PowerPoint Presentation

Physicians and Nutrition EducationPresented by:Deena WangJoceneia TimasCristina Rosario

BackgroundMost Americans say that their physician is their primary source for nutrition information Nutrition education is not mandatory for a medical degreeElectives in nutrition are limitedLack of communication between physicians, nutritionists and dieticians

SignificanceWithout proper nutrition education, physicians are not able to give dietary instructions to their patientsPatients cannot always afford consults with dieticians or nutritionistsThe public can be mislead about proper nutrition

Goals and ObjectivesGoal Improve physicians knowledge of nutrition, so that they may better serve their patients needs. Objectives To teach physicians nutrition principles Increase communication between nutritionist/dietitians and physicians

Who is involved?ProfessionalsPhysicians and Family PractitionersNutritionists and DietitiansPolicy Makers

OrganizationsHospitalsClinics/Healthcare CentersMedical Institutions

EvidenceHow much does your Doctors know about Nutrition? The New York TimesI know were supposed to know about nutrition and diet, but none of us really does.Physicians Nutrition Education Lacking Surveyd 126 schools American Dietitian AssociationSeparate nutrition course: 30Minimum 25 h recommendation met: 40Avg of 21 hours in 4 yr curriculum93 (88%) needs morePhysicians Nutrition Education Lacking What Do Resident Physicians Know about Nutrition? An Evaluation of Attitudes, Self-Perceived Proficiency and Knowledge94% - felt obligated to discuss with patients14% - felt adequately trained

More EvidenceNutrition Education for Physician, Medical school Review (1978-1995)Effective: family practice residency, noon time lecture conference series model, registered dietitians involvement Innovative Teaching Strategies for Training Physicians in Clinical NutritionIncorporate nutrition assessment into busy medical practicesEffective in helping patient overcome nutrition-related maladies(ASNS, 2003)Total Nutritional Therapy: A Nutrition Education Program for Physicians2-day course in clinical nutritionIncreased use of nutrition assessmentIncreased number of patients placed on nutrition therapy (Nutr Hosp 2004)

Implications for Health Education & Program Planning Raising physicians awareness of their insufficient knowledge and education optionsHealthy People

Healthy People 2020Objectives Retained But Modified From Healthy People 2010Increase the proportion of physician offices visits that include counseling or education related to nutrition or weight.

Implications (cont.)Health EducationProvide in-person training sessions and online coursesEvaluate effectiveness of training sessions and courses ex. Nutrition Therapy & Nutrition Assessment

Coordinate patient care with other providers and other health institutions if neededImprove communication among nutritionist/dieticians and physicians

Provide culturally relevant nutritional care to patients from multicultural backgrounds

Implications (cont.)Health AdvocacyAdvocate to policy makers and medical school administrators to implement mandatory nutritional education for physiciansAdvocate to physicians the need for proper nutrition education and its benefits to their patientsProvide cultural competent health literacy materials for patients that are from other countries Promote physician nutrition education at different health and academic institutions

ChallengesPolicies, costs, time constraints and proper nutrition educationIt is difficult to provide the education at a specific point during a physicians careerMay seem relatively unimportant and it is difficult to provide nutrition education in already crowded medical curriculum of medical schoolsEvaluation of training courses

QuestionsDo you think physicians should be educated in nutrition or should they just refer to nutritionist/dietitians?When would you give physicians nutrition education? During pre-med, medical school, residency, or later on? How much nutrition education do you think is appropriate?

ReferencesPhysicians' Nutrition Education Lacking, American Dietetic Association, Retrieved on http://www.medicalnewstoday.com/articles/42226.phpVetter, et al (2008) What Do Resident Physicians Know about Nutrition? An Evaluation of Attitudes, Self-Perceived Proficiency and Knowledge Division of General Internal Medicine, Section of Primary Care, Department of Medicine, New York University School of Medicine, New York, New York Retrieved on http://www.jacn.org/cgi/content/abstract/27/2/287Kelly et al (2008) Status of nutrition education in medical schools. Department of nutrition, University of North Carolina. Retrieved on http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2430660/?tool=pubmedNovick, Jeffrey S. (2000). Effects of a Nutrition Education Program on the Related Knowledge and Behaviors of Family Practice Residents, Dept. of Family and Consumer Sciences, Indiana State University. Retired on http://www.beyondveg.com/novick-j/nutrition-education/physicians-1.shtmlThoresen, L., Rothenberg, E., Beck, A. M., Irtun, . and on behalf of the Scandinavian Nutrition Group (SNG) (2008), Doctors and nurses on wards with greater access to clinical dietitians have better focus on clinical nutrition. Journal of Human Nutrition and Dietetics, 21:239247.Walker W. (2003). Innovative Teaching Strategies for Training Physicians in Clinical Nutrition: An Overview. Division of Nutrition, Harvard Medical School. Retrieved on http://jn.nutrition.org/cgi/content/full/133/2/541SHealthy People 2010 & Healthy People 2020 http://www.healthypeople.gov/Waitzberg, DL (2004) otal Nutrition Therapy, A Nutrition Education Program for Physicians, Nrtr, Susp. Retrieved on http://www.scielo.isciii.es/pdf/nh/v19n1/original.pdf