1. for the challenges Of preventing dis-ease
Untapped Tools
for the challenges Of preventing dis-ease

2. Family Physician-Ellensburg WA Consultant-Shared Medical Appointments
Byron L. Haney, MD
Family Physician-Ellensburg WA
Consultant-Shared Medical Appointments
Family Health Care of Ellensburg
PNWU Associate Professor

3. Yakima WA 8/25/2018

4. Obesity Causes Hypertension
Dyslipidemia (Lower HDL and elevated LDL/TG)
Type 2 diabetes
Coronary heart disease (CAD, atrial fibrillation,
Stroke
Gallbladder disease
Osteoarthritis
Sleep apnea
Some cancers (endometrial, breast, colon, kidney, gallbladder, prostate, and liver)
Low quality of life
Mental illness (depression, anxiety, and other mental disorders)
Body pain and difficulty with physical functioning
Complications of pregnancy
Menstrual irregularity
Stress incontinence
Congenital malformation
Discrimination (employment, college acceptance…)
Obesity Education Initiative, NIH 10/1998

5. Add a Slide Title - 1

6. 3 Untapped Tools for Prevention of Disease
Shared Medical Appointments (SMAs)
Ideal Protein (IP)
Providers of Healthcare

7. Yalom’s Therapeutic Factors
SMA’s
Why Groups Work?
Yalom’s Therapeutic Factors
Harnessed

8. Why Groups Work?
Instillation of hope: encouragement that recovery is possible
Universality: Feeling of having problems similar to others, not alone
Imparting information: helpful to learn factual information from others
Imitative behavior: modeling another’s manners and recovery skills
Interpersonal learning: Achieving greater self-awareness through group feedback on their behavior and impact on others.

9. Altruism: Helping and supporting others
Group Cohesiveness: Feeling of belonging to and valuing their group.
Catharsis: relief of emotional tension by telling their story to a supportive audience, gaining relief from chronic feelings of shame and guilt.
Corrective recapitulation of the primary family experience: Identifying and changing dysfunctional patterns and roles one carries out in their family.
Existential factors: Learning one must take responsibility for one’s own life and the consequences of one’s decisions.
-Yalom I.

10. DIABETES PREVENTION LITERATURE
REDUCTION in the INCIDENCE of TYPE 2 DIABETES with LIFESTYLE INTERVENTION or METFORMIN
N Engl J Med February 7, 2002
Diabetes prevention program research group (DPRRG)

11. DPPRG VS SMA’S (FHC)

12. IDEAL PROTEIN Ally in the Triple Aim of healthcare
Why is it unique and so effective

13. Chuck and Christina 10 months 11/6/17 - 9/10/18
Chuck # to 222#
Christina 298# to 162#
344# Combined

14. IP Protocol 4 phase weight management solution Science based
Reduces carbohydrate and fat
Maintains moderate protein intake
NOT HIGH PROTEIN
Preserves muscle mass
Ketogenic:
(NOT the KETO DIET)
One-on-One Coaching
Balanced Lifestyle Education
Health Provider Supervised

15. How Ideal Protein Works
Hypocaloric Diet
Ideal Protein Phase 1
“Balanced” Diet
Vitamins
& Minerals
Vitamins
& Minerals
2000 Calorie Diet
Vitamins
& Minerals
1200 – 1400 Calorie Diet
So instead of eating a typical ‘Balanced Diet’ which only allows us to maintain our current weight or eating a “Hypocaloric Diet” like Nutrisystem or WW, where we are indeed losing lean mass, including muscle, at the same rate as fat, Ideal Protein recommends a temporary “unbalanced diet,” in which we are giving the body the protein it needs to protect muscle so that only fat is targeted.
850 Calorie Diet
1200 – Calorie Diet
850 – Calorie Diet
2000 Calorie Diet

16. OUT COMES Medical Financial Decrease or Eliminate Increase
HTN
Diabetes
Creatinine abnormality
LDL elevation
GERD symptoms
Sleep apnea
Major joint pain
Elevated triglycerides
Increase
HDL
Financial
Decrease or Eliminate
Medications
CPAP
Reduction of per Capita costs
306 Aspirus employees 2013-’15
Self-insured community-directed health system.
Dr. Logemann cardiologist
Average claims cost decrease per year
$ overall
$ for female employees
$ for male employees
Improved Provider Quality Indicators

17. Our perception is our reality We have a Paradigm Change
PROVIDERS
Our perception is our reality
unless
We have a Paradigm Change

18. BS: 964, A1c: 11.6, TC: 235, TG: 887, HDL: 23, LDL: 121, O2 sat: 78% sleeping, D/C ICU w/o glucometer/ACE/Statin: 7/12/17
metformin 500 BID, Lantus 40U BID, NovoLog 15U AC.
Returned to driving truck, d/c insulin, metformin 500 BID; LDL 31, TG 139, HDL 22.

19. What do we call this sign?

20. What do we call this Clock?

21. How Ideal Protein Works
Hypocaloric Diet
Ideal Protein Phase 1
“Balanced” Diet
Vitamins
& Minerals
Vitamins
& Minerals
2000 Calorie Diet
Vitamins
& Minerals
1200 – 1400 Calorie Diet
So instead of eating a typical ‘Balanced Diet’ which only allows us to maintain our current weight or eating a “Hypocaloric Diet” like Nutrisystem or WW, where we are indeed losing lean mass, including muscle, at the same rate as fat, Ideal Protein recommends a temporary “unbalanced diet,” in which we are giving the body the protein it needs to protect muscle so that only fat is targeted.
850 Calorie Diet
1200 – Calorie Diet
850 – Calorie Diet
2000 Calorie Diet

22. BS: 964, A1c: 11.6, TC: 235, TG: 887, HDL: 23, LDL: 121, O2 sat: 78% sleeping, D/C ICU w/o glucometer/ACE/Statin: 7/12/17
metformin 500 BID, Lantus 40U BID, NovoLog 15U AC.
Returned to driving truck, d/c insulin, metformin 500 BID; LDL 31, TG 139, HDL 22.

23. THE CHOICE IS YOURS
HOPEISNOWHERE

24. THE CHOICE IS YOURS
HOPE-IS-NOW-HERE
HOPE-IS-NO-WHERE