Physicians and Physicians and Nutrition Nutrition EducationEducation

Presented by:Presented by:Deena WangDeena Wang

Joceneia TimasJoceneia TimasCristina RosarioCristina Rosario

BackgroundBackground

Most Americans say that their physician is Most Americans say that their physician is their primary source for nutrition their primary source for nutrition information information

Nutrition education is not mandatory for a Nutrition education is not mandatory for a medical degreemedical degree Electives in nutrition are limitedElectives in nutrition are limited

Lack of communication between physicians, Lack of communication between physicians, nutritionists and dieticians nutritionists and dieticians

SignificanceSignificance

Without proper nutrition education, Without proper nutrition education, physicians are not able to give dietary physicians are not able to give dietary instructions to their patientsinstructions to their patients

Patients cannot always afford consults with Patients cannot always afford consults with dieticians or nutritionistsdieticians or nutritionists

The public can be mislead about proper The public can be mislead about proper nutritionnutrition

Goals and ObjectivesGoals and Objectives

Goal Goal Improve physicians’ knowledge of nutrition, so Improve physicians’ knowledge of nutrition, so

that they may better serve their patients’ that they may better serve their patients’ needs. needs.

Objectives Objectives To teach physicians nutrition principles To teach physicians nutrition principles Increase communication between Increase communication between

nutritionist/dietitians and physiciansnutritionist/dietitians and physicians

Who is involved?Who is involved?

ProfessionalsProfessionals Physicians and Family PractitionersPhysicians and Family Practitioners Nutritionists and DietitiansNutritionists and Dietitians Policy MakersPolicy Makers

OrganizationsOrganizations HospitalsHospitals Clinics/Healthcare CentersClinics/Healthcare Centers Medical InstitutionsMedical Institutions

EvidenceEvidence

How much does your Doctors know about Nutrition? The New York Times

“I know we’re supposed to know about nutrition and diet, but none of us really does.”

“Physician’s Nutrition Education Lacking” Surveyd 126 schools American Dietitian Association Separate nutrition course: 30 Minimum 25 h recommendation met: 40 Avg of 21 hours in 4 yr curriculum 93 (88%) needs more “Physician’s Nutrition Education Lacking”

“What Do Resident Physicians Know about Nutrition? An Evaluation of Attitudes, Self-Perceived Proficiency and Knowledge 94% - felt obligated to discuss with patients 14% - felt adequately trained

More EvidenceMore Evidence

Nutrition 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 Nutrition Incorporate nutrition assessment into busy medical practices Effective in helping patient overcome nutrition-related maladies

(ASNS, 2003)

Total Nutritional Therapy: A Nutrition Education Program for Physicians 2-day course in clinical nutrition Increased use of nutrition assessment Increased number of patients placed on nutrition therapy

(Nutr Hosp 2004)

Implications for Health Education Implications for Health Education & Program Planning& Program Planning

Raising physicians’ awareness of their Raising physicians’ awareness of their insufficient knowledge and education insufficient knowledge and education optionsoptions

Healthy PeopleHealthy People

Healthy People 2020Healthy People 2020 Objectives Retained But Modified From Healthy Objectives Retained But Modified From Healthy

People 2010People 2010 Increase the proportion of physician offices visits Increase the proportion of physician offices visits

that include counseling or education related to that include counseling or education related to nutrition or weight.nutrition or weight.

Implications (con’t.)Implications (con’t.)

Health Education Provide in-person training sessions and online

courses Evaluate effectiveness of training sessions and courses

ex. Nutrition Therapy & Nutrition Assessment

Coordinate patient care with other providers and other health institutions if needed Improve communication among nutritionist/dieticians

and physicians

Provide culturally relevant nutritional care to patients from multicultural backgrounds

Implications (con’t.)Implications (con’t.)

Health Advocacy Advocate to policy makers and medical school

administrators to implement mandatory nutritional education for physicians

Advocate to physicians the need for proper nutrition education and its benefits to their patients

Provide cultural competent health literacy materials for patients that are from other countries

Promote physician nutrition education at different health and academic institutions

ChallengesChallenges

Policies, costs, time constraints and proper nutrition education

It is difficult to provide the education at a specific point during a physician’s career

May seem relatively unimportant and it is difficult to provide nutrition education in already crowded medical curriculum of medical schools

Evaluation of training courses

QuestionsQuestions

Do 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?