“There takes quite a bit of time for a symptom change, unless the person involved in the change really immerses himself, and I have data on that. So this expectation that one visit we’re all in doesn’t play out in the world that I’ve been working in,” Dr. Prather said, noting that sustainability is hard.
Even with challenges, social prescribing efforts have a shot at making a difference, said Dr. Prather. Another study showed that despite lack of standardized validation, missing data and other problems, most evaluations for social prescribing actually went toward a positive change.4
Impact on Providers
For healthcare providers, beware of burnout among those leading efforts to implement social prescribing. Exhaustion, no energy, mental distance and negative feelings related to your job is something “we all know about,” she said.
Cultivate a support system with colleagues to implement workplace interventions and promote cultural change and workload modification, Dr. Prather advised. Foster social support within small groups of people who you work with both in-person or virtually. She noted that working for change within a large system can be more difficult.
“Connection is really, really important for you as a provider,” she said, adding that sunlight and nature also bring bountiful benefits.
Lifestyle Medicine
Dr. Prather continued her discussion with highlights about programs she helped develop at Washington University School of Medicine, St. Louis, and her current post at the HSS Lifestyle Medicine Program. She began by naming other types of medical practices: integrative, alternative, functional and preventive, and conventional medicine.
“Then there’s lifestyle medicine, which is looking at root cause aligned with behavioral change, and we have very strong evidence that this works,” Dr. Prather said. “So lifestyle medicine focuses on educating and motivating patients around six pillars of health, which is including nutrition as whole food, plant, predominant diet, lifestyle, regular activity, physical activity, restorative sleep, managing stress, social connections, as well as avoidance or minimizing risky substances.
“The big difference in this, it’s all evidence-based and requires the patient to engage,” she said. “I cannot passively ask somebody or force them to sleep better. It doesn’t work. So these six pillars, again, are really important.”
Patients are not ready or likely to engage in their own healthcare if they don’t understand how different aspects of the pillars are related. This lack of understanding can lead to a sort of revolving door, with a patient coming back in the office six months later for the same unresolved issue, noted Dr. Prather. Health literacy is a key element in lifestyle medicine, she said, because better literacy is related to better outcomes.
