Strength Training in Primary Care Strength Training in Primary Care

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Thread: Strength Training in Primary Care

  1. #1
    Join Date
    Feb 2017
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    Default Strength Training in Primary Care

    First off I apologize if this topic has come up before. Bits and pieces seem to come up within the Starting Strength forum/ resources/community but I wasn't able to find any discussion at length on the topic. I would also like to thank the starting strength community, particularly Mr. Rippetoe, Dr. Sullivan, Dr. Feigenbaum and Dr. Baraki for renewing my passion for strength training as I come out of residency and begin a family practice in Canada.

    Why can't strength training be a part of primary care? I appreciate the challenges that were raised on the Barbell Medicine podcast re: producing high level, practice changing research, but do we really need such studies? I also agree that strength training is hard, people are lazy and that getting patients (let alone other HCPs) to buy-in to strength training is an uphill battle. However, considering the heavy burden of preventable diseases and increasing healthcare costs, it stands to reason that the system will eventually wake up to the fact that investing in strength training is good medicine. This is particularly true in a public, single-payer, system.

    I'm excited about the new Steady MD initiative that Dr. Feigenbaum and Dr. Baraki are undertaking. This is a huge step in the right direction.
    I'm also envious of what Dr. Sullivan has going on. Why can't that be a part of a family medicine/ primary care practice? The potential legal, ethical and financial repercussions not-withstanding.

    I live in a rural community of 4000 in Ontario, Canada, with a catchment of like 20,000. There are 6-8 practicing physicians at any given time. I am just starting off with 500 patients and will grow to a practice ~1500 over the next year. My goal would be to have a well equipped gym in my clinic for my patients but don't see this being economically sustainable (not yet anyway) and the medico-legal implications are daunting. To overcome these limitations, I'm planning on opening a facility similar to what Dr. Sullivan has going on. Unfortunately, I will need to have a slightly broader membership initially to make the project sustainable. At first I may not allow my practice patients to join as I'm not sure how best to navigate the patient-physician relationship in this setting.

    Are there are other PCPs on this forum attempting to incorporate strength training into their medical practice? Any thoughts/ suggestions?
    -Eric

  2. #2
    Join Date
    Jul 2007
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    North Texas
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    Quote Originally Posted by Eric Blanchard View Post
    Why can't strength training be a part of primary care? I appreciate the challenges that were raised on the Barbell Medicine podcast re: producing high level, practice changing research, but do we really need such studies?
    And when we've had the studies, what have they produced? Saturated fat causes heart disease, dietary cholesterol causes hypercholesterolemia, salt causes hypertension, tendonitis cannot be corrected without surgery, squats are bad for the knees, etc. Strength training will be a part of primary care when physicians start lifting weights, and not until then. You guys better get busy with your peers.

  3. #3
    Join Date
    Aug 2014
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    I think it depends on what you mean by "part of primary care." If you mean that a physician-trainer would get reimbursed by Medicare or Canada Care (I forget what they call it) then probably never. These agencies would rather you die sooner to decrease recurring costs for the elderly (I know I'm cynical, but am I wrong?)

    If you mean that physicians routinely recommend it to their patients.... That's also a tough question, because how many of them are going to recommend something that has a chance of actually making a difference? And since they won't be paid, and most people won't do it anyway...

    I will tell anyone who I think is genuinely interested and/or I think might do it, so naturally it rarely comes up.

    However, considering the heavy burden of preventable diseases and increasing healthcare costs, it stands to reason that the system will eventually wake up to the fact that investing in strength training is good medicine.
    The "system" will never wake up to this fact. It takes individuals.

    This is particularly true in a public, single-payer, system.
    Wow, you are a young doctor.

  4. #4
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    Boston, MA
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    In a perfect world a SS Seminar would be approved by the AMA for continuing ed credits. (Or better, yet covered by my health insurance.)

  5. #5
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    That world is light years away.

  6. #6
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    Jun 2013
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    Quote Originally Posted by TommyGun View Post
    In a perfect world a SS Seminar would be approved by the AMA for continuing ed credits. (Or better, yet covered by my health insurance.)
    Agreed. I keep thinking I should at least be able to use my HSA to pay for my SSOC service... It is preventative medicine after all.

  7. #7
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    Quote Originally Posted by TommyGun View Post
    In a perfect world a SS Seminar would be approved by the AMA for continuing ed credits. (Or better, yet covered by my health insurance.)
    The AMA is a primarily political action committee which seems, as far as I can tell, committed to single payer. I am not a member and I don't care what they say. I was briefly a member in residency, since my program helpfully took some of the money that Medicare gives them to train us to pay our dues because of some ostensible benefits we would incur that would apparently be better than paying us enough to afford our student loan payments. This is a pretty good example of how unions work: you are forced to pay "dues" which are then funneled into left wing propaganda organizations so that they can elect people you oppose and enact policies that are detrimental to your professional well-being using your money. You are then told you should be grateful.

  8. #8
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    Quote Originally Posted by TommyGun View Post
    In a perfect world a SS Seminar would be approved by the AMA for continuing ed credits. (Or better, yet covered by my health insurance.)
    The guild protects its own.

  9. #9
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    Nov 2015
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    Vancouver, BC
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    Not to change the topic too much but I've noticed there's only one SSC in all of Canada. Luckily, I'm only two blocks away from him but I'm wondering why we don't see more SSC's up in the great white north? Is it just a lack of Canadians coming to the seminars? You guys have nine times our population so there should be more than one if that's all we take into account.

  10. #10
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    It's obviously racism.

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