Why Medical Schools Need to Focus More on Nutrition
This piece appeared in The Wall Street Journal on October 10, 2019.
BY LLOYD MINOR
Ask any doctor, and they will tell you: One of the best ways to lead a healthy life is through proper nutrition. But don’t expect the topic to come up proactively. Today in America, nutrition is still rarely discussed during office visits because doctors seldom broach this subject with their patients.
Until nutrition becomes a consistent part of patient-doctor conversations, we will continue missing a major opportunity to help people live longer, healthier lives. And a good place to start is with medical education. Doctors have historically received almost no nutritional training, which limits their ability to effectively talk to patients about it. During four years of medical school, most students spend fewer than 20 hours on nutrition. That’s completely disproportionate to its health benefits for patients.
Worse, the limited time medical students spend on nutrition often focuses on nutrients—think “proteins” and “carbohydrates”—rather than training in topics such as motivational interviewing or meal planning. As a result, we physicians often sound like chemists rather than counselors who can speak with patients about diet, including how to make healthy, delicious foods on a budget or in ways that honor cultural traditions.
The nature of U.S. medical practice is also a barrier. Reimbursement for medical care in the West remains largely focused on treating illness, so doctors rarely dedicate significant time to disease prevention during patient encounters. Considering that the medical cost of diabetes in the U.S. is estimated at $245 billion a year, we would all be better off having conversations about eating better to avoid diabetes—a largely preventable disease—rather than providing resources to people only after symptoms appear.
While the simplest change would be to increase the time that medical students spend on nutrition education—something many institutions are now doing—this doesn’t account for the one million doctors already practicing in the United States, who are often pressed for time. We need other practical solutions for this group, especially given that the average patient visit in the U.S. is only 20 minutes, and expectations for what should be accomplished in those visits grows each year.
Fortunately, technology can play a key role in addressing the challenge. Online nutrition courses designed as continuing medical education can be a quick and highly effective way to provide physicians with practical information for engaging patients about nutrition. They can also provide a useful platform, outside of the doctor’s office, to help patients continue developing strategies and new skills for cooking healthy meals at home.
Physicians who completed Stanford Medicine’s Introduction to Food and Health CME course, for example, reported being far more likely to discuss various aspects of nutrition with their patients. And a formal study of a patient-facing version of the same course—with more than 200,000 people enrolled to-date—found that it produced positive changes in patients’ eating behaviors and meal composition at home.
Our food choices have an unparalleled impact on our health, and we can make better choices when physicians become more effective advocates for proper diet and nutrition. Making it easier for doctors and their patients to discuss nutrition in practical terms is one of the best methods we have to improve public health. Let’s start talking.