The theme of this year’s virtual Lifestyle Medicine Summit is “Evidence-Based Chronic Disease Solutions That Work.” The 10-day annual event, hosted by the passionate and dedicated Johannes R. Fisslinger, features nearly 40 presentations and panels with an estimated 50,000 health professionals in attendance.
I had the honor of returning as keynote speaker, delivering a presentation on “3 Big Changes Coming To American Medicine.”
As U.S. medical practices look for ways to embrace lifestyle medicine principles, such as plant-based diets and stress management, it’s vital for practitioners to stay up to date on the latest advancements that can help shape the future.
To kickstart that conversation, I pointed out the problems of American medicine. Today, nearly half of all patients struggle to afford healthcare costs. A growing chronic disease epidemic is gripping our nation as physicians face ever-higher rates of clinician burnout. I then outlined three rising trends in the areas of technology, commerce and biopharmaceuticals, which will have a massive influence on the practice of lifestyle medicine going forward:
1. TECH: The use of generative AI in healthcare
One of the greatest advances in medicine is also one of its newest, the launch of generative AI technologies like OpenAI’s ChatGPT and Google’s Med-PaLM 2 (the latter of which has scored an expert-level 86.5% on the U.S. medical license exam).
As these tools become exponentially smarter, safer and more reliable (an estimated 32 times more powerful in the next five years), everyday Americans will gain access to unparalleled, personalized medical expertise—doled out in easily understandable terms, at any time, from any place.
Using ChatGPT, patients will have the power to establish a firm knowledge base concerning their medical conditions (and do so prior to their clinical encounters). Future consultations will be collaborative rather than physician dominated. With patients already understanding their medical problems, clinicians will have more time to dive deep into proactive health strategies and long-term chronic-disease management solutions instead of having to start at square one. This approach will also address the reality that at least 50% of patients leave the doctor’s office unsure of what they’ve been told.
And with 60% of Americans living with one or more chronic diseases, generative AI will become an invaluable tool in the day-to-day management of these medical problems. “Conversational” AI products like Google’s Bing already have the ability to ask users questions and the potential to combine the answers with data from at-home monitoring devices. In the future, this will lead to more accurate diagnoses and effective, evidence-based treatments.
The combination will allow clinicians to update recommendations in real time. This will facilitate doctors seeing patients who are not responding to treatment as expected while allowing longer intervals for those who are doing well. Generative AI will also help patients keep track of their preventive care needs, schedule the appropriate services when overdue and arrange transportation when required.
And generative AI will help people follow their health coach’s recommendations around lifestyle medicine by creating and monitoring exercise programs, helping families maintain a healthy diet, and even recommending personalized meal plans and shopping lists for the week.
2. COMMERCE: The rise of the retail giants
Clay Christensen, the late Harvard Business School guru, pointed out that industry disruption rarely comes from incumbents. Instead, transformations are largely driven by new entrants. In healthcare, these are likely to be retail giants like Amazon, CVS and Walmart.
For years, these retailers have been acquiring the necessary healthcare pieces—including clinicians, home-health services, pharmacies, insurance arms and electronic medical record systems—to replace the current medical system.
The retail giants recognize that healthcare is exorbitantly priced, uncoordinated, inconvenient and technologically ineffective. And they are attracted to the hundreds of billions of dollars of revenue they could earn by offering a consumer-focused, highly efficient alternative. If others don’t step forward, I predict that in five to 10 years, one of these retail giants will become a dominant force in healthcare, delivering the kind of value-based care most health systems have only talked about.
3. BIOPHARMA: The obesity-fighting wonder drug
Many in lifestyle medicine lament that American patients have been conditioned to rely on “miracle” drugs and quick-fix solutions in the form of a pill. I agree for the most part.
But a relatively new drug class (GLP1 agonists) has many in medicine and public health reexamining their beliefs. Not only can these medications result in major weight loss, but they have been shown to reduce serious heart disease, the nation’s No. 1 cause of death.
In a nation where an estimated seven in 10 people are overweight or obese, resulting in an estimated 300,000 preventable deaths per year, with extreme obesity lowering life expectancy by 14 years on average, combining these effective drugs with lifestyle medicine offers great hope.
We know that added weight not only makes everyday life more difficult, but it also produces serious health consequences that include cardiovascular disease, diabetes, musculoskeletal disorders and cancer. In total, obesity costs an estimated $260 billion annually in inpatient and outpatient care. Once the prices for these medications are reduced, they will be an important part of medical practice. But weight loss alone won’t achieve superior health. Proper nutrition, exercise, preventive measures and lifestyle coaching will also be required to bring our nation back to better health.
The Future: Quality, Service, Cost
In 1998, shortly after I was named CEO in Kaiser Permanente, I visited the Oregon Health Sciences center to keynote a conference on healthcare in the coming century. As I wandered the halls after my talk, a sign caught my attention.
In bold letters across the top, it read: “Cost. Access. Quality.” And below, in tiny font: “pick any two.”
I found the message appropriate for the time, even if a bit sardonic. Back then, most administrators believed it was possible to improve in two of these areas but only at the expense of the third. Unfortunately, they were right. Almost three decades later, this outdated mentality persists—despite radical scientific and technological advances that make it possible to deliver all three as part of a value-based healthcare system that includes lifestyle medicine.
The future of healthcare is dependent on our ability to improve quality and make care more accessible as the optimal way to lower costs and make coverage affordable. Lifestyle medicine will be a vital contributor along with these three upcoming opportunities. The time to figure out how to include each in medical practice is now.
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Dr. Robert Pearl is the former CEO of The Permanente Medical Group, the nation’s largest physician group. He’s a Forbes contributor, bestselling author, Stanford University professor, and host of two healthcare podcasts. Pearl’s newest book, “Uncaring: How the Culture of Medicine Kills Doctors & Patients,” is available now. All profits from the book go to Doctors Without Borders.
