Wednesday, September 2, 2009

MD + RD = : )

The article, "Diabetics Be Aware: Doctors Are Not Dietitians," is brilliant. The title got your attention, didn't it?

Warning: stepping on soapbox today.

As a dietetic intern and diet technician in hospitals I felt like last man on the totem pole. The nutrition teams in hospitals have always felt like paper-pushers who crossed their T's and dotted their I's (I mean aren't all dietitians type-A freaks? - Ha!). Logistics and liability coverage only. Dietitians like myself are left feeling not only under-appreciated, but obviously under-utilized!

A newly diagnosed diabetic, for instance, may be getting their only nutrition education as they are being discharged from the hospital and wheeled out on a gurney. Literally. And if you think that's an exaggeration, I assure you it's not. I was the frustrated little intern running after that patient caring deeply for their disease state and prognosis.

I adore my current job and I can't help but make the connection between my job satisfaction...and the appreciation for dietitians among our providers! {{rainbows and clear blue skies}} Nutrition is a focal point of patient care at my clinics, ESPECIALLY among diabetics (duh, medical world).

So I get forwarded this incredible article today, written by a DOCTOR (Dr. Stephen Ponder)...who happens to be a type 1 diabetic AND an endocrinologist. The article proposes the vital role of a nutrition expert (dietitian) in the comprehensive care of a diabetic patient. I genuinely appreciate doctors and all that they do -- it's a ton! Yet, few doctors have the time or expertise to counsel a diabetic on proper diabetic nutrition. And MD's, for the record, "eat less carbs" won't do. It's not only incorrect information, but one must know WHAT a carb is to understand such a statement to being with.

The article states, "You should see a dietitian at diagnosis and periodically thereafter. Rememeber, doctors are not dietitians. I got little formal training in medical school on this subject. ...All diabetics need proper nutrition to maintain their health, not just pills or shots." [1]. Music to my RD ears.

Another important point to be made -- batting for the same team improves outcomes for all. Many of my patients are willing to hear me out (...and show UP to their appointment!) BECAUSE their provider emphasizes the role of nutrition in diabetes management. Having the MD's on board enables RD's to reach patients on a deeper level as the rapport begins building with the MD who coordinate the patient care.

Dr. Ponder is a type 1 diabetic working in pediatric endocrinology at the Children's Diabetes and Endocrine Center of South Texas at Driscoll Children's Hospital. Our team of RD's will be sending him a thank you card for his voice in support of nutrition and dietitians. Thank you!

P.S. Kristen (my ICU nurse friend in Chicago) -- don't forget to start your tube-feedings!!!!!!

[1]. Ponder, Stephen. Diabetics Be Aware: Doctors Are Not Dietitians. Caller. August 2009.

5 comments:

  1. Thank you, Thank you, and thank you again.!!!!
    Yahoo :)

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  2. Great post, again. I had seen that article, but did not read it. I agree with it though, 100%, and I'm glad someone published it! People need to know that we are RDs for a reason, and we do know more about nutrition than MDs!

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  3. Speaking as a nursing student and an ex-dietetic student, I just wanted to say that it's not the doctors fault so to speak. I think a lot of doctors agree that they are not the experts on nutrition, and that it would be very important to see a dietitian. I mean I think seeing a dietitian could cure probably 100% of the diseases out there. Now if only we could get the insurance companies to pay for it. I think this is the main reason more people don't see dietitians. The insurance companies would rather pay for the insulin shots and the hospital stays, that I feel would cost them way more money than if they would pay for a measley dietitian visit. Come on insurance companies....GET WITH IT!! :)

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  4. Eww PS I just realized that picture is of 5 dead mice. That's disgusting. Who would a. take a picture of that and b. make a poster out of it?

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  5. Kelly, I'm pretty much convinced you only read my blog to bust my chops! Kidding! I <3 you!

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