Lifestyle medicine patient encounters can be accomplished in both the inpatient and outpatient settings, although it is more common to complete them in the outpatient setting. Our hope is that lifestyle medicine will be another lens that each resident will use to assess and treat every patient they interact with in a clinical environment when appropriate. Within the 400 unique patient encounters, there are subdivisions for the various lifestyle medicine pillars that also need to be met to provide broad base competency in all lifestyle medicine pillars.
These subdivisions include: 1) nutritional assessments and interventions, 2) physical activity assessments and interventions, 3) emotional and mental well-being, sleep, and connectedness assessments and interventions, and 4) tobacco and toxic substances assessment, brief intervention, and referral training.
The great news is that many of these requirements can be met simultaneously with the same patient encounter. For example, if a resident sees a patient with diabetes, we hope the resident will address all the usual diabetes visit expectations and also have their lifestyle medicine lens on to address physical activity, nutrition, sleep and/or connectedness. If the resident takes a motivational interviewing or coach approach to counseling based on the stage of change in any of the 4 subdivisions, the resident can count the encounter as one of the 400 lifestyle medicine encounters and obtain credit for the specific subdivision(s) covered, as well. Thus, one unique encounter can meet multiple subdivision requirements.
At this time, we do not have a hard and fast rule about what does and does not count as a qualifying lifestyle medicine visit, however, our general rule of thumb is the visit will count if the patient walks out of the room having been counseled and/or having set a SMART goal based on appropriate interventions for stages of change.