Does your doctor ever talk to you about nutrition or exercise? No? You’re not alone. Polling shows that fewer than one-eighth of visits to physicians include any nutrition counseling and fewer than 25 percent of physicians believe they have sufficient training to talk to patients about diet or physical activity. And the number of hours devoted to teaching future physicians about nutrition in medical school has actually declined recently, from 22.3 in 2004 to 19.6 in 2009. (The National Academy of Sciences says it should be 25 to 30 hours.)
Meanwhile, a good number of physicians are overweight and don’t exercise regularly themselves. And nearly 15 percent of Americans face food insecurity; it’s difficult to worry about adequate nutrition when your primary concern is making sure your children don’t go hungry.
This worrisome glimpse of one of the obstacles to addressing the U.S. obesity epidemic is contained in a comprehensive report scheduled for release Tuesday by a group of organizations that are calling for major changes in medical education and other aspects of the healthcare system to combat the chronic diseases that stem from our unhealthful lifestyle.
Along with the American College of Sports Medicine and the Alliance for a Healthier Generation, the Nutrition and Physical Activity Initiative of the Bipartisan Policy Center, a think-tank founded by four former U.S. senators, issued nine recommendations for reform.
The most far-reaching includes developing a “standard nutrition and physical activity curriculum” for the nation’s 170 accredited medical schools and other health professional schools, encouraging more testing on nutrition and physical activity when health professionals take licensing and certification exams, and providing better insurance reimbursement for preventive care such as nutrition and exercise advice. The latter must be done as part of a long-term shift toward more emphasis on prevention and less on cure, the group said.
“As long as the healthcare marketplace undervalues preventive care, healthcare professionals will lack financial support to address these issues with their patients and medical schools will have less incentive to train their students accordingly,” the report notes.
“As we’re discussing cost containment in healthcare, this [shift toward prevention] is a critical piece of cost containment,” Donna Shalala, co-chair of the Nutrition and Physical Activity Initiative, said.
The report notes that some of this is already occurring. The University of Colorado’s medical school has added nutrition education to instruction during all four years, and offers nutrition electives for internal medicine and pediatric residents. Faculty and students at the University of South Carolina School of Medicine in Greenville have organized nutrition and fitness activities.
And the trend toward private employers’ taking an active role in employee wellness continues to spread.