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12COMMUNIQUFALL2014LifestylemedicineprogramshelpfuturephysiciansunderstandthechallengesofchangebyLauraProbynChangeisdifcult.Anyonewhosevertriedtoloseafewpoundsquitsmokingorstartexercisingcanattesttothat.ButhowcanaphysicianwhosneverbattledaweightproblemadviseapatientonthestepstotaketomovethatdialonthescaleThisisatopicthatKariHortosassociatedeanfortheMSUCOMMacombUniversityCentersitebelievesisanimportantaspectofprimarycarephysicianeducation.ShetooktheopportunitytouseaGlaxoSmithKlinegranttodevelopahealthpromotionpracticumtohelpphysiciansintrainingbetterlearnaboutnutritionandhealthylifestylessothattheycanprovidebetteradviceandbetterunderstandthestrugglestheirpatientsface.AfterofferingandexaminingtwoyearsofdatafromthepracticumshereceivedsupportfromMSUCOMtoofferapilotpre-clerkshiplifestylemedicinefellowshipprogramforfourmembersoftheClassof2017atMacomb.OneoftheconstantcomplaintsfromphysiciansisWedontgetenoughnutritioninformation.Theydogetitbuttheydontknowwhattodowithitshesaid.Thephysiciancompetenciesrequiredtohelppeoplemakelifestylechangesarereallycoachingskillswhichareverydifferentfromdeliveringexpertadvice.HortosbuiltthepracticumandfellowshipincollaborationwithWeightWatchersofMichigan.Thepracticumtookplaceearlierthisyearwith19studentsattheMacombsiteandthreeassistantprofessorsofosteopathicmanipulativemedicineLoriDillardAdamFeinsteinandTeriHammer.ShemeasuredtheparticipantssubjectiveawarenesslevelsbeforeandafterthepracticumandpresentedtheresultsattheAACOMannualconferenceinApril.Herndingshaveshownthatparticipatingstudentschangedtheirfeelingsaboutthevalueofnutritioncounselingaftertakingpartintheeight-weekpracticumthattheygainednutritionknowledgeanddiet-planningskillsandimprovedtheirself-efcacyaroundbothdietandexercise.HortosaninternistwhocompletedaHarvard-afliatedclinicalfellowshipatBrighamandWomensHospitalinnutritionisconnectingthepracticumandfellowshiptoProchaskasresearchonchange.Thestagesrangefrompre-contemplationwhenapersondoesnotfeeltheneedtochangetocontemplationpreparationactionandnallymaintenance.Insteadoflookingatthedatafromtheanglethatthevastmajorityofpeoplewhoneedtoinstituteahealth-relatedchangeintheirliveswillnotdoitHortoswantsthestudentstolookattheopportunitytoconnectwiththosewhoarepreparedtotakeactionandadoptacoachingratherthanexpertmindset.ThestudentsarenottypicalWeightWatchersclientsassomestarttheprogramatahealthybodyweight.Hortosgotspecialdispensationforthemtotakepartinthesessionfocusingonimprovingtheirhealthbehaviorsasaresultoftheirparticipation.Shehopesallparticipantswillbeabletoapplywhattheylearnedintheirownlivesaswellasinpractice.ThepilotfellowshipisnowunderwaywithsupportfromSarahMcCaskeyaregistereddieticianandinstructoratMacomb.ThefourparticipatingstudentsareJaredDavisBettyJohnsonSalomiRamiandJustinStewart.Theyareattendinga12-weekWeightWatchersprogramtolearnaboutnutrition.InSeptembertheyalsotookpartinfunctionalmovementsessionsandlearnedaboutcoachingfromDaynaElfontanMSUCOMalumnaprimarypracticedoctorandahealthandwellnesscoach.Functionalmovementwasdevelopedformembersofthearmedforcesandhigher-levelathletestohelpthemlearnhowtomovetopreventinjury.Itsbeenadaptedforusewithanyonewhowantstoperformdailyactivitiesandexerciseswithoutgettinghurt.Hortoshopesthestudentscanincorporateaspectsoffunctionalmovementintotheirosteopathicmanipulativemedicinepracticelater.In2015thefellowswilltakepartinthethirdpracticumleadingaWeightWatcherssessionandcompletingacapstoneproject.Shealsowantsthemtounderstandhowasphysicianstheycanserveascoachestotheirpatients.CoachingrequiresusingacompletelydifferentpartofyourbrainHortossays.Youasthephysicianarenotthebossyourethepartner.Youareencouragingandfosteringpossibilities.Thepatientshavetodothehardworktogethealthier.Atalittlemorethanamonthintothehealthpromotionpre-clerkshipfellowshipparticipantBettyJohnsonwasalreadysurprisedbywhatshewaslearningfromtheWeightWatchersmembers.Iamimpressedatthegeneralairofpositivitythatcomesfromtheparticipantsshesaid.Iwouldnothaveexpectedsomuchenthusiasmforhealthiereating.Thereisalsoatremendoussenseofcommunityandsupportamongthemembers.Thegreatestlearningopportunityformehoweverhascomefromobservingandinteractingwithothersintheprogram.Ramiseesthevaluethatthefellowshipwillbringtoherlaterinhercareer.Thisfellowshipisgivingmeskillsindietnutritionexerciseandstressmanagementshesaid.IbelievethatitwillgivemethetoolstorelateonapersonallevelwithmypatientsinthefuturemerelybecauseIpracticewhatIpreach.ThankstohisexperienceStewartknowsthathellbeanempatheticphysiciancoachwhocanrelatewhatothersaregoingthrough.IintendtousethisexperiencesoIcansaytomypatientssincerelyYesIknowchangecanbehardIvedoneitandsonowIcanhelpyou.BecauseHortosseesexpandedhealthpromotionprogramsasbeingverycompatiblewiththeosteopathicphilosophyofviewingeachpatientholisticallyshebelievestheresalogicaltforfutureactivitiesinthecollegewithanoptionforstudentsandresidentstogetcerticationinlifestylemedicinecompetencies.UltimatelyIdlikeMSUCOMtobealeaderthatdemonstratesinaconsistentmeaningfulwaythetenettondhealthisthedoctorsobjectiveshesaid.IdlikeustobeabletosayHereswherewereconsistentlydoingthis.KariHortoscenterworkswithlefttorightSarahMcCaskeyandstudentsBettyJohnsonSalomiRamiandJustinStewart.EDUCATION