Dr. Braman

It's About Patients

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Most Important

While in medical school my step-mother asked me what kind of doctor I wanted to be (meaning Family Practice, Orthopedic Surgeon, etc). I responded, “A good one!”

I am still committed to being the best doctor I can be for those I serve - to provide them with the care I would want if I were the patient. There is no professional training or certificates you can hang on the wall that can be half as important as the dedication to serve well.

The ultimate goal is creating the next generation of healthcare that is the kind of healthcare I would want as a patient.

The Journey

I grew up swearing I would never be a doctor. Never say “never”!

Nutrition, wellness, the body’s ability to heal itself if given opportunity, more “natural” approaches supported by good science — these were the things I was interested in before going to medical school. Following formal education, including a residency in Preventive Medicine and a Masters in the science of medical research, I did a lot of learning on my own, exploring all kinds of therapies, approaches, etc. But always examining the evidence for reality. Only reality would help my patients truly heal and have the best health possible.

But healthcare as it has been isn’t about patients or what is best care for them. We must change what our fellow human beings have access to as healthcare. Thus the journey that follows….

The big missing piece in healthcare was that, despite mountains of scientific evidence, treatment was still based on pills and procedures for treating symptoms and consequences. To build a system that made any sense whatsoever, we needed “treat the cause” care on the playing field, and it needed to be foundational to everything else. The best way to do that was to develop a professional organization that would define and represent the field and providers in this discipline. So, like there is the American Academy of Family Practice or the American College of Surgeons, we built the American College of Lifestyle Medicine. My friend and colleague, John Kelly, MD, MPH, was the Founder and first President. I became Secretary, then second President, then first Executive Director, spending the better part of 7 years doing the blood, sweat, and tears of building something that everyone knew was what was needed and no one wanted to support with time or resources.

We built infrastructure, established annual national conferences, built a board of Advisors of the best scientists and experts on the planet in Lifestyle Medicine, including former US Surgeon Generals, Chairs of Departments at Harvard, etc. We developed regular publications, member support, collaborations with other professional societies such as the American College of Preventive Medicine, collaborations with Sage Publications and the American Journal of Lifestyle Medicine. We began work to establish standards for the field, culminating in the publication in the Journal of the American Medical Association of the product of a national Blue Ribbon Panel with recommended competencies for all providers in prescribing Lifestyle Medicine. We established formal Fellow designations and systems for those who had substantially contributed to the field professionally, etc, etc, etc. We got Lifestyle Medicine on the map as a credible, professional field, with every reason to be the foundation of healthcare everywhere.

Thanks to the continued efforts of others the American College of Lifestyle Medicine continues to grow and shine a bright light on the heart and foundation of a better kind of healthcare.

The American College of Lifestyle Medicine

The Lifestyle Medicine Foundation

We set up the Foundation early on so that the College could focus on the professionals, and the Foundation could focus on the public, promotion, the science, awareness, etc. I have the privilege of serving as President of the Lifestyle Medicine Foundation.

Our primary project is LifestyleFacts.org. We want people anywhere, any time, to be able to be taught by the best experts on the planet, based on the best science, in the most user friendly format possible, how to use lifestyle as medicine for them. And we want it to be free. We are also building systems to support integration for providers to make it easy for them to provide better care, more efficiently, by using LifestyleFacts.org as part of their care systems.

And there are many other projects we want to get to as funding allows, such as a shared database of the core science of Lifestyle Medicine to empower education, clinical care, further research, etc.

Understanding the concepts and science of clinical Lifestyle Medicine is great. But unless it can be operationalized in sustainable ways it is just mental entertainment.

I have talked with hundreds and hundreds of doctors and other healthcare professionals passionate about Lifestyle Medicine but who struggle with making Lifestyle Medicine work financially in today’s healthcare climate that is not built for patients or real care. To support providers and practices and systems in making Lifestyle Medicine work in the real world, we formed Lifestyle Medicine Pro, LLC in 2016. Not just a typical consultancy, we are building the science of community into all that we do, functioning more as a network of colleagues with shared resources and helping each other — “Bringing Lifestyle Medicine To Life - Together”.

Lifestyle Medicine Pro

I was at an NIH Consensus Development Conference on Physical Activity and Cardiovascular Health, using some of my oh-so-precious vacation time during internship to attend. Top scientists on the topic from around the country were discussing the state of the science and what we should tell the public as a nation. One scientist presented the results of their study comparing lifestyle to medication for treating hypertension (high blood pressure). Interestingly, the medication group lowered their blood pressure more than the exercisers. BUT — the exercisers had fewer heart problems and lived longer, despite higher blood pressure numbers. Light bulb! We aren’t measuring or treating what really matters. Logically — based on the scientific evidence and keeping in mind what we really care about — we should be measuring lifestyle factors like exercise more than things like blood pressure. Unfortunately, medicine is actually not as logical as everyone likes to think.

We need a system for easily, consistently assessing the driving forces of health or disease. This should be the foundation of all care. It should be a universal language or system that translates from the doctor’s office, to the work site, to many different apps on smartphones, to insurance premiums, etc. We need “lifestyle vital signs”.

Sparing many details, “Vitalities” is born. Used to it’s potential, it will change healthcare more than almost anything else. But we have a lot of work to do. We are looking for movers and shakers to work with in bringing Vitalities into its full potential.

Vitalities

LifestyleMedicine.com

People need expert-vetted resources, tools, and systems for implementing lifestyle as medicine in their daily lives. LifestyleMedicine.com will be the place for people to operationalize Lifestyle Medicine. We are looking for those with the skills, passion, experience, and resources to partner with us to bring LifestyleMedicine.com into it’s own.

Patient-Directed Health Care (PDHC)

It really is all about patients. At least it could and should be.

There is a lot of talk these days about things like “patient centered medical homes”. Great concepts, but patients are still not usually part of the design process(!?). To build a working system patients have to have voice and control. In the existing system they have neither. So…we are Americans…and we need to seize our destiny. So…we have set up a non-profit organization to become the patient voice. There is still a lot of work to do. But patients need to be telling the government and insurers and other players how they expect healthcare to work. And they need to be in a position to do something about it and make things happen.

All this political back and forth in Washington about health care is laughable relative to real innovation and designing a working system. They are just arguing about how to shuffle the dollars around in a non-system that isn’t what it could or should be in any sense. The action is where the patients are — or it can be. We must be organized…strategic, we won’t sit down and shut up any more. Activism is a beautiful thing when we come together to help each other and overcome barriers and bureaucracy to fight for the common good and for future generations.

Presentations at Stanford Medicine X on strategically and methodically designing an actual health care system with patients in charge of their health are part of our efforts thus far. Want to change things in a major way? Contact us. Help us build Patients United.

The Big Kahuna - Next Generation Health Care System For All Of Us Patients

We have the conceptual framework together, domain names, etc for a patient-directed health care system based on open-source universal standards and functionalities. Innovation will be fostered and flourish, instead of being systematically stifled and stymied.

Wow, is there a lot to do! But WOW, will it be cool!

Want to be part of creating the impossible? Contact us.

And there is my own practice. I’m located right inside the front doors of a big beautiful fitness center. We are developing new practice models, as well as a comprehensive clinical model of healthcare. So it is a bit of a laboratory. If you come as a patient, we hope you will consider it a positive thing that we may have medical students or professional guests with us. It is fundamentally all about the patient and how we can provide the kind of care we would want as patients.

Personal

People normally want a sense of what someone is like as a person, what their non-work interests are, what they enjoy.

I love my God, my family, the great outdoors of the beautiful Northwest, inventing and creating, deep philosophy and multi-dimensional integration, and bringing life, health, and joy into others lives. My family teases me that I need 10 lifetimes to do all the things I want to do. I am by nature an inventor and entrepreneur. These qualities are tasked with accomplishing as much permanent good as possible in the world and for others with the life and opportunities I am privileged to have.

I teach, speak, write, and consult for professional and lay audiences and entities on topics from whole person clinical care, business, science, spirituality/philosophy, and innovation, to universal principles integrating multiple dimensions.