April 22, 2025, Matt LaMar —Family physicians know that the care they deliver in the clinical setting is vital, especially in moments of acute physical distress. But they’re also aware that many factors besides clinical care affect health outcomes.
“As it turns out, only 16% of your long-term morbidity and mortality is related to the quality of health care services that you receive,” says Meagan Grega, M.D., FACLM, DipABLM. “The biggest drivers of our longevity and vitality are our own health behaviors, the impact of the built environment around us, and educational and socioeconomic factors. To be effective as healers, we can’t just ignore that other 84%.”
Grega is the subject matter expert working on a new project examining how family physicians can increase their impact on community health. She, Julia Flax, M.D., in Springfield, Missouri; Jose Rodriguez-Garcia, M.D., in Phoenix; and Lindiwe Greenwood, M.D., FAAFP, in Columbia, Maryland, mean to answer an important question: How can family physicians best impact the lives of their patients outside the clinic?
While Grega notes that family physicians are generally focused on taking a holistic approach to individual health outcomes, intentionally integrating the pillars of lifestyle medicine to optimize healthy behavior choices is an effective strategy to support patients and communities.
The AAFP Whole Health pilot projects are underway in Springfield, Phoenix and Columbia. The goals for the pilot projects include
Each of the three physicians had a unique approach and goal for their community.
In Springfield, Flax partnered with Ozark Food Harvest and Umoja Food for Health to supply prescription food boxes to patients who have both food insecurity and medical dietary limitations. Rodriguez-Garcia worked with the Chicanos por la Causa and one·n·ten outreach programs with a community aim to help prevent HIV transmission within the Phoenix LGBTQ+ community while improving social connection and stress management strategies among participants. And in Columbia, Greenwood partnered with HopeWorks, Healing House and Edesiagurl to provide wellness programs integrating nutrition, physical activity, social connection and stress management for survivors of domestic and sexual violence. Their work is described in AAFP Whole Health Guide: Pilot Projects, which is supported by the American Academy of Family Physicians Foundation and the Ardmore Institute of Health.
They agree that the results have been positive for both physicians and patients.
“All three doctors have mentioned a lot of engagement by the patients involved in these initiatives,” Grega says. “But even more interesting is that the doctors, their clinical support staff and the community partners they are collaborating with are feeling so energized and excited about being a part of these programs.”
“I feel that this project has had a great impact on the community, not just because they told me, but also because of the changes in the participants that I saw,” Greenwood reports. “It also gave me the opportunity to forge relationships and collaborative efforts with other practitioners in the community.”
Grega says family physicians can take some key lessons into their own practices. One is simply to recognize how a patient’s life situation is central to health outcomes.
“We should elevate in our analysis and treatment plan the importance of the social ecosystem and the group around our patients,” Grega says. “How can we help them connect with social nudges that are going to be most supportive of their health, that also address the things that we are talking about in the clinic?”
In practice, this means building relationships with organizations that can contribute to whole-person health outside the clinic, such as food banks, the YMCA, community gardens, volunteer programs and walking clubs.
“If we talk to a patient in our office about changing their eating pattern, for example, it’s really hard to make those changes on their own if their social ecosystem is not supporting them,” Grega says. “These community-engaged lifestyle medicine and whole-health projects create a support group around the people that are engaged in it, setting them up for long-term success.”
AAFP Whole Health resources include testimonials from the three family physicians involved in the pilot projects in a three-part video series. Full data from the projects will be released in June and shared with members in AAFP News.