Confessions of Five Doctors: Dietitian’s Refute!
Have you ever wondered what doctors really think about their patients? Are they afraid of catching what you’ve got? Or, what do the medical notes really say about you?
Well, earlier this week I came across the article Medical Confessions, published in the Guardian newspaper.
The article indeed makes for gripping reading, however to say I was miffed by some of the content, would be putting it lightly!
Here are a few of the questions the doctors were asked, and their truthful responses:
#1 What are the most important factors in someone’s health? Their family history, their diet, or the amount of exercise that they take?
Dr Cancer
“In oncology, the family history is pretty important, diet and exercise less so.”
Dr Gynae
“Diet and exercise are hugely important, and they are the things to focus on.”
Dr Everything
“Still an evidential whirlpool. However, in my opinion, it is family history, followed by smoking and alcohol, followed by diet, followed by exercise.”
My thoughts
I absolutely agree that family history is very important. In terms of cancer, two-thirds of cancer cases are not thought to be related to lifestyle, and therefore there is little we can do to prevent the disease in these circumstances.
However, Professor Wisemen suggests that more than 3 million of the 10 million cases of cancer diagnosed across the world each year could be prevented if healthy lifestyle recommendations were followed.
We only have to read the Food, Nutrition and the Prevention of Cancer: A Global Perspective, previously discussed in Preventing Our Risk of Cancer, to find out just how important diet and exercise really are in the prevention of cancer.
It also surprises me that Dr Gynae is more ‘clued in’ than the other two doctors, give their field of expertise!
Does it seem to anyone else that Dr Cancer and Dr Everything have a bias against recognising the importance of diet and exercise as a necessity for good health?
Surely the evidence is already crystal clear that if we follow a healthy lifestyle, eating well, and exercising regularly we significantly decrease our risk of disease?
#2 Are you concerned about what your patients eat while in hospital?
Dr Cancer
“Yes, particularly as cancer patients have higher nutritional requirements than many others. Hospital food is generally pretty bad so it’s a good idea for relatives to bring in extra food. We often refer at-risk patients to hospital dietitians to make sure they are given supplements.”
My thoughts
A dietitian’s job is not merely to give out supplements! Yes, from time to time we do provide supplements to patients in need of a nutritional boost, but that is just one part of a number of other services available.
To suggest that a dietitian is called upon to “Make sure they are given supplements,” is a shamefully inaccurate understanding of the role of a dietitian in the care of cancer patients.
What is the role of hospital dietitians?
Dietitians are involved in promoting the well being of individuals and communities to prevent nutrition related problems.
They are also involved in the diagnoses and dietary treatment of disease, working with those who have special dietary needs, and providing unbiased advice for conditions such as:
- Kidney disease
- Food allergies
- Eating disorders
- Diabetes
- Obesity
- HIV/AIDS
- Oncology
- Gastroenterology
Aside from the above, a dietitian should also be involved in the education of doctors, nurses, and health professionals on matters relating to nutrition.
Maybe this is an area we need to work harder on? What are hospital dietitians doing in this area?
#3 What about the doctors own eating habits? Were they setting an example?
- What do you usually have for lunch? One response was “Sandwich, diet coke, bag of crisps.”
- What is your exercise routine? One doctor said, “As little as possible.”
- How many glasses of water a day do you drink? These answers ranged from usually none to three.
Need I say any more?
What barriers do doctors face?
A small South African study (2008) found that “Doctors who had a nutrition component in their training referred patients to dietitians more often than those who did not, and older doctors referred to a dietitian less often.”
Barriers for doctors regarding nutrition counseling:
- 45% said insufficient time was the strongest barrier to providing nutrition counseling to their patients.
- 49% said they were unaware of dietitians in the vicinity of their practices.
- 64% of doctors believed that better marketing by dietitians would increase their referrals.
This study draws attention to the responsibility of both dietitians and doctors to work together, with the goal of providing patients with a more efficient team approach to treatment, and the care service as a whole.
Concluding thoughts
I do realise the immense time constraints on doctors. However, I feel that it is extremely important that our medics recognise the importance of a healthy diet and exercise, not merely for obesity and diabetes, but also for other medical conditions, and subsequently refer patients to us for help.
Ultimately, if patients receive good quality nutritional advice and support, during their hospital stay, it can lead to a shorter duration in hospital, helping patients return home sooner. Isn’t this what everyone wants?
What are your thoughts on this? Have I been too critical on the medical profession? I’d love to hear from you!
Please be assured I do have the utmost respect for the medical profession as a whole, they are truly amazing in what they do!
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Mar 15, 2008
My dad is a doctor who also successfully battled pancreatic cancer. When he finished his treatments, he lost a total of 70 pounds, and his diet became even more important. He did and still does take supplements, because he was deficient in certain areas, but he places a great emphasis on proper nutrition. In order to regain his weight and strength, he had to monitor is diet to help optimize exercise. His cancer was not determined to be base on lifestyle, but he does emphasize that proper diet helps prevent many types of diseases. And although it doesn’t guarantee prevention of these diseases, it can greatly reduce the risk.
Mar 15, 2008
Hi Tom,
Many thanks for commenting! It’s great to hear about your dad, and his successful battle with cancer, thank you for sharing.
Mar 31, 2008
Totally agree with you.
The way i see it, control the controllable. You can’t control your family history but you most certainly can control diet and exercise!
Most people are only concerned about fat loss when they speak the word exercise. There are so many life long benefits to be had apart from that.
From an Australian perspective check these out..
Diabetes is an epidemic..
http://www.dav.org.au/epidemic/index.htm
The benefits of exercise aside from “weight loss” (cardio in this case)
http://www.lifeadvantage.com.au/benefitsofcardio/
90% of adults have risk factors they can change so why not do it? (source: http://www.aboutyourwellbeing.com.au/justthefacts/)
Apr 4, 2008
Hi Brendon,
Many thanks for commenting. I will check out the links listed above, and I really do appreciate you sharing them!