The Reverse Mullet Healthcare Podcast

A Radical Rethinking: Susan Benigas on Transforming Healthcare at Its Roots

• BP2 Health

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Susan Benigas, Executive Director of the American College of Lifestyle Medicine (ACLM), pulls back the curtain on how a radical rethinking of medicine is transforming healthcare at its roots. Having served in her role for over a decade, Susan represents half of ACLM's 20-year history—a journey that's seen membership explode from just 380 members to thousands of passionate practitioners worldwide.

The conversation begins with a surprising revelation: Susan isn't a clinician at all, but a business and marketing professional whose personal awakening came in 2007. "I just don't believe that God designed us all to become chronically ill and dependent on medications," she explains, describing her growing discomfort with America's pharmaceutical-dependent healthcare approach. After discovering T. Colin Campbell's groundbreaking book "The China Study," Susan recognized that every food choice represents either a step toward health or away from it—a realization that would ultimately transform both her personal and professional life.

What truly distinguishes ACLM is its remarkable growth trajectory, particularly during the COVID-19 pandemic when most medical associations were losing members. From 2019 to 2022, membership skyrocketed from 3,500 to 9,500, reflecting the pandemic's stark illumination of how lifestyle-related chronic conditions dramatically impact health outcomes. Today, with nearly 4,500 conference attendees representing 64 countries, ACLM has evolved from a niche organization to a global movement.

Perhaps most compelling is Susan's assertion that lifestyle medicine is essential to any meaningful healthcare transformation: "It is impossible to optimize value-based care without a lifestyle medicine-first approach." The model not only aligns perfectly with the quintuple aim of healthcare but also reconnects practitioners with their original motivation—becoming true healers rather than disease managers. For many physicians, discovering lifestyle medicine has literally saved their medical careers by restoring purpose and demonstrating what's truly possible in patient care.

Ready to witness healthcare transformation that actually works? Discover how ACLM is unleashing an unstoppable force for change by returning to medicine's foundational principles while creating scalable, evidence-based solutions for our most pressing health challenges.

Justin Politti:

Welcome to the Reverse Mullet Healthcare Podcast from BP2 Health. We are live at ACLM Orlando, florida 2024. I'm Justin Politti, I'm Dave Pavlik.

Ellen Brown:

And I am Ellen Brown, and we are here at the American College of Lifestyle Medicine Conference and we are here with a legendary person, susan, that I didn't even think we were going to be able to get on.

Dave Pavlik:

She's a hard woman to catch up with.

Ellen Brown:

Yes, you're a hard woman to catch up, but you have put this is amazing, and so introduce yourself, and then let's just chat for a few minutes. I'm so excited you got to come on. Oh well, thank you, I am just delighted to be here and you got the memo about the blue.

Susan Benigas:

Yes, exactly, we're matching, we're good. Yes, yes, we're in ACLM blue here today. There you go, and I'm Susan Benigas. I serve as Executive Director of the American College of Lifestyle Medicine. I've been in this role for 10 and a half years and since we're here celebrating the 20th anniversary of ACLM, it means I've been here. Half of ACLM's life.

Ellen Brown:

Well, more than half, if you say 10 and a half. Well, 10 and a half, yeah, so it's been a long time. It's amazing. A long time. Yeah, that's a long time, yeah, that's amazing. So it's been just such a joy though.

Susan Benigas:

Congratulations, thank you. Thank you so much. Yeah, so you asked us a question. Yeah, so so tell me so, reverse mullet. So how did the reverse mullet, how did this come about? The reverse mullet podcast? I'd love to hear the history.

Justin Politti:

We're obsessed with mullets.

Dave Pavlik:

So the podcast itself was born out of just sort of a passion project for us. So we do a lot of work in the industry around payment transformation and there was kind of a point where we wanted to like how do we get the message out to a broader audience? You know, we have clients that hire us to do certain things, you know, and one of the opportunities we had was, you know, it was suggested that we start a podcast. So the reverse mullet part of it is know, we're thinking, all right, we're going to do a podcast. What's it going to be about? Health care? Oh, that sounds really exciting, you know, right? So so there's a ton of health care podcasts and we just no offense to you know, anybody in the health care podcast.

Dave Pavlik:

But you know they're not that fun, so that's kind of boring. So we said we're going to have some fun. So party in the front, business in the back like a mullet, but reversed. And that's what we do. We have fun with our guests, Okay.

Susan Benigas:

But it's business in the back, and then we get into the serious conversations of healthcare.

Justin Politti:

I love that.

Ellen Brown:

There's no reason we can't have fun doing it we like that philosophy and the reason that we are here at ACLM is because our platform is to bring thought leaders in healthcare on to talk about how to affect real change in the industry. And as a firm, we really wanted to see payment transformation move beyond just sort of the toe in the water that it's really largely been, and what we realized is we needed to look for the solutions and not just the unicorns, but like how, how do we make outcomes based care effective? Like payment models can't succeed if you don't have the interventions for them to succeed. And so we kind of we started on this path, this journey a bit, and one of the first things that we ran into, other than you know, food is health, food is medicine, food industry was American College of Lifestyle Medicine and Martin.

Ellen Brown:

All I kept hearing was Ellen, you have to talk to Martin Tull, and so I did. I got, I talked to him and I was like this is it? This could be the magic bullet that helps us transform healthcare, because it's something that can be layered into the existing system. It's not so disruptive that nothing works economically. It could be the answer.

Justin Politti:

And as a sidebar, the mullet is so popular I've got to hop out and go take a yes, he does.

Ellen Brown:

He has to go live interview. It's in demand, it is so popular here.

Dave Pavlik:

Oh.

Ellen Brown:

I can see why, he's got videos.

Dave Pavlik:

I've got other stuff. Yeah, absolutely.

Ellen Brown:

He's got to go meet the entourage. He's got to do a promotional video for who I don't know, dude, he calls.

Dave Pavlik:

Yeah, dude, he calls, he's a man in demand. We'll see you on the other side.

Susan Benigas:

The man in demand. There he goes Well, yeah.

Ellen Brown:

So tell us how you got to ACLM like 10 years ago.

Susan Benigas:

What in Like, what in the background, was the journey? Well, you know, a number of years ago I was president of a worksite health promotion company and this was back like oh gosh, you know, back in 2005, 6, 7, back in those years, and we were doing what everyone else was doing. We would go in with an employer, we would do biometric screenings and health risk assessments. When anyone was found to have a chronic condition or multiple risk factors, we would say, well, you need to see your primary care doc and get a script. And then you beat the drum of medication persistency and I was finally getting to the point that I thought something is wrong with this.

Susan Benigas:

I just don't believe that God designed us all to become chronically ill and dependent on medications. Yet you know, hey, the stats then. And now it's like what we have a 70% of all adult Americans, 90% of seniors on prescription meds. We spend more on pharmaceuticals than the rest of the world combined. Only two countries in the whole world allow direct to consumer advertising for pharmaceuticals. And you know? And then when you get to the point where type two diabetes can no longer be called adult onset because so many children are being diagnosed, with this lifestyle related disease.

Susan Benigas:

So I was thinking something is really wrong with this. And I was invited to a presentation in late 2007, by an oncologist and I didn't even really know what it was going to be about, other than something about healthcare, you know and she stood up in front of the room and she said when I was in my early 50s, I was diagnosed with fibromyalgia, a skin condition, arthritis and she said I was living on the treats that my grateful patients brought. And she held up a book and said but this book has changed my life and has changed the lives of many of my patients, and it was the China Study by T Colin Campbell.

Susan Benigas:

And again, this is late 2007. So the book had only been out a couple of years at that point in time. And well, I went out, read the book and, based on where my head was at the time, really starting to question the status quo. And that's what really was the catalyst that sent me on this new journey, because it connected the dots between that. Every bite we take is either a step toward health or a step in the other direction. And it kind of painted this picture that we didn't necessarily have a health care system. We had a disease and disability care system, a sick care system.

Susan Benigas:

And my background. I am not a clinician, my background is all business, marketing. That is an entrepreneurship. That's what I brought to the table. Well, I read this and you know, anger can sort of be a motivator, right and I then just felt like, oh my good, well it totally it changed my personal and professional life.

Susan Benigas:

And then there were many steps in between, but that was what ignited my journey to begin with the real awareness that we needed to identify and eradicate the root cause of disease, with the clinical outcome goal of health restoration. So for me that's when the seed was planted.

Dave Pavlik:

Wow, until you said you weren't a clinician, I was thinking for sure you were.

Susan Benigas:

No, it's amazing.

Ellen Brown:

On the business side. It's amazing, though, how, when you really start to learn about lifestyle medicine and it's funny, we were just talking about how the fact that we call it lifestyle medicine is almost humorous, because it's just medicine it's like how we should live our lives. It's like, like somebody said earlier, it's almost too simple. Yes, yes but when you really read books, like the China study, and you consume some of the now like fast forward right, that was back when we were all just reading books right, right.

Susan Benigas:

I feel like starting in 2015, 2016,.

Ellen Brown:

I started all of a sudden podcasts.

Ellen Brown:

Oh, sure you know, and I think Rich Roll has done an amazing job of he was a real sort of early distribution mechanism of some of what we're talking about in a more mainstream, consumable way. Right, you know, putting Zach Bush on, putting it just, it's it. There were all sorts of different folks that all of a sudden you're like you know all the, all the folks that you're talking about that are legends. It was like, all of a sudden, now, the masses, right, right, they weren't in those conferences.

Susan Benigas:

It's true, and I think what first ignited it, you know I through my journey again. You know what I just described was late 2007 and there was this series of events, but I really came to this conclusion that we had to reach medical professionals, that we had this gaping void of lifestyle medicine and food as medicine in medical education right, and that until we really got medical professionals on board, that too often individuals may see a documentary, read a book, listen to a podcast, feel led to change their behavior, but if they go to their unenlightened medical professional who's been trained in an allopathic, diagnosed the ill prescribed the pill right and a lifetime of disease management, you know, too often, you know I will say that a doctor's word is second only to God's and so often they hold the trump card right and that we really had to reach clinicians. And that was why ACLM was established. You know, 20 years ago. It was established by visionary physicians, led by founding president John Kelly, who looked around and saw that there was no other field of medicine that represented evidence-based therapeutic lifestyle intervention to treat and even reverse already existing disease, knowing that if the dose was efficacious for treatment, reversal prevention was the natural byproduct. And that really, you know, set the wheels in motion.

Susan Benigas:

And, interestingly enough, and you know, I joined ACLM in 2014. And we did a member survey in 2015. Now, back then, like in 2015, we probably had 500 members by the time 2015 rolled around. But we asked them you know, what drew you to ACLM? Now this is 2015. And we listed. You know, was it a book, was it a documentary? Was it a class in medical school? Was it a? You know? Just tell us. Over 50% of the respondents back in 2015 said it was the documentary. Forks Over Knives. Yes, and that that was what was, you know, had kind of led them. But now, my goodness, had kind of led them. But now, my goodness, there's so many, as you say, from Rich Roll to your podcast, to so many podcasts and incredible books and so many more research studies and papers that are published from the Lancet to JAMA, it's undeniable.

Susan Benigas:

I mean the gentleman whom we just gave a special recognition award to today, dr Ali Mukdad, who is head of the Institute of Health Metrics and Evaluation out of Seattle Washington University of Washington, the largest repository of healthcare-related data in the world, funded by the Gates Foundation, and you know some of Ali has been the one that's been championing, saying that it's lifestyle that's the leading cause of disease and death, and you know what people are and are not eating, sort of at the, at the tip of that particular sphere.

Ellen Brown:

So what? I guess this is sort of a double edged question. You can answer how you see fit. Is there's obviously been tremendous moment, right? Yeah, I mean, if you look at the trajectory of a attendance to this conference be the number of diplomats, you know just sports or all of it, the adoption of it but at the same time, like I guess, I would ask, what do you think has been sort of that magic? And then how do we keep that going? Right? But then the other piece to it is what is the friction that we need to remove? Right, like, how can we make this? Because this really should be, I feel like every when we talk about advanced primary care, right, and all of these new primary care models, it's like hello, everybody should be board certified in this.

Ellen Brown:

This should be part of the core curriculum, or I mean's, you know no, no question about it.

Susan Benigas:

I mean even aclm stated vision statement is a nation and world wherein lifestyle medicine is the foundation of health and all health care.

Ellen Brown:

Right it's about, so I get knuckles on again. This is yeah, absolutely applause. Can you do okay?

Susan Benigas:

well, it's true, you know it's. Uh, I like to say all things old are made new again, right, hippocrates and all of his infinite wisdom, over 2,500 years ago. So you look up so many of his quotes, probably the most notable being let food be thy medicine and medicine be thy food, right, and so many of the famous quotes that are attributed to him. Clearly, you know, the father of medicine knew that. Again, it's the, if you just he was really preaching lifestyle medicine. I mean, there's no question about it, but we really strayed so far from that, because there's immense profit in disease right you know there's immense profit in disease.

Susan Benigas:

The system has really been designed, even from quality measures to you know so much, to really support a disease and disability care system.

Susan Benigas:

And hey, thank goodness for modern medicine, I mean, if you need acute care absolutely I mean, you know, we've got the best health system in the world but so while we've done an amazing job by and large of like preventing infectious disease, we have done a horrific job of preventing chronic disease and, quite frankly, it has been. I think COVID-19 did more to. You know. It really shined a bright light on the urgent need to address the underlying conditions that exacerbated the virus's most harmful effects, and what were those?

Susan Benigas:

Yeah, those underlying conditions were lifestyle related chronic diseases and the disproportionate impact on our underserved communities. So it really made the awareness about and urgency for lifestyle medicine root cause treatment all the more relevant, and so we our fall conference in the fall of 2019, we had 3,500 members. By the time we had our next live in-person conference in the fall of 2022, we had grown from 3,500 to 9,500 members, and that was during the time of COVID, when most medical professional associations were bleeding members. But I think that now you can't put the genie back in the bottle right, and this is such a good thing that there's such awareness about amongst all the.

Susan Benigas:

I mean look at the. We have nearly 4,500 registered for this conference.

Ellen Brown:

I mean the registrations.

Susan Benigas:

we've had several hundred that have come in just since yesterday and it's globally. 64 countries are represented in our registrants and in our Lifestyle Medicine Global Alliance that we founded back in 2016, when there were only five Lifestyle Medicine Medical Professional Associations around the world. There are now nearly 30 on every continent around the world, because it's the burden of non-communicable chronic disease that is not just facing the United States.

Susan Benigas:

I mean we've exported the standard American diet, and so now the world is really suffering under the burden. But the good news is hey, I mean, hey look, the Reverse Mullet podcast is tuned into this. That's right, as are the thousands of physicians and medical professionals who are here, and this you know.

Susan Benigas:

Aclm is more than a medical professional association, it's a transformation catalyst right, that is such a magnet for purpose, passion driven medical professionals and healthcare executives who understand what's at stake, and they are committed to being the change they know that we so desperately need. And so ACLM, bringing everyone together, we represent a galvanized force for change, and it is unstoppable.

Ellen Brown:

Like I said, your whole organization is a unicorn. Like we say we're always looking for the unicorns in healthcare and I'm like ACLM. The entity is a unicorn. It's like at the global level.

Dave Pavlik:

So this is the 20th anniversary. It is so what do the next 20 years look like? Hey, you know what.

Susan Benigas:

I think we're coming into the bend of the hockey stick right, because when I joined 10 years ago, we had one part-time event coordinator and 380 members, and for the first 10 years, by and large, aclm had been a volunteer physician-led organization and when it started, it was MD, do, phd only. And then, in 2012, really recognizing the power of the interdisciplinary team, opened its doors to all members of the team.

Ellen Brown:

So I feel like in those years right because we were really, we've always been really involved with, you know, with payment transformation, so the early years of CMMI and value-based program development, and you know we were part of organizations doing the same work that ACOs were doing before there were ACOs, before there were acronyms right yes.

Ellen Brown:

And so, and then that it's that same timeframe, do you think that that is one of those examples of when that practice transformation concept came into healthcare? Then all of a sudden people like wait, lifestyle medicine is, is, is you know?

Susan Benigas:

you know it's so interesting. I do say that you know the probably the best thing that came out of the affordable care act was the accountable care organization. Right, because it finally was going to incentivize, you knowize, superior outcomes and cost containment. The problem was it was sort of like everybody was doing the same thing over and over again, expecting a different result.

Ellen Brown:

Well, we know what that leads to, right.

Susan Benigas:

And so we have been like on the sidelines going yeah, yeah, yeah, hey, we love the ACO model, but value-based care you cannot. It is impossible to optimize value-based care without a lifestyle medicine first approach. Unless you're identifying and eradicating the root cause of disease, it's impossible. So now that we've got the quintuple aim right, it's like you cannot achieve the quintuple aim, you cannot manifest whole person health, you cannot optimize value-based care or achieve patient-centered care or high-value care without a lifestyle medicine-first approach to healthcare. So I mean the momentum is there and the time is now, and there is really an awakening now that this is possible and it's being done in a way where, gosh, we have very in-depth reimbursement roadmaps and we're seeing clinical practice models and I mean people are doing this. We have doctors out there while others are saying oh, this needs to happen.

Susan Benigas:

We're doing it. We've got thousands of people here who, every day, in every state across this country, thousands of people here who, every day, in every state across this country, they are implementing intensive therapeutic lifestyle change in ways that people are experiencing health restoration and lifestyle. Medicine reignites the passion for why most went into medicine to begin with to become true healers.

Dave Pavlik:

Every single practitioner we've sat down with has stories about this transformation.

Susan Benigas:

Oh yeah, even members of our board of directors who say that they would no longer be practicing medicine if it weren't for lm.

Ellen Brown:

Not found aclm and lifestyle medicine, no, I mean we have clients in this room who we are helping with payment like we are helping them negotiate and, you know, make sure exactly to that point because I I actually, from my perspective, having been on the dark side for so long I believe that the barrier for this is the payment model at the large health system and at the large health plan level, that when you find that vertically integrated kind of more community-based, it's an easier piece, but it's not difficult. When you sit down with the CFO and you have the right stakeholders in the room and you explain, you show the massive savings. There's just not a there's not a common knowledge yet.

Ellen Brown:

And so we're here we are champions.

Susan Benigas:

Our firm is totally committed. We're so glad that you're doing what you're doing because you know, when we think about it it's like for whom is there immense profit in optimal health?

Ellen Brown:

Well, we know it's self-funded employers.

Susan Benigas:

Number one right, absolutely. It's self-funded employers, because you know, for them incentives are totally aligned.

Ellen Brown:

But they need those health care delivery models to deploy. They do, and so that's why you have to find those health systems or other delivery care models are saying okay, I'm willing to step up and do this and partner with you as the employer or the government or whoever the insurer. I'm willing, like Blue Zones Health right when it's like. I'm willing to create that care model and take that financial risk and be your partner to deploy this model for you, to save the money so that you can reinvest it. So we're in.

Susan Benigas:

Well, and now that we have, you know, thrown, we already have, by the time the end of the year comes, we will have over probably around 6,000 certified medical professionals in the. United States alone, and the fact that we can. You know, what COVID showed us as well, is that the deployment of even lifestyle medicine, shared medical appointments, the efficacy is equal to or even superior, when delivered, you know, virtually than even in person, and so the scalability is there for us to do what we need to do, and so you know, the time is now.

Susan Benigas:

It is.

Dave Pavlik:

Time is now so well, thank you for joining us, Susan, Well thank you for joining us.

Susan Benigas:

Susan Well, thank you.

Dave Pavlik:

Thank you for having us here Such a pleasure.

Susan Benigas:

Thank you for being here at Lifestyle Medicine 2024, helping to celebrate the 20th anniversary of ACLN.

Ellen Brown:

That's fantastic Way to bring it home. Thank you, okay. Catalyst for transformation yeah, applause, applause, yay.

Susan Benigas:

Thank you so much. Well, I hope you.