Why Lifestyle Medicine Can’t Thrive Inside the Current Healthcare System — And What Needs to Change
Lifestyle Medicine has gained tremendous momentum in recent years, and for good reason. The evidence is undeniable: daily habits around nutrition, movement, sleep, stress management, substance use, and connection have more power to reverse disease than nearly any medication we prescribe.
But there’s a paradox at the heart of it that we don’t talk about nearly enough.
The Problem: We’re Trying to Force Lifestyle Medicine Into the Wrong System
Lifestyle medicine—when practiced authentically—reduces the need for medical intervention. Patients often require fewer medications, fewer surgeries, fewer office visits, and fewer costly procedures.
In other words: it makes people healthier, which makes the healthcare system less profitable.
Corporate healthcare has grown comfortable—and profitable—on chronic disease management. Prevention is celebrated rhetorically but rarely prioritized in practice, because it runs opposite to the financial incentives that drive the system.
So while Lifestyle Medicine is worthy and transformative, it still gets squeezed into a system that rewards treatment over prevention. Any attempt to integrate it must, by necessity, still support cost savings or revenue generation. That tension limits its reach.
My Origin Story With Lifestyle Medicine
I first learned about Lifestyle Medicine during my third year of residency. My program director introduced me to an alum whose work centered around prevention and whole-person care. For the first time, I felt seen. Here was a professional community that aligned with everything I believed about health.
At that time, the movement emphasized strictly plant-based eating—something that didn’t fully resonate with me. Thankfully the field has evolved toward “plant-predominant” patterns, a more inclusive and realistic approach. And the evidence is strong: plant-forward diets lower risk of heart disease, diabetes, cancer, and even Alzheimer's disease.
Trying to Practice Lifestyle Medicine in a Fee-for-Service World
When I became an attending in 2016, I was determined to practice Lifestyle Medicine within the traditional fee-for-service system. It was largely unknown back then, and I was optimistic I could be part of the change. Today, we see more Lifestyle Medicine clinics and programs, but they often exist as separate silos—services bolted onto a system rather than woven into its foundation.
A Better Future for Lifestyle Medicine
I envision a future where Lifestyle Medicine is:
Integrated into communities
Fully embedded in primary care
A starting point, not a referral
A default approach, not an optional add-on
But to create that future, we must rethink how we deliver it.
If Lifestyle Medicine continues to depend on insurance reimbursement, special coding, and productivity metrics, it will always be limited.
For it to become pervasive, we must explore models—like Direct Primary Care and community-based programs—that allow prevention, education, and lifestyle-based interventions to be practiced without restriction.
In other words: lifestyle medicine needs room to breathe.
The Takeaway
Lifestyle Medicine is not just another service line. It’s a philosophy of care that empowers people to live longer, healthier, more vibrant lives. But it will never reach its full potential as long as we rely on a profit-driven system to validate it.
If we want true prevention, true health, and true transformation, we must build a healthcare model that lets Lifestyle Medicine be what it was always meant to be: the foundation, not the afterthought.
