Performance Medicine: Owning Your Health

Dr. Rich Joseph, MD MBA
Dr. Rich Joseph, MD MBA
10 minute read
January 27, 2023
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As is true for many, my earliest awareness of health started with general puberty-induced body consciousness. Raised by a single mother, my family ate what was inexpensive, palatable, and quick. When I hit adolescence, my less than stellar eating patterns fueled excess weight gain and exacerbated the insecurity and self-criticism of a predictably tumultuous life phase.

When high school athletics took center stage, my world changed. I experienced an incredible surge of power as I learned to literally reshape my body through physical training. This was magic to me, as if I’d unearthed some innate capacity to manipulate my body and build my confidence. A decent student, I tapped into a new level of discipline that seeped into my academics and undoubtedly changed my professional trajectory.

I’ve subsequently spent my career—as a personal trainer, physician, and social entrepreneur – nurturing that same sense of agency in others. I do it through a life philosophy and clinical process that I call Performance Medicine.

Grounded in the science of behavior change, Performance Medicine is an approach to health that focuses on the imperative and rewards of improving physical, mental, and emotional performance right now. The essential prescription of Performance Medicine is simple: move. The power of physical activity not only improves overall health and wellbeing, but serves as a medium to enhance stress management, self-discipline, delayed gratification, comfort with discomfort, and an appreciation of process over outcomes. These are critical competencies in our exceedingly frenetic, distracted, dopamine seeking, and outcome grasping modern world.

What’s more, Performance Medicine advances more than just the health of a single person. By cultivating agency at the individual level, I believe we can transform entire communities.

The Need for Performance Medicine

 Preventive medicine is failing. Six in ten Americans have at least one chronic illness. Over 90 percent of U.S. adults are metabolically unhealthy. Musculoskeletal conditions are the largest driver of disability and lost productivity. And cardiovascular disease is our number one killer. And yet, prevention is not a pertinent, persuasive, or at all pleasurable proposition to patients. In fact, after years training as a primary care doctor, I can say with conviction that providers simply do not have the time, training, or team to provide the promise of prevention. Financial incentives of insurance-based care only serve to contort modern medicine into a deficit-oriented, algorithm-driven, episodic, and reactive transaction.

Most of us receive little-to-no expert health guidance and planning as we go through the day to day routines of building our relationships, careers, families—our lives. This lack of attentiveness impedes our ability to perform optimally and often allows maladaptive and even destructive habits to insidiously take root. As such, we engage in health only later in life when disease prevention cedes ground to disease management. It’s no different than seeking the wisdom of a financial planner after you’re broke.

We need a new paradigm.

The Transformative Power of Performance Medicine

Amid a global pandemic which magnified our own health susceptibilities and our nation’s ubiquitous health inequities, Performance Medicine has never been a more glaring need.

First, because the process of getting healthy confers values like self-respect, courage, and fortitude. Consistent and deliberative acts to protect and preserve our wellness are, in effect, statements that our lives have meaning. We are worthy of a vigorous and vibrant existence. Certainly, our genetics, upbringing, environment, and socioeconomic circumstances play an outsized role in our health status. But the decision to prioritize health expresses a willingness to confront the barriers that exist because you deserve to exist.

No doubt, this work of getting healthy is hard. Regardless of living situation, we’re all swimming in toxic environments that counter, subvert, or directly affront the hard-wired needs and rhythms of our human species. Our biology is based on an ancestral heritage of the communal hunter-gatherer while we are now largely sedentary, overly sated, chronically stressed, and mostly alone. That means that with the odds stacked against us, the very act of striving for health is courageous. Indeed, it’s precisely because improving our health is so challenging, however, that it’s so well-suited to empower.

"The very act of striving for health is courageous"

That defiance demands focus, foresight, and our full attention. This process is one that moves us from complacent extras in a play of our life, into protagonists in control of our stories. That transition has a contagious effect. When we become our own source of vitality, we infect others with the same sense of self-determination and resilience.

Secondly, staying healthy is an act of love. As a husband and father, I think often about how I show love. Birthdays and anniversaries entail the usual set of tangible or transitory gifts. Our health, conversely, is a sustained gift that represents a kind of “intent to stay.” It’s a statement that the lives of our loved ones matter, and therefore, we are determined to remain active participants for as long as possible. As a parent, perhaps my greatest responsibility is to consistently demonstrate the behaviors that prioritize self-care, confer self-respect, and build character and resilience.

Finally, the collective pursuit of health itself can be a catalyst for community transformation. We humans are interdependent and social creatures. We need a community to keep us safe, motivated, accountable, and well. So when communities come together to pursue and practice health as a shared goal, it fuels a virtuous cycle to advance collective prosperity. Moreover, as our health journey buoys a sense of confidence in our own lives, we are more apt to join forces and work collaboratively to take on other deeply rooted, structural injustices in the world around us.

Performance Medicine in Action

In practice, Performance Medicine is a medically supervised, coach-led approach to health that complements traditional primary care and occurs largely outside conventional healthcare delivery systems. Clinically, it focuses on increasing an individual’s adaptive capacity throughout life, building the behaviors that prioritize health and wellbeing, and developing the agency—among individuals and communities—that drives sustained contribution.

My clinical practice provides clients with a Performance Plan and Team, ongoing health metrics and monitoring, expert-led care and coaching, and access to a diverse network of specialist practitioners. We partner with Vital CxNs, a Boston-based nonprofit that strengthens historically marginalized communities by forging new partnerships and co-creating sustainable solutions for a more accessible, empowering, and equitable health ecosystem. Here at Restore, we have a tremendous opportunity to operationalize the core principles, practices, and prescriptions of Performance Medicine on a national scale to enhance the lives of many.

Own Your Health

As a physician, I know more intimately than most of the disempowering nature of the current healthcare system. Many patients feel unseen and lost amidst a shuffle of specialties and strangers who know little of their lives, challenges, and aspirations. Providers, too, often experience disillusionment and burnout, incapable of doing what is needed and best for their patients. We’re all left with a sense that the machine of modern healthcare has little to do with helping us lead healthier, more vital lives.

Health as a defiant, disruptive force has never been more important than now. As we recover from the worst health and social crisis in our lifetimes, our pursuit of health and wellness can cultivate the individual agency and shared humanity needed to build empathy, bridge divides, and reduce inequities.

My mission in this work is to help inspire, instruct, and enable others—individuals and entire communities—to truly own their health, and thereby, instill a sense of agency to direct their lives. With Performance Medicine, let’s usher in more preventative, empowering, and community-driven models of care.

Richard Joseph, MD, MBA, is the founder of VIM Medicine and co-founder of Vital CxNs, as well as the Chief Medical Officer for Restore Hyper Wellness.  

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