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.

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