Integrative Lifestyle Medicine Is Within Your Scope of Practice, Learn How to Use It
By: Nataliya Zlotnikov, HBSc, MSc
By: Nataliya Zlotnikov, HBSc, MSc
Out of Challenge Emerges Inspiration
20 years ago, Ginger Garner was just starting out in physiotherapy.
She began working in one of the top 3 hardest-hit areas in the United States for the opioid epidemic.
This area was of course underserved and many did not have access to healthcare.
Witnessing far too many horrific cases that were very much lifestyle-driven and in which earlier interventions could often have made tremendous impacts. Ginger's fire for using an integrative and lifestyle approach was fueled.
Dr. Garner created this program based on a yoga viewpoint. She considers yoga to be an original lifestyle medicine.
In her online healthcare course, An Introduction to Integrative Lifestyle Medicine, Dr. Garner shares a small part (whatever she could fit into an hour) of the curriculum that emerged.
This curriculum is person-centred, integrative, biopsychosocial-driven and is very much evidence-based.
What You Will Learn the Introductory Course
Here is a quick snippet from the introductory course in which Ginger Garner discusses what this 1-hour intro course will cover.
In This Course You Will Learn:
- The vital signs of Integrative Lifestyle Medicine.
- The distinctive roles of Lifestyle, Integrative, & Functional Medicine in physiotherapy practice.
- The evidence-base that supports the use of best practice methods of Lifestyle Medicine & Integrative Medicine.
- What lifestyle factors impact physical therapy outcomes, chronic disease and manage or halt chronic pain conditions.
- The expanded scope of service for physiotherapists using Integrative Lifestyle Medicine.
We're Leaning Our Ladders up the Wrong Wall
How many times have you heard the terms biopsychosocial care? Person-centred care? Pain science?
Hundreds if not thousands I'd say.
But, are we actually applying these things in clinical practice?
Not only are not enough practitioners applying these things consistently in clinical practice, but we also do not receive the medical education that we need to prepare us to apply them straight out of school.
We tend to lean our ladders against the biomedical wall. We try to find the smoke and fan it, but more often than not do not really search for the cause of the fire, the root issue.
Why ILM, Why Now?
Over 86% of the expense in healthcare is spent on lifestyle-driven factors.
That means that we really need to be focusing on not necessarily the curative side, but the preventative side.
More Money, More Problems
The United States spends a LOT on healthcare annually, more than any other country in the world (16.9% of its GDP) (2018); Canada comes in 7th, spending 10.7% (Health expenditure as a percentage of gross domestic product in selected countries in 2018).
Yet, despite this spending, people are getting sicker.
Money Well Spent?
Below, we see some data from the United States from Ginger Garner's online healthcare course.
Here we see that the highest percentage of health spending is allocated to health services, however, at the same time, it contributes the least to mortality.
While lifestyle spending sees the opposite - the lowest spending accompanied by the highest contribution to mortality - that can't be right.
And while it may not be right, this is the current reality. Ladder - up - wrong - wall.
USA Health Expenditure vs. Contribution to Mortality
Figure from Ginger Garner's course.
What Is the Right Wall?
The right wall is the preventative wall. The one that addresses lifestyle issues.
Poor nutrition, physical activity and obesity are the top three most common risk factors for:
- Cardiovasculoar disease
- Cancer
- Stroke
- Type II diabetes
- Osteoporosis
- MSK issues
As physiotherapists, we can begin to address the top risk factors for these conditions with our patients in our focus on prevention.
Physiotherapists Can Be Multilingual
We can speak more than one language. We can speak the languages of integrative, lifestyle and functional medicine.
We can achieve this through these five pillars/components of lifestyle medicine.
Five Pillars of Lifestyle Medicine
Scope of Practice
But what do physiotherapists have to do with nutrition? With Stress management?
In case you didn't know, turns out, a whole lot.
It has been found that all 5 components/pillars are within the scope of practice of physiotherapists.
For example, in Ginger's field of pelvic health, her clients often may not realize that what they are putting on their skin or inside their body could be contributing to the pain that they are feeling.
It is within our scope of practice to educate these individuals.
We must also remember that once something falls outside our professional and/or personal scopes of practice, it's important to have a tight referral network.
To Treat Better, Improve Public Perception
Although most of us are quite qualified to help our patients with issues related to the 5 pillars of lifestyle medicine listed above, we may need to work on our feelings of personal confidence and competence.
We also need to improve the public’s perception of our ability to address these issues.
"I'm here for my shoulder, why are you talking about stress management?"
Such situations and others similar to this are when you would quickly whip out your handy elevator pitch and explain to someone why these components are so important.
Knowledge and education are the keys!
Click Here for Some Tools You Can
Start Using With Your Patients Today
ILM Certification
If you have already taken the introductory course discussed today or feel that the ILM certification may be the right fit for you, here is a little more information about the certification:
The ILM certification is divided into 5 modules (courses) (24 hours online), you can take them all, or just take the ones that appeal to and interest you.
- Module 1: Integrative Lifestyle Medicine: Impacting Chronic Disease & Pain
- Module 2: Creating “3D” Health from the Oral Cavity to the Pelvic Floor through Trauma-Informed Psychology
- Module 3: The Gut-Brain-Body Axis - Achieving Better Neuromuscular Outcomes through Nutrition
- Module 4: Sound & Sleep in Rehabilitation & Health Promotion - Fostering Whole Health
- Elective 1 of ILM Certificate: Physical Activity Prescription
- Elective 2 of ILM Certificate: Environmental Influences on Rehabilitation Outcomes: Tobacco Cessation & Other Toxic Exposure
More ILM Reading?
If you would like to read some more about integrative and lifestyle medicine, we invite you to take a look at our blog, Why Your Patients Need Yoga Therapy! The Top 10 Yoga and Pain Science Resources for Healthcare Practitioners and Yoga Therapists.
Yoga is an original lifestyle medicine!
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Date written: 31 May 2021
Last update: 1 June 2021
PT, DPT, ATC, LAT
Dr. Ginger Garner PT, DPT, ATC/L is a clinician, author, educator, and longtime advocate for improving access to physical therapy services, especially pelvic health.
She is the founder and CEO of Living Well Institute, which has been training and certifying healthcare providers in Integrative Medical Therapeutic Yoga & Lifestyle Medicine since 2000. She also owns Garner Pelvic Health in Greensboro NC, which offers digital and in-person care.
Ginger is the author of multiple books and book chapters, published in several languages. She has presented at over 20 conferences worldwide and has reached an audience across 6 continents, teaching on a range of topics impacting the pelvic girdle, respiratory diaphragm, and the voice (which she calls the 3D or Three Diaphragm approach).
Ginger is an active member of APTA, serving as the Legislative Chair for APTA North Carolina, a Congressional Key Contact for APTA Private Practice, and in the Academy of Pelvic Health on the Prenatal and 4th Trimester Task Force. Ginger lives in Greensboro, NC and is a mom of four – three sons and the family rescue Lab, Scout Finch. Visit Ginger at the links above, on Instagram and YouTube.