I know I am “preaching to the choir” here, but for the sake of argument, let me ask this question, “What if nutrition interventions were put into action earlier and more proactively?” If we agree that preventative health is crucial, how do we achieve this to a greater degree and increase our reach? Moreover, why isn’t more being done to prevent the growing number of hospital admissions for conditions with a significant nutritional component in the first place?
I have had the pleasure of working with some of the finest physicians I believe the world will ever know. My experience working with Vancouver Coastal Health has led to a multitude of collaborative opportunities with doctors to provide the best patient care, mostly in inpatient settings.
While working in the clinical world, days turned into months, months turned into years, and before I knew it, three years had passed since I graduated. During the last year or so, I’ve found myself asking the question, “How do we keep more people from being admitted to the hospital?”
I like working with inpatients and there is satisfaction in improving their nutrition status post admission, but so many patients are admitted each year for conditions where the diet plays an integral role. These patients could’ve made positive changes way before landing in the emergency room.
When a member of the general public gets sick, they don’t make an appointment with a dietitian. Most people go see their family physician or specialist for treatment and advice. Physicians are the first point of contact to provide a nutrition intervention, if warranted, before a dietitian ever gets consulted, if at all.
The truth about medical training
The evidence is overwhelming that there is a deficiency of nutrition education in medical training. Only a relatively small percentage of physicians currently use nutrition-related resources in their clinical practices, and continuing education initiatives targeted at physicians to enhance nutrition education are desperately needed.
It wasn’t until a fellow dietitian introduced me to Dr. Karlinsky that I had the opportunity to discuss my concerns with a physician in an intentional and meaningful way. During my initial meetings with him, he was very candid and humble in confirming that, at least in his own experience, there was very little nutrition education built into his medical program. Dr. Karlinsky identified a need for this training that was indisputable.
The only question remaining was: How do we design a program that engages doctors in a fresh and fun way and also provides them with continuing education credits (so there’s more incentive to attend)?
Colouring outside the lines
At our very first meeting on an early Saturday morning back on March 7, 2015, we identified what our individual strengths and weaknesses were and how they would (or wouldn’t) serve the target population’s learning needs and objectives. We also reviewed successful models of the creative approach we aspired to emulate, most notably of all the culinary medicine program at Tulane University in New Orleans, LA.
It didn’t take long before we agreed that in order for us to focus on our strengths (medicine and nutrition), we needed to invite a professional instructor to teach the culinary objectives and deliver the food demonstrations.
We met Chef Tony while looking for a venue that could host our program. He echoed the need for better food and nutrition education for physicians, for both the sake of the greater population, as well as the health of physicians themselves. (Oh, and Tony’s state-of-the-art professional culinary school, the Northwest Culinary Academy of Vancouver, won us over as well.)
The pieces slowly began to fit together and before long, Dr.Karlinsky, Chef Tony, and I had designed an innovative workshop that invites two way communication and discussion amongst the “lecturers” and students. We decided to name the workshop The Physician in the Kitchen. Each session integrates evidence-based nutrition information, chef-led demonstrations, and hands-on kitchen work in a communal and interactive learning environment, with the goal of educating physicians (and allied health professionals and students).
Keep moving forward
After a lot of planning and hard work, our first culinary medicine workshop will be held in mid-November! While it is our sincere intention to create positive change by sharing this concept, no one can tell the future. However, I am very excited to see how this program grows and evolves over time.
My hope for this program is that physicians will feel comfortable enough after this training to provide basic diet education to their patients and give them reliable, consumer friendly handouts (e.g. from PEN, Dietitians of Canada, or HealthLinkBC). In the long term, I hope this program leads to more physicians understanding the important work that dietitians, working in all different areas (clinical, community, private practice, food service), do each day. And perhaps, the spotlight on nutrition that this program provides will foster more interest in this area, as well as an increase in physician referrals to dietitians. I’m also excited to see the outcome of this close collaboration between a physician and dietitian.
I can only imagine how different the world will be when physicians are better equipped with nutrition knowledge to use as part of their toolbox in improving the health of their patients. Maybe, just maybe, it will lead to shorter emergency room wait times, fewer hospital admissions, and a healthier population that enjoys a higher quality of life.
Editor's note: For many dietitians, educating members of the healthcare team about our diverse and unique roles is an important part of advocating for our profession. Angel's program is a unique example of this.
Have you taken the initiative to educate other healthcare professionals about our role as dietitians? Tell us about your experience!
Please share your thoughts or question for Angel below in the comments section.