A look inside biopsychosocial care using comprehensive functional, integrative, and lifestyle medicine.
By Dr. Ginger Garner PT, DPT, ATC/L
Functional, integrative and lifestyle medicine (FILM) is fast becoming the gold standard for effective care in PT and OT. Expanding your professional toolbox to include these methods is critical when addressing the growing epidemic of co-and-multimorbidity in the U.S. population.
Chronic Disease has Reached a Tipping Point.
Chronic disease in the US has reached a tipping point. According to the CDC, chronic conditions are the leading causes of death and disability in the U.S. They are the leading drivers for the nation’s 4.1 trillion in annual health care costs.
The statistics are shocking:
- 81% of hospital admissions,
- 91% of all prescriptions filled, and
- 76% of all physician visits are attributed to chronic disease management.1
Insurance spending for gastrointestinal disorders increased from $20 billion in 2004 to $135.9 billion in 20152.
It is estimated that somewhere between 50-70 million Americans suffer from chronic sleep deprivation.3 Lack of sleep increases the risk of accidents as well as chronic conditions like diabetes and hypertension, and pain.
By failing to address the intersection of chronic illness and rehab science, we diminish the possibility for effective and lasting outcomes. Moving beyond traditional movement interventions alone is necessary to remain relevant.
While the concept of whole-person care is not new, there has been a reluctance to incorporate even evidence-based interventions by the traditional medical establishment.
But that is changing. The movement toward therapists embracing the frontline role of primary practitioner has already begun. The APTA states, “Physical therapists play a unique role in society in prevention, wellness, fitness, health promotion, and management of disease and disability by serving as a dynamic bridge between health and health services delivery for individuals and populations.”
The AOTA has similarly long supported the evidence-based “gold standard” biopsychosocial model of delivery.
Are You Addressing Whole-Person Health in your Practice?
We can effectively break the loop of chronic disease in this country by embracing whole-patient care.
In my clinic, we treat chronic joint pain, pelvic floor dysfunction, and hip pain using Functional, Integrative, & Lifestyle Medicine methods using a private pay model. We use the following tools to identify and address the unique root cause of each person’s pain or disease:
- Stress management and mindfulness training
- Physical activity prescription across the lifespan
- Health and wellness coaching
- Diet and nutritional counseling
- Sleep and relaxation training
- Tobacco cessation and substance abuse screening and counseling
- Identifying environmental contributors, such as commonly known endocrine disruptors and pollutants
Many physical and occupational therapists struggle with how to implement FILM treatment modalities in a time efficient manner, especially in non-supportive traditional settings.
Once you understand the why and how (evidence-based) of integrative methods, even small changes such as deep listening and assessing readiness to change can make a huge difference in patient outcomes and satisfaction.
I treat patients in fewer total visits overall while achieving better outcomes with longer lasting results. This ends up saving hundreds if not thousands of dollars for each patient.
Staying Focused with FILM
When it comes to efficiency, my patients help me stay focused. For example, I had a patient fly from Hawaii to see me in NC for intensive integrative physical therapy for her hip pain. Talk about the need to be dialed in and ready to go!
Understanding how to manage your time properly to be completely present with this patient & listen to her challenges, while observing her movement impairments, past medical history, and current lifestyle in an effective manner is critical. In these situations, every second counts when you need to make significant, objective gains quickly.
Flash forward less than a year later, and she just completed her first half marathon! The Functional/ ILM approach is the key to her success. It works because I’m looking for the root cause, not just simply prescribing physical therapy exercise for movement, only.
I have been practicing using variations of FILM for 25 years. The field of PT is always changing and expanding and so is FILM which continues to inspire and motivate me year after year.
Our methods encourage increased patient ownership in rehab and significantly lowers the burden of care, which is a leading cause of clinician burnout. Without FILM, my patients would still feel lost in the system without relief and I’m not sure I would still be a PT.
What will you do with your one wild and precious life?
There are lots of options when it comes to expanding your toolbox. I recommend doing your own research to find the program matches your core values. For me, lifelong is essential. l am so honored to have taught all ages from around the world. I firmly believe that it’s never too late to have a satisfying career. American poet, Mary Oliver, sums it up best, “What will you do with your one wild and precious life?”
ABOUT THE AUTHOR
Dr. Garner is a passionate, unapologetic advocate of improving access to pelvic physical therapy, a mother to 3 sons, & a 25+ year veteran in Functional, Integrative, & Lifestyle Medicine-based physical therapy. She is the author of Medical Therapeutic Yoga, Integrative & Lifestyle Medicine in PT, founder & CEO of Living Well Institute, owner of Garner Pelvic Health, and loves making music and adventure seeking outdoors as often as possible.
Resources
(1) Anderson G, and Horvath , May 2004
(2) Peery et al, 2012, 2019 AHRQ 2006, Jones 2007
(3) Harvey R Colten, Bruce M Altevogt, NHLBI, 2003
