Sports Medicine Meets Lifestyle Medicine: Latest Trends

Featured Physician: Siatta Dunbar, DO

Featured Sections: Gen Med, Mind-Body

Dr. Siatta Dunbar is Board-Certified in Family Medicine with fellowship training in Primary Care Sports Medicine. Her clinical practice is focused on orthopedic care, with incorporation of orthobiologics and lifestyle medicine counseling. She is deeply passionate about lifestyle medicine and the power of food! As a Certified Health Coach, she is committed to changing her clinical practice from “sick care” to patterning with her patients to help them become the dominant force in their life and create optimal health.

What Is Lifestyle Medicine?

myDotqer: Thank you so much for joining us today, Dr. Dunbar. You bring a new and exciting approach to Medicine that takes a more complete view of the person, incorporating nutrition, sleep, exercise, and wellness to your treatment approach. You are a Board-Certified physician but also a member of the American College of Lifestyle Medicine. Can you tell us about your background and how you became interested in this approach to Medicine? 

Dr. Dunbar: I have had a non-traditional path into medicine. I have a Bachelor’s Degree in Architecture from the University of Virginia and worked as a project manager in construction for nearly 10 years before returning to school to pursue Medicine. Subsequently, I attended an Osteopathic medical school because the philosophy matched mine. Although I narrowed my focus by getting fellowship trained in Primary Care Sports Medicine, I always incorporated a whole-person approach. I feel blessed to have found The American College of Lifestyle Medicine because it is in complete alignment with my philosophy and provides me with the tools and support to formalize and more effectively provide lifestyle counseling.

myDoqter: Can you tell us more about your practice and its innovative practice model?

Dr. Dunbar: At the core of my practice is understanding where my patients are currently with regards to their health and wellness, what are their goals of care and also their readiness for change. Given that I specialize in Primary Care Sports Medicine, that is the entry point for most patients. However, while discussing their chief complaint I incorporate my family medicine training, health coaching and lifestyle medicine counseling. Most patients leave with an understanding of how nutrition may impact their current diagnosis, what are some specific nutrition recommendations, and whether should they be taking Turmeric, Omega 3 and / or Vitamin D.

Incorporating Cutting Edge Health Technology

myDoqter: We notice that you use a lot of cutting-edge technology and bring the spirit of innovation to your practice.

Can you tell us more about the specific technology tools that you employ in your practice, such as cutting-edge treatments like Platelet-Rich Plasma (PRP) and Biologics. How do these fit in specifically with your scope of practice? 

Dr Dunbar: Orthobiologics is definitely an emerging and growing field, and I tell all my patients to ask lots of questions when they are considering PRP or other biologics. We have to be judicious and mindful that we’re following the research and giving our best guidance and recommendations.

As it currently stands, in my opinion, there is sufficient evidence to support the use of PRP to treat pain and improve function in the case of mild to moderate arthritis, with results better than cortisone or viscosupplement injections (such as hyaluronic acid injections). Given this, in all my conversations related to osteoarthritis, I discuss PRP injections as part of my treatment algorithm. I also include PRP in my treatment algorithm for chronic tendinopathy. This applies to the Achilles, patella, elbow (tennis elbow), gluteus, rotator cuff and hamstring. 

I use cortisone very sparingly for tendinopathy and, if patients do not improve after addressing their mechanics with structure physical therapy, then I discuss the role and expected outcome with PRP injections. There is emerging evidence for biologics to treat pain and function related to more advanced arthritis, meniscal or labral tearing, and rotator cuff tears - as examples. Since, in my opinion, we do not have sufficient evidence for widespread use of PRP, in these clinical scenarios I have extensive conversations with my patients reviewing what we understand, and have a thorough discussion on risks, benefits and expected outcomes. 

New Approaches to Patient Wellness

myDoqter: You also place a great emphasis on some of the basic factors of health, like the importance of nutrition, exercise, sleep, and wellness. Can you expand on how you utilize health coaching to guide patients in these areas? 

Dr. Dunbar: I firmly believe that we all have the ability to create the health we desire, but we may not know how or where to start. Herein lies the opportunity to provide coaching and to create shared goals for my patients’ health and wellness. As an example, if a patient presents with knee pain due to osteoarthritis, and they have co-existing obesity, high blood pressure or diabetes, I take this as an opportunity to educate patients on how this affects their treatment options. In this case, I may be limited in my choice of medications such as anti-inflammatories or cortisone injections to treat the osteoarthritis because these may adversely affect the diabetes or high blood pressure of the patient. I also educate patients on the fact that the long-term outcome of the disease is affected by co-existing medical conditions; for example, there can be faster progression of their osteoarthritis due to obesity. 

I also explore with them how their life would be different and what might they accomplish if they were at a healthy weight and didn’t have diabetes or high blood pressure. I review how nutrition alone can stimulate weight loss and how eating foods with a low glycemic index can help to regulate their blood sugar. When they are able to see the possibilities and how their choices can have profound impacts on their health, they are more willing to commit to change. The challenge is having adequate time to properly educate and foster this shared commitment to their new goals of health and wellness. Knowing that coaching and lifestyle medicine is what will reverse chronic disease and truly create optimal health, I have been sprinting, in a manner of speaking, towards starting my own practice.

The Direct-Pay Model

myDoqter: Your practice is based on a Direct-Pay Model. Many primary care and even specialty physicians are going this route. Can you talk about how this will enhance your practice and your ability to better care for patients? 

Dr. Dunbar: As I explored my options for private practice, the Direct Primary Care (DPC) model, in my opinion, is what fully addresses the current failings of our health system. DPC eliminates the middleman (i.e. insurance companies, administrators, etc) from the physician - patient relationship, and allows me to partner and work solely on behalf of the patient. It allows for easier access - usually no later than next day, ample time during office visits, cost transparency and care is given at a significantly lower cost.

For more information about Dr. Dunbar and her Physician-Led Orthobiologics and Health Coaching practice, visit: www.SaravitWellness.com