Want to know what doctors know about nutrition? If you’re a dietitian, wondering if the doctors you’re working with know more than you do, because they’re, well, doctors – this is to reassure you they don’t.
This is what I’ve learned from teaching medical resident interns about medical nutrition therapy. Hint: you know more than they do.
So what DO doctors know about nutrition?
Here’s the short answer: when it comes to medical nutrition therapy, you know more than doctors do. Way more.
After teaching medical students about nutrition, I can confirm for you that they don’t learn nutrition in med school. They also don’t learn it as interns doing medical rotations.
Crazy, but true!
Can doctors give nutritional advice?
Yea, they can. But it doesn’t mean they should. After all, they’ve had about zero training in the area.
Most medical interns don’t know what someone’s estimated nutritional needs are and they certainly don’t know how to calculate that. Most of the time, med students don’t understand why there’s such a large range when determining caloric or protein needs in the first place. And they certainly don’t always make the connection between lab values and nutrition needs.
Lastly (and most importantly), they usually don’t really care.
There is so much information new doctors are constantly gathering. Understanding the details that go into determining tube feed requirements or why you’re insisting on a low sodium diet instead of a cardiac diet, just aren’t a priority to them.
New doctors are learning to be expert generalists in medicine. They aren’t yet specialists anything, which means they’re absolutely not specialists in everything.
This of course, includes nutrition.
It’s the dietitian’s job to know the nutrition side of healthcare, and as dietitians we should take ownership of this information.
Dietitians are THE nutrition specialists of healthcare
Just as there’s a need and a place for those who have a strong handle on general medicine, there’s also a need for those with a strong handle on a specialty. No one can know everything, and this is exactly the reason why referrals in health care are so important.
This again, of course, includes nutrition.
Need a non-nutrition example?
Most general MDs can of course prescribe medication to help manage all sorts of medical conditions. Many do in fact set their patients up with beta blockers, diuretics and instructions to avoid salty food. Or they’ll start a patient on Metformin with instructions to avoid all potatoes and bread when their A1C levels begin to elevate.
But just because a doctor CAN provide nutrition information, doesn’t mean they’re the ones best qualified to do this part of the job.
Patients get sent to a cardiologist when there’s a heart concern or should be getting a referral to an endocrinologist when there’s blood sugar issues. Not because their primary care doctor is incompetent, but because they are highly competent and understand their limitations. Good doctors know that a health care specialist is going to support their patient better than they can support them by treating them alone.
Likewise, just because a doctor CAN provide dietary information, doesn’t mean they’re best qualified to do that either. This is your job – the job of a dietitian. You’re the nutrition professional in the room. Own that confidence as a dietitian and remember you’ve been trained for this.
Know your worth as a dietitian
Self-doubt as a dietitian (especially when you’re new) is normal. It’s also totally unnecessary.
As a new dietitian just working through your internship, there are a lot of chances to worry all about what you know and don’t know. It’s also easy to defer to someone with the more respected title of doctor — and then conveniently forget that they don’t know the medical nutrition therapy that you know.
Unfortunately, this battle doesn’t stop once you’re an experienced dietitian.
Even with confidence in your skills and knowledge, having to regularly prove your worth can take a toll. Dealing with doctors (both new interns and experienced MDs) can be an exhausting experience.
Just because nutrition isn’t their specialty doesn’t mean new doctors won’t assume they know what you know (or more). There are egos. There’s confusion. There’s misinformation coming from people who have been educated to believe they have all the information.
For all these reasons, being able to stand up and talk to other medical professionals with confidence and be able to justify your medical nutrition therapy decisions is a major part of being a respected member of the interdisciplinary team.
Because, at the end of the day, no matter what is said (or believed), medical students and doctors who do not have a specialization in a nutrition-related field are not registered dietitians or qualified to educate or support a patient’s nutritional well being the way you are.
Always remember that the nutrition knowledge you have is a key component to a person’s overall health status is something to never forget.
Dietitians are nutrition specialists is a mantra you should hold onto and repeat to yourself every single day.
And That’s It!
Keep your chin up and do whatever it takes to remember you know your shit.
I like affirmations, post-it notes (everywhere) and that tried and true, fake it till you make it. If it works for Rihanna, it can work for you too.
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