Does your doctor really know what you should be eating?

For years, it has been widely known throughout the medical profession that basic education in nutrition for training physicians has simply been ineffective.  And whether this failure was due to a lack of time or simply a failure of emphasis, the point remains that the medical profession in general is woefully inadequate when it comes to a sound knowledge base related to nutrition and its effects on optimal health.  And the sad thing is that we all know it.

As early as the mid-1980’s, the National Academy of Sciences addressed this failure in a landmark report highlighting the lack of adequate nutrition education in medical schools.  And although the authors recommended a minimum of 25 hours of nutrition instruction, since then several studies have identified that as many as three decades later, a majority of medical schools still fail to meet these basic recommendations.

What we eat plays an enormous role in our ability to ward off disease and achieve good health, overall.  In addition, what we eat both before and after surgery can have a dramatic effect on how well we ultimately heal.  As a result, some physicians will check blood protein levels prior to major surgical procedures as a means to predict overall healing.  The less optimal the protein levels are, the greater the potential for delayed wound healing and other related complications.

Our patients are literally hungry for information on what they should and should not eat.  Wondering about the level of interest your patients have?  Then go to your local bookstore and look at the myriad of new diet books.  Along with self-help, books on diets and nutrition are traditionally some of the most popular topics readers are looking for.  And the reason there are so many is that none of them really solve the problem and there is simply no one-size-fits-all approach that works for everyone.

Another issue which has contributed to this illiteracy is the continued focus on nutritional training for generalists.  Although I would agree that family practitioners and internists spend more time discussing general health with their patients, I feel that the specialists are also missing out when they don’t take the opportunity to do the same.  As a plastic surgeon, I feel that it is critical to look at the whole patient and not simply their isolated part.   A landmark study from the UT Southwestern Plastic Surgery Department several years ago identified three key elements in achieving long-lasting results after body contouring and included the following:

  • Choice of surgeon (e.g.:  experience and technical expertise)
  • Overall diet
  • Level of physical activity

The last two elements are within the patient’s control and play a huge role in achieving good results years following their procedure.

Study after study confirms the fact that most patients actually do listen to their doctors and respect their opinion.  That being said, it is critical that we as physicians gain enough knowledge and background to be able to at least initiate an intelligent discussion related to our patient’s daily diet habits and fill the current void with solid evidence-based information.  After all, as specialized or as generalized as we all are, dispensing good information to our patients is simply good medicine.

Gregory A. Buford is a plastic surgeon and blogs at be for living.

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