{"id":5506,"date":"2022-12-12T07:44:00","date_gmt":"2022-12-12T07:44:00","guid":{"rendered":"https:\/\/lifestylemedicine.org\/?p=5506"},"modified":"2023-08-23T17:18:33","modified_gmt":"2023-08-23T17:18:33","slug":"eliminating-barriers","status":"publish","type":"post","link":"https:\/\/lifestylemedicine.org\/articles\/eliminating-barriers\/","title":{"rendered":"\u201cI can manage my health!\u201d"},"content":{"rendered":"

\u201cI can manage my health!\u201d<\/strong><\/h1>\n

How one health system is eliminating barriers to diabetes treatment using lifestyle medicine to educate health care providers and patients.<\/strong><\/p>\n

\n

\u201cWe want patients to improve their self-efficacy by reducing their social determinants of health (SDOH) barriers and having them work toward addressing diabetes through nutrition awareness and education.\u201d\u00a0<\/em>\u2013 Hugo Ortega, MD<\/p>\n<\/blockquote>\n<\/div><\/div>

<\/div>
\"Img<\/div><\/div>
<\/div>

Dr. Ortega (far left) joins Dr. Dexter Shurney (center) \u00a0and Janet Calhoun (right) at the LM2022 conference this past November.<\/p>\n

Serving on the American College of Lifestyle Medicine Board of Directors as Young Director is a full-circle achievement for Hugo Ortega, MD.<\/p>\n

Hugo Ortega, MD, an internist at\u00a0Northwell Health<\/a>, was recently elected to the ACLM Board of Directors as Young Director. Serving in this leadership role is a full-circle moment. While working on his own health and weight loss journey, Dr. Ortega tapped into the nutritional resources being offered to patients at Montefiore Medical Center, where he was a resident at the time. Dr. Robert Ostfeld, director of preventive cardiology, was a huge advocate of whole food plant-based nutrition and introduced many of his patients to the \u201cForks Over Knives<\/a>\u201d documentary.<\/p>\n

\u201cI was slowly transitioning, but I wanted to fully commit [to a whole food, plant-based diet],\u201d he said. At the recommendation of his nutritionist, he participated in\u00a0Plant Powered Metro New York<\/a>, a program for health care providers to do a two-week intensive meal-plan diet that is whole-food, plant-based. The results were promising.<\/p>\n

\u201cI was almost diabetic in terms of my A1C levels,\u201d Dr. Ortega said. \u201cThose numbers went down to 5.8%, in just two weeks. But more importantly, for me, in those two weeks, I lost eight pounds. It was then that I realized that lifestyle changes work. I wanted to teach this to my patients.\u201d<\/p>\n

The Eliminating Barriers Initiative<\/strong><\/p>\n

After being awarded $15,000 by an in-house Northwell Health grant, Dr. Ortega and his team sought to create a program that would improve patient self-efficacy and diabetes, which was impacting about 60% of Medical Specialties at Glen Oaks patients. \u201cWe had to fix that somehow,\u201d said Dr. Ortega before explaining the initiative\u2019s two-pronged approach. \u201cWe want them [patients] to improve their self-efficacy by reducing their social determinants of health (SDOH) barriers and having them work toward addressing diabetes through nutrition awareness and education.\u201d Any patient with an A1C level of 9% or above is automatically eligible to participate in the Eliminating Barriers Initiative. Forty-five patients are enrolled in the program, which was launched in July 2022.<\/p>\n

Northwell Health is on a \u201cmission to serve and care for the entire community regardless of the ability to pay.\u201d An\u00a0ACLM Health Systems Council<\/a>\u00a0partner, Northwell Health is the largest health system in New York providing health services to patients with Medicaid, Medicare, or no insurance at all.<\/p>\n

\u201cWe have a high patient population of Blacks, Hispanics, and Southeast Asians,\u201d said Dr. Ortega. These groups are historically medically underserved and typically have challenges finding physicians who look like them due to the lack of diversity in the medical workforce. However, Dr. Ortega, who is an underrepresented in medicine (UIM) physician, says that his ethnicity alone helps him positively reach patients. \u201cIt\u2019s extremely easy to form a relationship with the Spanish-speaking patients because I\u2019m able to immediately address the language barrier by speaking Spanish to them.\u201d<\/p>\n

Social Determinants of Health<\/strong><\/p>\n

In addition to tracking the patients\u2019 A1C levels, the program\u2019s team leads also assess the patients\u2019 social determinants of health and self-efficacy to ensure that the initiative\u2019s interventions are making a lasting impact. The social determinants of health model was adopted by Montefiore Medical Center in which each patient is screened to better understand barriers that may impede their ability to access health care, housing, nutritious food, and many other factors that are part of one\u2019s environment.<\/p>\n

\u201cAfter gathering all this information, we refer the patients to specialists and experts who can help them better navigate these issues by providing wrap-around services,\u201d said Dr. Ortega. \u201cIf the patient is housing insecure or struggling with getting access to medication, our social worker can assist for example.\u201d At the end of the program, all patients are reassessed with the hope that they can now answer \u201cno\u201d instead of \u201cyes\u201d in response to questions about SDOH barriers.<\/p>\n<\/div><\/div>

<\/div>
\"Heal<\/a><\/div>
<\/div>

Diabetes awareness and education<\/strong><\/p>\n

Addressing each patient\u2019s diabetes is more in-depth than a standard diagnosis. Instead, residents and attending physicians educate patients about evidence-based lifestyle medicine that, if prescribed intensively, could reverse their diagnosis. Dr. Ortega considers himself \u201cfrank\u201d and admits to some patients that medication may have to be the first course of treatment. However, he also reassures them that if they commit to the program and are able to operate in a \u201cmaintenance stage\u201d that coming off of medication is a realistic goal.<\/p>\n

\u201cWe haven\u2019t had any failures,\u201d he said. \u201cEveryone has improved to some degree. We have some patients who have come down on their insulin. I take that as a big win.\u201d<\/p>\n

While some patients are referred to on-site pharmacists to learn more about the medications they\u2019re prescribed, patients who identify as food insecure have access to \u201chealth bucks\u201d that they can use at the Queens County farmers\u2019 market, a Northwell Health partner that supports the clinic\u2019s patients with fresh produce. In addition, patients\u2019 Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) dollars and Supplemental Nutrition Assistance Program (SNAP) benefits count double at the farmers\u2019 market, meaning they can get 50% more fresh produce.<\/p>\n

Other lifestyle medicine pillars emerging as part of the Initiative<\/strong><\/p>\n

Nutrition is the most defined lifestyle medicine pillar informing the Eliminating Barriers Initiative. Dr. Ortega does hope to incorporate other pillars of lifestyle medicine as the program evolves. Currently, patients in the program have one-on-one visits with providers. However, Dr. Ortega is gearing up to co-host bi-weekly group sessions alongside the program\u2019s diabetes educator and nutritionist in which participants can forge social connections with class members to help them stay encouraged and on-track. Lifestyle medicine is largely successful when patients are able to master behavior change, which has been proven to occur when patients see physicians during shared medical appointments or group visits.<\/p>\n

\u201cI think the group visits are good for two reasons,\u201d said Dr. Ortega. \u201cOne, people are more trusting of people who they think are like them. Secondly, it gives them accountability.\u201d These two reasons align with lifestyle medicine\u2019s positive social connections pillar, a pillar Dr. Ortega strives to teach his residents along with sleep and stress management.<\/p>\n

Lifestyle Medicine Residency Curriculum at Northwell Health<\/strong><\/p>\n

Dr. Ortega has done a significant amount of front-end work to ensure that residents at Northwell Health can learn about lifestyle medicine and its benefits for preventing, treating, and reversing chronic disease. When he first learned about\u00a0ACLM\u2019s Lifestyle Medicine Residency Curriculum (LMRC)<\/a>, he was a third-year resident at Montefiore Medical Center. He wasted no time promoting it to his co-resident and upcoming chief resident who pitched the idea to the program director, but by the time the LMRC was implemented, Dr. Ortega had already finished his primary care and social internal medicine residency. He didn\u2019t give up and worked diligently to bring the LMRC to Northwell Health, which has been delivering the comprehensive, applicable, and flexible curriculum to residents since July 2022.<\/p>\n

Dr. Ortega recently took\u00a0ACLM\u2019s \u201cRemission of T2 Diabetes & Reversal of Insulin Resistance\u201d course<\/a>, which he says aligned nicely with the Eliminating Barriers Initiative. Of the 11 patients that Dr. Ortega referred to the program, five are doing exceptionally well. One patient was weaned completely off of insulin and is now only taking metformin. His A1C, which started at 12.8%, is now at a 6%, which is considered pre-diabetic. In the next two months, Dr. Ortega plans to take him off of metformin if his repeat A1C levels show a controlled range.<\/p>\n

The Eliminating Barriers Initiative is another full-circle career moment for Dr. Ortega, who has a few patients who are trending toward complete remission. \u201cI\u2019ve never had someone go into remission so that would be nice.\u201d<\/p>\n<\/div><\/div><\/div><\/div><\/div><\/div><\/section>

Register for the webinar<\/span><\/a><\/div>
<\/div>
\"Essentials<\/div><\/div><\/div><\/div><\/div><\/div><\/section>\n","protected":false},"excerpt":{"rendered":"

Addressing each patient\u2019s diabetes is more in-depth than a standard diagnosis. Instead, residents and attending physicians educate patients about evidence-based lifestyle medicine that, if prescribed intensively, could reverse their diagnosis. Continue Reading \u201cI can manage my health!\u201d<\/span><\/a><\/p>\n","protected":false},"author":6,"featured_media":5509,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[51,12,57],"tags":[],"acf":[],"yoast_head":"\n\u201cI can manage my health!\u201d - American College of Lifestyle Medicine<\/title>\n<meta name=\"description\" content=\"How one health system is eliminating barriers to diabetes treatment using lifestyle medicine to educate health care providers and patients.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/lifestylemedicine.org\/articles\/eliminating-barriers\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"\u201cI can manage my health!\u201d - American College of Lifestyle Medicine\" \/>\n<meta property=\"og:description\" content=\"How one health system is eliminating barriers to diabetes treatment using lifestyle medicine to educate health care providers and patients.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/lifestylemedicine.org\/articles\/eliminating-barriers\/\" \/>\n<meta property=\"og:site_name\" content=\"American College of Lifestyle Medicine\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/lifestylemed\/\" \/>\n<meta property=\"article:published_time\" content=\"2022-12-12T07:44:00+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2023-08-23T17:18:33+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/lifestylemedicine.org\/wp-content\/uploads\/2022\/12\/IMG_3409-scaled.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"2880\" \/>\n\t<meta property=\"og:image:height\" content=\"1920\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"Leslie Casey\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:creator\" content=\"@ACLifeMed\" \/>\n<meta name=\"twitter:site\" content=\"@ACLifeMed\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Leslie Casey\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"6 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/lifestylemedicine.org\/articles\/eliminating-barriers\/\",\"url\":\"https:\/\/lifestylemedicine.org\/articles\/eliminating-barriers\/\",\"name\":\"\u201cI can manage my health!\u201d - American College of Lifestyle Medicine\",\"isPartOf\":{\"@id\":\"https:\/\/lifestylemedicine.org\/#website\"},\"datePublished\":\"2022-12-12T07:44:00+00:00\",\"dateModified\":\"2023-08-23T17:18:33+00:00\",\"author\":{\"@id\":\"https:\/\/lifestylemedicine.org\/#\/schema\/person\/7207dbcbfd39bf48d8906a16f59eff09\"},\"description\":\"How one health system is eliminating barriers to diabetes treatment using lifestyle medicine to educate health care providers and patients.\",\"breadcrumb\":{\"@id\":\"https:\/\/lifestylemedicine.org\/articles\/eliminating-barriers\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/lifestylemedicine.org\/articles\/eliminating-barriers\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/lifestylemedicine.org\/articles\/eliminating-barriers\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/lifestylemedicine.org\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"\u201cI can manage my health!\u201d\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/lifestylemedicine.org\/#website\",\"url\":\"https:\/\/lifestylemedicine.org\/\",\"name\":\"American College of Lifestyle Medicine\",\"description\":\"Redesigning Healthcare, Better\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/lifestylemedicine.org\/?s={search_term_string}\"},\"query-input\":\"required name=search_term_string\"}],\"inLanguage\":\"en-US\"},{\"@type\":\"Person\",\"@id\":\"https:\/\/lifestylemedicine.org\/#\/schema\/person\/7207dbcbfd39bf48d8906a16f59eff09\",\"name\":\"Leslie Casey\",\"url\":\"https:\/\/lifestylemedicine.org\/articles\/author\/lesliecasey\/\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"\u201cI can manage my health!\u201d - American College of Lifestyle Medicine","description":"How one health system is eliminating barriers to diabetes treatment using lifestyle medicine to educate health care providers and patients.","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/lifestylemedicine.org\/articles\/eliminating-barriers\/","og_locale":"en_US","og_type":"article","og_title":"\u201cI can manage my health!\u201d - American College of Lifestyle Medicine","og_description":"How one health system is eliminating barriers to diabetes treatment using lifestyle medicine to educate health care providers and patients.","og_url":"https:\/\/lifestylemedicine.org\/articles\/eliminating-barriers\/","og_site_name":"American College of Lifestyle Medicine","article_publisher":"https:\/\/www.facebook.com\/lifestylemed\/","article_published_time":"2022-12-12T07:44:00+00:00","article_modified_time":"2023-08-23T17:18:33+00:00","og_image":[{"width":2880,"height":1920,"url":"https:\/\/lifestylemedicine.org\/wp-content\/uploads\/2022\/12\/IMG_3409-scaled.jpg","type":"image\/jpeg"}],"author":"Leslie Casey","twitter_card":"summary_large_image","twitter_creator":"@ACLifeMed","twitter_site":"@ACLifeMed","twitter_misc":{"Written by":"Leslie Casey","Est. reading time":"6 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/lifestylemedicine.org\/articles\/eliminating-barriers\/","url":"https:\/\/lifestylemedicine.org\/articles\/eliminating-barriers\/","name":"\u201cI can manage my health!\u201d - American College of Lifestyle Medicine","isPartOf":{"@id":"https:\/\/lifestylemedicine.org\/#website"},"datePublished":"2022-12-12T07:44:00+00:00","dateModified":"2023-08-23T17:18:33+00:00","author":{"@id":"https:\/\/lifestylemedicine.org\/#\/schema\/person\/7207dbcbfd39bf48d8906a16f59eff09"},"description":"How one health system is eliminating barriers to diabetes treatment using lifestyle medicine to educate health care providers and patients.","breadcrumb":{"@id":"https:\/\/lifestylemedicine.org\/articles\/eliminating-barriers\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/lifestylemedicine.org\/articles\/eliminating-barriers\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/lifestylemedicine.org\/articles\/eliminating-barriers\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/lifestylemedicine.org\/"},{"@type":"ListItem","position":2,"name":"\u201cI can manage my health!\u201d"}]},{"@type":"WebSite","@id":"https:\/\/lifestylemedicine.org\/#website","url":"https:\/\/lifestylemedicine.org\/","name":"American College of Lifestyle Medicine","description":"Redesigning Healthcare, Better","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/lifestylemedicine.org\/?s={search_term_string}"},"query-input":"required name=search_term_string"}],"inLanguage":"en-US"},{"@type":"Person","@id":"https:\/\/lifestylemedicine.org\/#\/schema\/person\/7207dbcbfd39bf48d8906a16f59eff09","name":"Leslie Casey","url":"https:\/\/lifestylemedicine.org\/articles\/author\/lesliecasey\/"}]}},"_links":{"self":[{"href":"https:\/\/lifestylemedicine.org\/wp-json\/wp\/v2\/posts\/5506"}],"collection":[{"href":"https:\/\/lifestylemedicine.org\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/lifestylemedicine.org\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/lifestylemedicine.org\/wp-json\/wp\/v2\/users\/6"}],"replies":[{"embeddable":true,"href":"https:\/\/lifestylemedicine.org\/wp-json\/wp\/v2\/comments?post=5506"}],"version-history":[{"count":38,"href":"https:\/\/lifestylemedicine.org\/wp-json\/wp\/v2\/posts\/5506\/revisions"}],"predecessor-version":[{"id":14551,"href":"https:\/\/lifestylemedicine.org\/wp-json\/wp\/v2\/posts\/5506\/revisions\/14551"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/lifestylemedicine.org\/wp-json\/wp\/v2\/media\/5509"}],"wp:attachment":[{"href":"https:\/\/lifestylemedicine.org\/wp-json\/wp\/v2\/media?parent=5506"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/lifestylemedicine.org\/wp-json\/wp\/v2\/categories?post=5506"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/lifestylemedicine.org\/wp-json\/wp\/v2\/tags?post=5506"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}