This semester I got to take a few pretty snazzy electives including Spanish (apparently my pronunciation has improved during the semester, but that's not saying much, as it was profoundly awful at the start. The spouse accused me of sounding French and then Japanese while practicing...). The highlight was a class on Lifestyle Modification though.
What's that all about, you may be wondering...
The short answer is that whenever your doctor says, "Improve your diet and get more exercise" there ought to be someone for you to see to help you figure out what this means. Depending on what's wrong with you, just getting on the right diet can mean you get to scale back your medications a lot. Think of it as getting a prescription for exercise that you take to an extra-cool pharmacy and we help you fulfill it.
The long answer is that with the success of the Asheville project where pharmacists were hired by a company (the city of Asheville NC) to cut healthcare costs by optimizing medication regimes and improving health, there's about to be a big market for people who can run a service like this. Wearing a pharmacist hat, we fix medication problems and help people find medications that work best for them and their lives, while wearing a Lifestyle Modification hat we help implement little steps toward healthy changes in diet and exercise that in turn mean changing medications because maybe people don't need them anymore.
How super cool is that? Really! If people with hypertension can learn to stick with an appropriate diet, you can see a drop in blood pressure equal to that you get from most first-line medicines. Yep, programs like this usually need the support of a dietician to make it work for the greatest number of people, but with pharmacists at the center, it's a great model AND we get to use all of our skills (I really like using skills beyond "try to read the doctor's mind based on what is prescribed and what the patient can tell me" and "telephone the insurance company... again..." whenever possible).
The other thing that's nice about it is everyone at the company can benefit from company-wide wellness efforts, not just people who are already sick enough to be taking medications. Things like smoking cessation groups or online classes are often available in a program like this, as are a certain number of mental health visits a year. Often cheap gym memberships or having a gym in-house gets included for everyone at the company, not just for those in the medication management part of it.
This class focused on how to figure out a diet prescription for someone to lose weight (and about how fast it's safe to lose weight), how to develop an exercise program that will work for someone without them overdoing it, and how exercise changes medications we're taking (that's the technical stuff with names so long we abbreviate it to PK and PD that is really fascinating and complex and makes me appreciate the miraculous workings of our bodies). We covered a little bit of the business of getting set up and resources to support such a business, and I'm considering seeing if I can weasel a rotation doing this into my schedule. I have the problem that I want to do ALL the rotations, especially ones that are far away, so that's bound to be an obstacle.