What’s Missing At Your Doctor’s Office?

Part 1

“Unless someone like you cares an awful lot, nothing is going to get better. It’s not”

-Dr. Seuss

You may be so pleased that you finally found a doc that was referred to you by a friend and can miraculously see you in less then 4 weeks. You are excited to be proactively taking steps to decipher the unhappy conundrum your body has presented you. When your appointment arrives, you happily greet your new medical team – a nurse practitioner, medical assistant and primary care physician. They tell you that given your family’s predisposition to diabetes, age, a body weight that is 27 pounds over the current “acceptable standards” and your history of hypoglycemic episodes that you are at high risk for type 2 diabetes. They’d like to run some blood tests to see where you are with that risk. Your nurse practitioner tells you to stop eating “sugar” and to drink less alcohol. “Eat less processed foods and start exercising” she says. Your 15 minutes of medical stardom is over.

One week later, you get a call from your new doctor’s office telling you that you are pre-diabetic and that you should not eat sugar, drink too much alcohol, and to start exercising. You can try to see a dietitian but will need to call your insurance company first as it may not be covered. Good luck. Yes – best of luck to you in figuring this out. What exactly to eat, how to cook, what to buy, what recipes to look for, how to pack a lunch, what to eat for breakfast, how to eat when going out? Maybe you are uber-savvy when it comes to things or maybe – as true for the general population, you have no idea where to begin.

Before the nursing shortage in the 1970’s, dietitians were paid equally to nurses. When I worked at a small hospital in New Jersey in the 1990’s, dietitians were part of a team of health care practitioners – a team that consisted of a social worker, a medical assistant and a nurse. When you go to your doctor’s office now, what are they doing for preventative medicine? Do they insist that even for 5 minutes, a nutritionist or dietitian review healthy eating with you and help trouble-shoot your diet if need be? Very likely no – there are very few nutritionists in doctor’s offices but it is precisely the place where they are needed the most. You likely won’t see them there because there is no funding for them. Nutrition – now touted as one of THE most important factors affecting your health has no support by insurance companies or the government.

Nutritionists and dietitians that undertook their studies with the desire to impart life-changing habits in people and to genuinely help those in need clamor to find meaning in their choice of profession. Many times, they go out on their own to open up a private business in hopes that insurance reimbursement will help support their business. Reimbursement will typically cover a few visits for diabetes, obesity and eating disorders. Why is one of the single, most important aspects of our health passed over for the subsidization of prescription medications and a 15-minute visit with your doctor? Haven’t we worked harder in life than this?

For now it seems that meeting with a nutritionist might be like getting a massage – it seems like a luxury service that you can maybe do without. It’s not. Everyone needs help in this respect – even other healthcare professionals. It’s overwhelming to get advice from social media groups and on-line forums. Get help from a professional – someone who went into this business specifically to give you a hand. Maybe ask around for a really great nutritionist/dietitian you can work with. It’s not a luxury –it’s your life!