I accidentally read a great article on the website Medscape. It was accidental because the title- “The Mediterranean Diet: Where ‘True’ Reform Misses the Boat”- was a little misleading with respect to the important message of the piece. Written by a practicing physician, the article reviewed, with a passion bordering on hopelessness, how our current medical and educational systems are failing to equip adults and children to be healthy, especially as related to food.
Dr. Melissa Walton-Shirley describes the current state-of-affairs as follows:
“But middle- and advanced-age patients, like the one who is the focus of this story, still face a life with no (healthy lifestyle) navigation system, and worse, they are now herded into healthcare arenas with time constraints and quotas. In many instances, they see physicians and healthcare providers who’ve had a collective five hours of nutrition training in their armamentarium. Those physicians are now servants to their new lord and master, the relative-value-unit (RVU) tally, which doesn’t reward a 45-minute sit-down talk about such menial issues. These patients are lost in a sea of disease- producing adipose tissue.”
Dr. Walton-Shirley pleads, “So, America! Government officials! Elected politicians! Dieticians! Educators! I need help. We’ve done a great job with “sex education,” but we need to busy ourselves with a rewrite of required curriculum of elementary and secondary education. We need to teach and test on what fuels and protects our bodies. We need to throw in important stuff like “which side of your body your gall bladder lives” and “how you feel when it gets sick.” We need to demand an hour of physical activity every day. We need to teach that lifesaving and life-preserving information with even more zeal than we teach a high-schooler how to put on a condom. We need a complete overhaul and rewrite of something more than lunchroom menus. God help (and I don’t ask that in vain) all of those folks who are caught in middle age or older with no tools to navigate what goes into their mouths. They are writhing with disease-producing fat lining their middles. They are breaking our budget. They are dying a slow, fairly miserable death. They are lost.”
The article goes on to concede that doctors “can’t do this alone.” This I agree with wholeheartedly, but I personally know hundreds, and know there are thousands more, dietitians and educators who would like nothing more than a patient referral from a physician who both recognizes that lifestyle support is necessary, and that they are not equipped to provide that service. And, we are perfectly educated, motivated, and thrilled to spend the necessary time, often reimbursed by insurance, to help these individuals.
I pointed out in my member’s newsletter on October 26th how this incredibly logical idea of getting people the specialized help they need for lifestyle support (especially people with diabetes) in a medical system that claims to be promoting prevention just doesn’t happen nearly often enough. And while it’s clear that government, insurance companies, and the patients themselves all drop their share of the proverbial ball, I’m sorry to say that way too often it’s the physician who simply doesn’t recognize the benefit or acknowledge their own limitation to provide the service that doesn’t take two minutes to write the referral. This does have to change.