By ALLAN DOBZYNIAK, MD
R.F.K. Jr. is mandating nutrition education for medical students. Certainly nutrition is an important part of health. But is teaching it as a course devoted to nutrition in medical school the best way to influence a general appreciation of good nutrition for our citizens?
In medical school and post doctoral training nutrition is generally taught related to illness. For example, a patient who has had a cardiac bypass needs a diet designed to achieve an ideal weight and decrease the LDL cholesterol to the data driven optimal range, likewise for diabetes. A risk factor analysis for heart disease would include cholesterol testing, perhaps coronary artery calcium scoring and diet adjusted appropriately. Dietary instruction would be done by referral to a nutritionist. It is not possible for a busy physician to sit down with every patient to discuss general nutritional guidelines. We already have an increasing scarcity of physicians with one of their most important and precious commodities being time.
To impact the population of the United States effectively regarding nutrition cannot be done by a limited number of doctors; it is impossible. Perhaps this public health goal of nutrition education is more appropriately a role for the government. Schools, parents and teachers are logical sources for such education.
Further, given the variety of medical specialties, this becomes nonsensical. Why does a neuro-interventional radiologist, an orthopedic surgeon, an endocrine surgeon, an infectious disease specialist, an intensivist etc. need to be bogged down by such tasks that are entirely irrelevant to his or her specialty?
There are appropriate roles for the government when it comes to public health. But what is being mandated by Mr. Kennedy is onerous, productivity sapping, suboptimal regarding outcome and an overzealous requirement for future physicians during their medical school education.