Josie Bidwell on lifestyle medicine
Josie Bidwell is associate professor of nursing and lifestyle medicine clinician for the University of Mississippi Medical Center (UMMC). She holds a bachelor’s, master’s and doctorate in nursing from UMMC. Bidwell spoke to Sun Staff Writer Anthony Warren about her position and about the school’s lifestyle medicine clinic.
What is lifestyle medicine?
“It’s an emerging specialty in health care and is a new board-certified field. It looks at different facets of life and lifestyle that could be causing chronic illness or could be a risk factor for the development of chronic illness. It looks at stress and mental health; sleep is a big part of lifestyle medicine as well. It looks at resiliency and relationships – the support systems and how those impact our overall health. It looks at substance abuse, tobacco and alcohol use, nutrition and fitness.”
What board certifies it?
“The American College of Lifestyle Medicine. I am sitting for the exam in October.”
How did you get interested in this field?
“I’ve been a nurse practitioner for 12 years. The majority of that time was in internal medicine or family medicine, seeing people every day with lifestyle disorders and wanting to be able to offer them more than what I was able to do. ‘If I could have talked to this person five years ago when they were at risk, what kind of impact could we have had?’ I started to self-learn, go to conferences, rotate with some diabetes educators and some registered dieticians and learn the foundations of how food and movement impact overall health, and incorporate those into my daily patient visits.”
Why is this field necessary?
“About 80 percent of chronic illness can be tied back to lifestyle factors – what we’re eating, how much we’re moving, the types of things that we’re putting in our body, whether we’re sleeping. That ties back to high blood pressure, diabetes. When you look at the guidelines, the first step in treating every one of these illnesses is lifestyle modification. You’re supposed to do that, but when you’re trying to manage the medication side, the referrals, the tests, you simply run out of time for good lifestyle education and teaching. When folks come to see us in lifestyle medicine, they get a 40-minute appointment to get them to focus on lifestyle factors and develop a plan to focus on those. We’re a compliment to primary care.”
How many people does the lifestyle clinic see in a year?
“We opened last September; we have not even been open a year. Currently, I am the only lifestyle clinician practicing (at UMMC). I’m only in clinic half a day each week. I see five patients on that one-half day. We’ll be adding a second half-day, because I’ll be moving to the Department of Preventive Medicine. Right now, I’m full-time in the School of Nursing and part-time in the Department of Preventive Medicine. In October, I’ll be transitioning to (preventive medicine) full time.”
What is the most common lifestyle issue you’ve seen?
“I always start my visits the same: ‘tell me what you’d like to work on.’ That’s the foundation. It has to be a mutually agreed upon plan, rather than a healthcare provider telling you to do this, this and this. It’s very partnership-driven. Most often (patients) tell me they want to work on their diet, their fitness or both.”
You mention that you will be working two days a week in the lifestyle clinic. Does UMMC plan to expand lifestyle medicine in the future?
“We’re always looking for ways to expand. That’s why I’m coming in on a more full-time basis, so we can see more patients. My schedule is always booked. We’ll go do cooking demonstrations and talk to different groups. I talked recently to (parents of) high school students about how nutrition and sleep impact performance.”
Are there other doctors and nurses practicing in this field now?
“There’s not nearly enough. It’s a relatively new board specialty – being established in the last five to 10 years. Right now, I’m the only person at UMMC practicing. We do have other healthcare providers in the Department of Preventive Medicine who trained in lifestyle medicine principles and are part of the team, but not as many as we would like. But the conversation is out there. Now people hear the (term) lifestyle medicine and understand what it is. Part of that is through efforts of getting information out there.”
So many people never think of preventive medicine. Rather, they wait until they’re sick before making any changes. How do you change that mindset?
“You help folks build a plan they see as achievable. We’re very big on self-efficacy, the person’s belief that they can do these changes. A lot of folks have tried diets over the years, gotten multiple gym memberships and were not able to complete them. When you aren’t successful in the past, it makes you believe you can’t do it. What’ we’re trying to do is help people make SMART goals, which are specific, measurable, achievable, relevant and time-oriented.
“So instead of someone who may be 100 pounds overweight, instead of telling them to get to their ideal weight (That doesn’t move a person’s behavior.), you say, ‘we’re going to lose five percent in a slow period of time.’ Even that amount of weight loss helps with heart health.”
For this field to be successful, though, people have to want to change.
“That goes with any health behavior, whether its stopping smoking or making a diet change.”
How many visits do people typically have when they come to your clinic?
“Some folks have one item, such as an annual wellness visit, to see where they are. Most folks have chronic illness and want to work on their lifestyles. They have an initial visit and come back in four to six weeks. The follow up from there can depend on how they’re doing on the change. If they’re rocking out those goals and have a good handle (on them), we will follow those folks every three months.”
Bidwell will be speaking to the Metro Jackson Lions Club on Monday, September 17. The meeting begins at noon and is open and free to the public.