1. Physicians and Nutrition Education Presented by: Deena Wang JoceneiaTimas Cristina Rosario

2. Background Most Americans say that their physician is their primary source for nutrition information Nutrition education is not mandatory for a medical degree Electives in nutrition are limited Lack of communication between physicians, nutritionists and dieticians

3. Significance Without proper nutrition education, physicians are not able to give dietary instructions to their patients Patients cannot always afford consults with dieticians or nutritionists The public can be mislead about proper nutrition

4. Goals and Objectives Goal 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

5. Who is involved? Professionals Physicians and Family Practitioners Nutritionists and Dietitians Policy Makers Organizations Hospitals Clinics/Healthcare Centers Medical Institutions

6. Evidence 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

7. More 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)

8. Implications for Health Education & Program Planning Raising physicians’ awareness of their insufficient knowledge and education options Healthy People Healthy People 2020 Objectives Retained But Modified From Healthy People 2010 Increase the proportion of physician offices visits that include counseling or education related to nutrition or weight.

9. 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

10. 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

11. Challenges 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

12. Questions 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?

13. References Physicians' Nutrition Education Lacking, American Dietetic Association, Retrieved on http://www.medicalnewstoday.com/articles/42226.php Vetter, 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/27/2/287 Kelly 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=pubmed Novick, 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.shtml Thoresen, L., Rothenberg, E., Beck, A. M., Irtun, Ø. 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: 239–247. 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/133/2/541S Healthy 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