The American Medical Society for Sports Medicine (AMSSM) is strongly committed to embedding Exercise is Medicine in the health of Americans. A member of the AMSSM’s leadership group is Associate Professor Irfan Asif, the Director of the Sports Medicine Fellowship within the Department of Family Medicine at the University of South Carolina Greenville. Our chat focuses on the practical aspects of Lifestyle Medicine – which is more than exercise medicine alone. You’ll hear about: (i) the patient’s journey through a 6-week clinical service, (ii) exercise being embedded in all 4 years of the medical curriculum, (iii) how medical students are engaging with high school students in very practical ways and with some surprising outcomes. We discuss the challenges of rolling out a lifestyle medicine programme in rural areas with minimal resources and the devil’s advocate asks the hard question: ‘Are doctors really the right persons in health care teams to prescribe exercise?’. Timeline: 00:47m - What is the Lifestyle Medicine clinic? Who is involved, what are the goals? 02:00m - The diet part – modifying the DASH diet with a Southern Flavour (Dietary Approaches to Stop Hypertension (http://ow.ly/VtPSR)) 04:00m - An example: walking through the patient’s journey – such as a patient with COPD. The role of partners such at the YMCA 05:30m - What the patient finds important – health or weight loss? 06:00m - How the curriculum embraces Lifestyle Medicine. See the link to Dr Jennifer Trilk’s work below (BJSM paper) 08:00m - Practical experiences of medical students within their communities. From given practical cooking advice to engaging high school students who are at risk of gang-related behaviour. Leadership concepts and team dynamic training – beyond the traditional medical model 10:00m - Physicians encouraging 7th & 8th grade children to ‘get your 30’ (minutes). Teaching CPR to children at this level. Encouraging young students to be open about concussion symptoms. Practical stuff 11:00m - Exercise Vital Sign: how many minutes do you exercise and how often do you exercise? Integrated into the Electronic Medical Record of the 13th largest health system in the US (with credit to Kaiser-Permanent as well). Flipping the health care system upside down from its focus on fee-for-service to prioritising prevention. 13:00m - Rural roll out: how to make this happen outside of major centres: ‘Think big but start small – practical first steps that will bring partners on board’ 14:45m - Taking a broader view – 'If we rely only on medical professionals to provide care our system is bound to sink'. 'There is plenty of pathology to go around'. The role of various health professionals in a team that provides excellence: 'Everyone plays a vital role' 15:30m - Dr Asif answers the hard question: 'What if an exercise professional feels he or she knows more about exercise prescription than the doctor?' Links: Incorporating ‘Exercise is Medicine’ into the University of South Carolina School of Medicine and Greenville Health System (Editorial, BJSM, 2014) - http://ow.ly/VtWv4 Check out the 2015 Physical Activity Issue of BJSM - http://bjsm.bmj.com/content/49/4.toc 2014 Physical Activity Issue of BJSM - http://bjsm.bmj.com/content/48/3.toc

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“What did the council decide on item 42?” — answered with the speaker and the moment.

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