence.
Padmaja Patel (10:49):
Exactly, there's a clear model that can be
delivered across virtualplatform, and that's what we
need to do.
Ellen Brown (10:56):
Yeah, totally agree .
Yeah, I mean, one of the thingsyou know I really believe is we
have to, you have to get awayfrom like, if you think about
sick care is sick care and youthink about health care is
health care.
I think when we talk abouthealth care, this obsession or
attachment to bricks and mortar,it just it becomes, it's
unsustainable, it's too capitalintensive, it doesn't have the
(11:19):
kind of economic model thatmakes sense.
And especially when we talkabout lifestyle health, I mean
lifestyle disease and lifestylehealth.
You know, the thing that hasreally struck us is, in every
conversation, I think, excepttwo, the whole group visit model
comes up.
Right, because it's this againit goes back to Justin's
question about scale.
So we have to solve for aclinician shortage and for just
(11:44):
access and also foradministrative burden, all of
those things.
And then you add the group model.
Not only does it solve thatwhole component, it also adds
that pillar of community, whichis something we spoke about.
Spoke to some clinicians todaythat are focused on equity and
(12:05):
like rural, and you know theysaid it's the isolation that
exists in rural communitiesespecially.
Right, that group model.
So it's just, it's amazing andagain, it makes all the sense.
That's what blows my mind aboutlifestyle medicine is it's so
simple.
Padmaja Patel (12:23):
It is, and I tell you that's part of the problem.
Also, sometimes I think earlyon.
What I felt when I learnedabout ACLM and the messaging
around is that it's too simple.
It is so simple that peopledon't take it seriously.
Justin Politti (12:38):
How could this be real?
Padmaja Patel (12:39):
Yeah, how can it be real and so?
Justin Politti (12:41):
exercise and eat better Sleep.
Ellen Brown (12:45):
Stay away from all the fat foods.
Don't drink all the time andsmoke.
Yeah, what yeah?
Padmaja Patel (12:51):
So I think we are intentional now in terms of how
we communicate lifestylemedicine and we're talking more
about the value proposition,right, what exactly it brings,
which is the quintuple aim ofhealthcare, and so we're making
sure that people get the valueand what it is, not just how we
deliver lifestyle medicine,which is the six pillars, which
(13:12):
is how we deliver, but whatexactly is the outcome.
Ellen Brown (13:15):
Agreed.
Justin Politti (13:16):
That's what we need to talk about.
Ellen Brown (13:18):
You know me, I am convinced that lifestyle
medicine is going to be, itcould be, the solution, one of
the core solutions and bridgesto taking that 2 trillion out of
the system of lifestyle disease, cardiometabolic syndrome,
because it can take.
We already have a wholeworkforce of clinicians that are
(13:38):
they're already clinicallyboard certified and so to be
able to train them additionally,right to complement what
they're already doing, to say,hey, here's a.
I think the piece you pointedout that we have to do is we
have to move the needle on theeconomic model, we have to
realign the incentives, we haveto, and then that money can be
redistributed.
And that's our champion is.
(14:00):
You know, this is value-basedcare.
Dave Pavlik (14:08):
That's what we're starting to implement is.
And payers are coming around,they are like each one's always
in its own spot, right, but thereality is you pay for the
intervention and then you payfor the progress that you're
making right.
So it is a it's an to Ellen'spoint, it's an incentive-based
component that's recognizing hey, you know, know what you're
getting paid for the reductionsin metabolic, yeah, improvement
in metabolic, uh, function alongthe spectrum.
(14:28):
So to me, that's a fairnesspiece, because right now they
share the same yeah, the dangeris all right.
You put this in and then itaccrues directly to the
insurance company without any,exactly without any credit going
to the people who are doing itright.
Padmaja Patel (14:41):
You're so well said.
All of us have deliveredlifestyle medicine very
successfully and it didn'tmatter because it was in
fee-for-service rule Nobodycares about the quality,
cost-saving outcomes, nobodycares, it's just the episodic
billing and collection is allthat we care about the
productivity yeah it's a number.
(15:02):
But, as you said, payers arecoming recognizing the value.
I don't know if you attended,but we had a panel discussion
earlier today and for the firsttime in the history of ACLM, we
had two major payers on thestage.
Ellen Brown (15:21):
We went in and watched.
That says a lot.
The change is happening.
Justin Politti (15:25):
I have two of them tomorrow.
Ellen Brown (15:27):
Okay, great.
Justin Politti (15:28):
Thank you.
Padmaja Patel (15:29):
So we had Susanna Bernheim, which is the acting
CMO of CMMI, which is the CMSInnovation Center, and we had
Kate Goodrich, CMO of Humana,and we've been working with
these two big pairs for sometime as part of our Innovators
Council and otherwise, so it's agroundswell right.
(15:51):
It's a real exciting time forthe field to see so much
interest from pairs and theyrecognize this.
And I think all these thingsthat we hear about whether it's
it's employers having to pay somuch for their benefit plan next
year with 7% to 8% increasedwar, whether it is this AMA
(16:12):
plans going- through theheadwinds, the 95% of C8.
Ellen Brown (16:16):
Whoops.
Padmaja Patel (16:17):
I think these are all wonderful opportunities for
lifestyle medicine, oh, totally, totally.
This is exactly where we needto insert lifestyle medicine as
a solution, because it has thepotential to no, it is.
Ellen Brown (16:31):
It is an ultimate solution.
Justin Politti (16:32):
So think of that , get healthier so you, you were
in private practice and thenyou went to work for a system,
system in texas yeah and like sowas the leadership always kind
of behind this lifestylemedicine.
In terms of the finances, youknow we need dieticians, we need
this staff, we need that staff.
It's going to cost you but inthe long run it's going to be.
Padmaja Patel (16:53):
No, you know, what was interesting is that
it's a safety net hospital in asmall community.
Ellen Brown (17:00):
Okay.
Padmaja Patel (17:01):
And we had redefined our vision, mission
and values to make Midland thehealthiest community in Texas.
So the way we approachedlifestyle medicine was more of a
broader solution, rightStrategy like how are we going
to get there?
So, initially, where I startedwas what are the pain points for
(17:23):
my health system?
Right, look at that pain pointsfor my health system, right?
Look that.
And well, as a self-insuredentity, they were paying almost
what?
$3 million more than thebudgeted amount every year.
So we said, okay, let's dosomething for the employee
health.
And so in about a year ofintervention which is the same
(17:45):
intervention we keep talkingabout intensive therapeutic
lifestyle change program, whichis a group medical visit, and
had about 150 employees that gothrough that intervention, we
demonstrated $3 million cost ofAIDS.
Right, so that?
Dave Pavlik (18:01):
opened up the world .
Padmaja Patel (18:04):
Like okay, we proved the model ROI because you
have to do the business andotherwise you know it's hard to
change that needle here andsupport.
I think.
So one was this alignment withtheir overall goal.
Second, we demonstrated the ROI.
And the third was that wewanted to create a program that
(18:25):
would actually lifestylemedicine program, that would
create a robust payments model,so with a reimbursement
structure, which was thisintensive cardiac rehab that we
brought.
So we brought the Ornishprogram initially and then later
changed to Pritikin intensivecardiac rehab.
But it brought revenue to mylifestyle medicine center, which
(18:46):
allowed me to develop a newprograms, hire more staff, you
know.
So I went about not opening acenter first, but I went about
looking at okay, what are thepain points, let's solve that,
get the confidence of theexecutives, and then expand and
create revenue first before youtalk about opening a center.
(19:09):
So all of these kind of cometogether.
Justin Politti (19:14):
That's great.
I think it's great that the youknow the mission is to have the
healthiest community in Texasand cost isn't going to be a
barrier.
Let's figure it out.
Yes, that's impressive, yeah.
Ellen Brown (19:26):
Yeah, it's amazing, so we could talk for like a
long time and I know that you'reneeded to like continue to
circulate.
Yes, there will be many morehugs.
Yes because we are going to dosome big stuff.
We are here to try to help.
Padmaja Patel (19:38):
you know we're completely committed to this and
thank you, thank you, no, Ithink, thank you for here being
here this year.
This brings a sort of a newexciting excitement among our
members.
Justin Politti (19:58):
You excitement among our members.
You know I love them passingthrough.
Yeah, they're like there's likebright lights we've got.
What is this we've got?
I've got them in my headcategorized as podcast curious
and podcast serious.
Oh so the curious, the curiousones, kind of go by, they look
in, they're like I'm a littlenot sure I want to get behind
that camera over there.
And then the serious ones arelike where's your sign up?
Ellen Brown (20:11):
but my favorite are the ones that are like just
sort of come in, oh and it'slike hi, hi, like, all right the
microphone did you?
Well, let's just sit down andgo so here's a coffee and a mic
tomorrow's.
Tomorrow we've got a jam packed, I think we have to start like
putting blocks so we canactually go get some water.
Justin Politti (20:29):
You know, but and I do think we are I think
we're gonna have at least one ofthose payers you referenced,
right?
Yes, I think so.
Maybe two, maybe two.
Yeah, that's the rumor on thestreet, but yeah, so super
excited you took the time yes,thank you so much thank you.
Ellen Brown (20:44):
You will certainly be part of a full episode.
You know great work you'redoing.
Justin Politti (20:47):
Thank you we will, she will, for sure yeah,
you make sure she does right?
Well, make sure she does.
Ellen Brown (20:55):
Don't worry, that's an easy task just don't make me
do it right yeah exactly allright well, thank you thank
Justin Politti (21:03):
you so much.
Welcome to the Reverse Mullet Healthcare
Podcast by BP2 Health.
We're here at the ACLMConference in Orlando, Florida
2024.
Justin Politti (00:10):
Sunny Florida 20th anniversary.
Right.
Who are you?
I'm Dave Pavlik the Mullet.
Ellen Brown (00:16):
Man.
Justin Politti (00:16):
I'm the Mullet man today.
Ellen Brown (00:17):
And I am Ellen Brown.
Justin Politti (00:18):
And I'm Justin Politti.
Ellen Brown (00:20):
And we're here with one of my favorite ACLM people,
dr Patel, and, yeah, americanCollege of Lifestyle Medicine
Annual Conference and superexcited to be here.
I think what's so exciting iswe have our little unicorn on
the table of always searchingfor the unicorns of healthcare,
and what's so amazing to meabout ACLM is like the whole
(00:40):
function of ACLM is a unicornright.
So not only is it likethousands of unicorns walking
around, it's also an entire youknow board certification.
That really is unicorn statusin terms of healthcare.
Justin Politti (00:54):
So I can't tell you how many people that I've
talked to that you know that.
Well, what are you doing?
What's the podcast about?
And I explained it to them andtell them what we do is BP2.
And they go yeah, I'm almostboard certified, I'm sitting for
the exam next month.
I can't wait.
It's like like I literally yeah, four or five different people
that I talked to just kind ofrandomly- yeah, there's a lot of
people sitting right now.
Ellen Brown (01:13):
There's a lot of buzz.
Justin Politti (01:13):
Yeah, I know they're supposed to be studying,
but instead they're here, yeah.
Dave Pavlik (01:25):
So it's actually part of attending this
conference.
Very nice, oh, I thought yousaid getting in front of BP2
Health was part of it.
Justin Politti (01:29):
It should be.
Dave Pavlik (01:30):
It's a new part of the curriculum Hold on a second.
Ellen Brown (01:37):
We just talked to the no nevermind Carry on yeah,
you're not going to remember wetalked to get that on the
curriculum.
Justin Politti (01:43):
Oh, brenda, brenda, yes, brenda, we need to
get.
Let Brenda know that we're anew part of a couple of CMEs,
for maybe one.
Ellen Brown (01:51):
Yeah, just one half .
Justin Politti (01:52):
Yeah, you just have to.
Ellen Brown (01:54):
Yeah, anyways, without further ado Dr.
Patel, so glad you're here.
Justin Politti (01:58):
Yes.
Ellen Brown (02:06):
You're a very find.
Padmaja Patel (02:06):
Oh no, maybe I can find you, but I can't
extract you to get you into thebooth.
So yeah, so tell us aboutyourself.
Oh, happy to be here, alan.
You.
You've been someone that I'vebeen following too, so, uh, on a
social media, and that's how Ifound you, but uh, she's not on
social media come on I haven'tseen one lot of her posts are
actually getting viral, as Ihear, she has a huge fan
following there, so I'm one ofthose.
(02:27):
But no, I think more about howI find that what you actually
write on your post on socialmedia and LinkedIn is something
I resonate so much with, andit's like, wow, someone is
exactly writing what I'mthinking, right, and so you
articulate so well and with somuch humor and fun, and so, yeah
(02:50):
, I think we're kindred spiritshere.
Ellen Brown (02:52):
We are kindred spirits, yeah, and you're the
same, and Ellen was ACLM beforeshe knew what ACLM was.
Justin Politti (02:58):
Yes, I was, I've been living an ACL dream.
Ellen Brown (03:00):
It's just like my husband and I took a year and a
half RV trip before there wasvan life and before there was
blogging, like it's right.
It's like Brenda with hercommitment to ACLM before most
people.
Justin Politti (03:12):
She's Forrest Gump, oh I am.
Dave Pavlik (03:14):
I'm like Forrest.
Ellen Brown (03:14):
Gump.
Justin Politti (03:15):
Trendsetter yeah .
Ellen Brown (03:16):
Didn't even know it , so yeah.
So tell us about what you'reworking on, what you're
passionate about yeah.
Padmaja Patel (03:22):
So so anyway, but I'm an internal medicine
trained clinician and thencertified in lifestyle medicine,
obviously.
So I've had fortunate, you know, as a primary care clinician.
We all go through the same, uh,sort of journey of, you know,
getting tired of doing this moreof the same, and fortunately I
found lifestyle medicine thatliterally changed my personal
(03:46):
and professional trajectory.
Um, I would have retired fromhealthcare if I had not found
lifestyle medicine and I don'tthink I'm the only one saying
that.
there are so many clinicianshere either are they are burned
out, you know from doing whatthey do, or they're looking for
another revenue to uh find howcan they deliver meaningful care
and find purpose and meaningalong the way, right?
(04:08):
So this is what LifestyleMedicine delivers, and I'm so
delighted that I had theopportunity of delivering and
establishing a program at alocal health system in Midland
Texas where I developed many ofthis intensive therapeutic
lifestyle program, and whatreally changed me the most was
(04:29):
more around the transformationsthat I actually witnessed.
You know I saw people like someof my patients are related.
You know they came back as afollow-up and I didn't even
recognize them.
Ellen Brown (04:40):
It was like that kind of a transformation?
After what period of time?
In three months?
Justin Politti (04:46):
Three months Wow , yeah, it was like that kind of
a transformation.
Padmaja Patel (04:48):
After what period of time?
In three months, three months,wow, yeah, three months.
Patients completely getting offtheir medications If they were
on insulin, reversing theirdiabetes, reversing their
cholesterol hyperlipidemia andthings like.
So this is not what we had seenor at least I had seen in my
traditional primary carepractice, right?
So that's brought me all thepassion and excitement, what we
had seen or at least I had seenin my traditional family care
practice, right?
So that's that's brought me allthe passion and excitement.
(05:09):
Wow, can we do this?
How can I do this?
And more of it, right, like Ididn't want to just practice my
own clinic, I wanted to actuallyhave that impact, bigger impact
.
So I aligned with the localhealth system and then now I'm
so excited to be part of thisbigger community here at ACLM
and in my leadership role I wantto replicate more of the
(05:33):
success that I've actually seenin my private practice and with
health systems to really see howwe can do this on a bigger
scale.
So that's my big agenda even asI step into my leadership role
within ACLM is to reallydemonstrate the value
proposition of lifestylemedicine across different
(05:56):
payment models.
Ellen Brown (05:57):
Do I hug you?
Do I hug you?
I think this is the first timeI've ever hugged a guest.
Justin Politti (06:01):
She does.
She usually gives a fist pump.
Ellen Brown (06:04):
But that was just hug-worthy right there.
Justin Politti (06:06):
this is why we are meant to be friends in in
your example I'm sure there aremany of of a patient that you
know came back three monthslater and you didn't recognize
them.
What are the?
What are the um interventionsyou're deploying, that that are
lifestyle medicine related?
All of them, some of them?
What?
What works the best?
Padmaja Patel (06:23):
You know, so early in my private practice I
didn't have the resources toreally bring in team-based care.
You know, in your privatepractice you don't have the
resources, you can't afford itin fee-for-service payment
models.
So a lot of that relied on justeducating them, providing them
some pamphlets, educationalmaterial or websites, so you
(06:45):
know.
So I had actually aprescription that we would give
them.
So you know, watch this video,look at this website.
Here are the recipes.
You know all these stuff thatwe gave and they go home.
And you know those who werereally motivated would continue,
but there was no support systemearly on.
Clearly, then I realized thatthere needs to be a very
structured program and we neededto integrate health coaching,
(07:09):
bringing into behavioral aspectand also bringing nutritional
counseling with a registereddietitian, and so that's why I
joined a health system to bringaround this entire
interdisciplinary team-basedcare as part of our approach.
But I have seen so, for example, in my community I co-founded
(07:30):
another non-profit called OurHealthy City.
So our biggest mission there isto more around educating
community around the benefits ofwhole food plant, predominant
dietary pattern and lifestylemedicine.
We would conduct and we stilldo annual food as medicine event
and we would have about 500members from our community just
(07:54):
come listen to one day seminar.
We would invite all these bigprofessionals and speakers from
around the world sometimes, butthe key is that they just
learned, they heard about it,they watched some presentations
and then they go home and we'veseen people losing 70 pounds, 80
pounds on their own right,without any further.
Justin Politti (08:18):
They just got motivated from a one-day event.
Padmaja Patel (08:20):
Yeah, that's what I'm saying.
So there are many ways to thinkabout this.
It's not everyone needs to havea structured medical program.
This community element isequally important for support
and education, and so all ofthese pieces have to be plugged
in together, even for doctors,many of our intensive programs,
(08:40):
yes, we can demonstrate goodoutcomes, but if we don't have
an ongoing support in thecommunity, it's very hard to
sustain.
Justin Politti (08:48):
that Keeps coming up.
Padmaja Patel (08:50):
Community.
Ellen Brown (08:50):
Community yeah.
Padmaja Patel (08:52):
That's the key here is to talk about lifestyle.
Analysis is not just whathappens in an office setting.
Ellen Brown (08:58):
Yeah.
Padmaja Patel (08:59):
It's much more than that, and you can see it
here, right.
Dave Pavlik (09:03):
Very much so.
Padmaja Patel (09:04):
The models that we see it's across, and so my
passion and excitement comesfrom it's not just I mean
predominantly primary care.
We want to integrate lifestylemedicine across the board, but
we also have it in specialtycare.
Ellen Brown (09:17):
Which is amazing.
Padmaja Patel (09:18):
We have it in different settings Yep Right,
inpatient, outpatient, you andme, yep and across different
payment models, so it's likeubiquitous, it can be anywhere,
yep Right, and so that's thebeauty of this foundational care
that we talk about.
Dave Pavlik (09:34):
So what are some of your thoughts on?
You mentioned scale a littleearlier.
What are some of your thoughtson how you can scale this across
the country?
Padmaja Patel (09:43):
Yeah, so when COVID-19 happened, during the
pandemic, I had a program whichwas, you know, in-person,
intensive group program, andobviously we couldn't gather
right, so I had to put thatprogram on a virtual platform
and I had no idea how that wouldwork.
Dave Pavlik (09:58):
I was actually very nervous.
I was like how?
Padmaja Patel (10:00):
are we gonna?
How do we, how do you motivate?
And you know all of that.
And then, first group I saw Imean there was this person, one
of my patients, who lost like 40pounds in 10 weeks.
His hemoglobin A1C dropped from7.9 to like 6.2.
Wow, it's just a dramaticchange.
(10:21):
And he convinced me thatvirtual model can be equally
effective.
And then I continued doingin-person groups versus virtual
groups and eventually publishedthe study as well that the
outcomes clinical as well asbiometrics, all of them exactly
same.
There's no difference.
So that gives me hope thatlifestyle medicine is really,
(10:44):
you know, it doesn't have to belimited within.
Ellen Brown (10:46):
Yeah, there's a huge confidence.
Padmaja Patel (10:49):
Exactly, there's a clear model that can be
delivered across virtualplatform, and that's what we
need to do.
Ellen Brown (10:56):
Yeah, totally agree .
Yeah, I mean, one of the thingsyou know I really believe is we
have to, you have to get awayfrom like, if you think about
sick care is sick care and youthink about health care is
health care.
I think when we talk abouthealth care, this obsession or
attachment to bricks and mortar,it just it becomes, it's
unsustainable, it's too capitalintensive, it doesn't have the
(11:19):
kind of economic model thatmakes sense.
And especially when we talkabout lifestyle health, I mean
lifestyle disease and lifestylehealth.
You know, the thing that hasreally struck us is, in every
conversation, I think, excepttwo, the whole group visit model
comes up.
Right, because it's this againit goes back to Justin's
question about scale.
So we have to solve for aclinician shortage and for just
(11:44):
access and also foradministrative burden, all of
those things.
And then you add the group model.
Not only does it solve thatwhole component, it also adds
that pillar of community, whichis something we spoke about.
Spoke to some clinicians todaythat are focused on equity and
(12:05):
like rural, and you know theysaid it's the isolation that
exists in rural communitiesespecially.
Right, that group model.
So it's just, it's amazing andagain, it makes all the sense.
That's what blows my mind aboutlifestyle medicine is it's so
simple.
Padmaja Patel (12:23):
It is, and I tell you that's part of the problem.
Also, sometimes I think earlyon.
What I felt when I learnedabout ACLM and the messaging
around is that it's too simple.
It is so simple that peopledon't take it seriously.
Justin Politti (12:38):
How could this be real?
Padmaja Patel (12:39):
Yeah, how can it be real and so?
Justin Politti (12:41):
exercise and eat better Sleep.
Ellen Brown (12:45):
Stay away from all the fat foods.
Don't drink all the time andsmoke.
Yeah, what yeah?
Padmaja Patel (12:51):
So I think we are intentional now in terms of how
we communicate lifestylemedicine and we're talking more
about the value proposition,right, what exactly it brings,
which is the quintuple aim ofhealthcare, and so we're making
sure that people get the valueand what it is, not just how we
deliver lifestyle medicine,which is the six pillars, which
(13:12):
is how we deliver, but whatexactly is the outcome.
Ellen Brown (13:15):
Agreed.
Justin Politti (13:16):
That's what we need to talk about.
Ellen Brown (13:18):
You know me, I am convinced that lifestyle
medicine is going to be, itcould be, the solution, one of
the core solutions and bridgesto taking that 2 trillion out of
the system of lifestyle disease, cardiometabolic syndrome,
because it can take.
We already have a wholeworkforce of clinicians that are
(13:38):
they're already clinicallyboard certified and so to be
able to train them additionally,right to complement what
they're already doing, to say,hey, here's a.
I think the piece you pointedout that we have to do is we
have to move the needle on theeconomic model, we have to
realign the incentives, we haveto, and then that money can be
redistributed.
And that's our champion is.
(14:00):
You know, this is value-basedcare.
Dave Pavlik (14:08):
That's what we're starting to implement is.
And payers are coming around,they are like each one's always
in its own spot, right, but thereality is you pay for the
intervention and then you payfor the progress that you're
making right.
So it is a it's an to Ellen'spoint, it's an incentive-based
component that's recognizing hey, you know, know what you're
getting paid for the reductionsin metabolic, yeah, improvement
in metabolic, uh, function alongthe spectrum.
(14:28):
So to me, that's a fairnesspiece, because right now they
share the same yeah, the dangeris all right.
You put this in and then itaccrues directly to the
insurance company without any,exactly without any credit going
to the people who are doing itright.
Padmaja Patel (14:41):
You're so well said.
All of us have deliveredlifestyle medicine very
successfully and it didn'tmatter because it was in
fee-for-service rule Nobodycares about the quality,
cost-saving outcomes, nobodycares, it's just the episodic
billing and collection is allthat we care about the
productivity yeah it's a number.
(15:02):
But, as you said, payers arecoming recognizing the value.
I don't know if you attended,but we had a panel discussion
earlier today and for the firsttime in the history of ACLM, we
had two major payers on thestage.
Ellen Brown (15:21):
We went in and watched.
That says a lot.
The change is happening.
Justin Politti (15:25):
I have two of them tomorrow.
Ellen Brown (15:27):
Okay, great.
Justin Politti (15:28):
Thank you.
Padmaja Patel (15:29):
So we had Susanna Bernheim, which is the acting
CMO of CMMI, which is the CMSInnovation Center, and we had
Kate Goodrich, CMO of Humana,and we've been working with
these two big pairs for sometime as part of our Innovators
Council and otherwise, so it's agroundswell right.
(15:51):
It's a real exciting time forthe field to see so much
interest from pairs and theyrecognize this.
And I think all these thingsthat we hear about whether it's
it's employers having to pay somuch for their benefit plan next
year with 7% to 8% increasedwar, whether it is this AMA
(16:12):
plans going- through theheadwinds, the 95% of C8.
Ellen Brown (16:16):
Whoops.
Padmaja Patel (16:17):
I think these are all wonderful opportunities for
lifestyle medicine, oh, totally, totally.
This is exactly where we needto insert lifestyle medicine as
a solution, because it has thepotential to no, it is.
Ellen Brown (16:31):
It is an ultimate solution.
Justin Politti (16:32):
So think of that , get healthier so you, you were
in private practice and thenyou went to work for a system,
system in texas yeah and like sowas the leadership always kind
of behind this lifestylemedicine.
In terms of the finances, youknow we need dieticians, we need
this staff, we need that staff.
It's going to cost you but inthe long run it's going to be.
Padmaja Patel (16:53):
No, you know, what was interesting is that
it's a safety net hospital in asmall community.
Ellen Brown (17:00):
Okay.
Padmaja Patel (17:01):
And we had redefined our vision, mission
and values to make Midland thehealthiest community in Texas.
So the way we approachedlifestyle medicine was more of a
broader solution, rightStrategy like how are we going
to get there?
So, initially, where I startedwas what are the pain points for
(17:23):
my health system?
Right, look at that pain pointsfor my health system, right?
Look that.
And well, as a self-insuredentity, they were paying almost
what?
$3 million more than thebudgeted amount every year.
So we said, okay, let's dosomething for the employee
health.
And so in about a year ofintervention which is the same
(17:45):
intervention we keep talkingabout intensive therapeutic
lifestyle change program, whichis a group medical visit, and
had about 150 employees that gothrough that intervention, we
demonstrated $3 million cost ofAIDS.
Right, so that?
Dave Pavlik (18:01):
opened up the world .
Padmaja Patel (18:04):
Like okay, we proved the model ROI because you
have to do the business andotherwise you know it's hard to
change that needle here andsupport.
I think.
So one was this alignment withtheir overall goal.
Second, we demonstrated the ROI.
And the third was that wewanted to create a program that
(18:25):
would actually lifestylemedicine program, that would
create a robust payments model,so with a reimbursement
structure, which was thisintensive cardiac rehab that we
brought.
So we brought the Ornishprogram initially and then later
changed to Pritikin intensivecardiac rehab.
But it brought revenue to mylifestyle medicine center, which
(18:46):
allowed me to develop a newprograms, hire more staff, you
know.
So I went about not opening acenter first, but I went about
looking at okay, what are thepain points, let's solve that,
get the confidence of theexecutives, and then expand and
create revenue first before youtalk about opening a center.
(19:09):
So all of these kind of cometogether.
Justin Politti (19:14):
That's great.
I think it's great that the youknow the mission is to have the
healthiest community in Texasand cost isn't going to be a
barrier.
Let's figure it out.
Yes, that's impressive, yeah.
Ellen Brown (19:26):
Yeah, it's amazing, so we could talk for like a
long time and I know that you'reneeded to like continue to
circulate.
Yes, there will be many morehugs.
Yes because we are going to dosome big stuff.
We are here to try to help.
Padmaja Patel (19:38):
you know we're completely committed to this and
thank you, thank you, no, Ithink, thank you for here being
here this year.
This brings a sort of a newexciting excitement among our
members.
Justin Politti (19:58):
You excitement among our members.
You know I love them passingthrough.
Yeah, they're like there's likebright lights we've got.
What is this we've got?
I've got them in my headcategorized as podcast curious
and podcast serious.
Oh so the curious, the curiousones, kind of go by, they look
in, they're like I'm a littlenot sure I want to get behind
that camera over there.
And then the serious ones arelike where's your sign up?
Ellen Brown (20:11):
but my favorite are the ones that are like just
sort of come in, oh and it'slike hi, hi, like, all right the
microphone did you?
Well, let's just sit down andgo so here's a coffee and a mic
tomorrow's.
Tomorrow we've got a jam packed, I think we have to start like
putting blocks so we canactually go get some water.
Justin Politti (20:29):
You know, but and I do think we are I think
we're gonna have at least one ofthose payers you referenced,
right?
Yes, I think so.
Maybe two, maybe two.
Yeah, that's the rumor on thestreet, but yeah, so super
excited you took the time yes,thank you so much thank you.
Ellen Brown (20:44):
You will certainly be part of a full episode.
You know great work you'redoing.
Justin Politti (20:47):
Thank you we will, she will, for sure yeah,
you make sure she does right?
Well, make sure she does.
Ellen Brown (20:55):
Don't worry, that's an easy task just don't make me
do it right yeah exactly allright well, thank you thank
Justin Politti (21:03):
you so much.
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