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"What do physicians think they need to know about nutrition?" — Qualitative study of physicians with formal nutrition training | BMC Nutrition

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Twelve participants consented to participate and entered the study (Table 2). Of these participants, 9 were physicians and 3 were medical students. Additionally, 11 (92%) of these participants were identified as female and 1 as male. The majority of participants (42%) were aged between 25 and 34. Those who completed medical professional training had 5 to 10 years of medical experience (58%). Most were general practitioners (58%) and had a bachelor’s degree in nutrition and dietetics (58%) before beginning medical studies.

Table 2 Demographics of interview participants

Qualitative analysis identified four key themes outlined below, further illustrated by the citations provided.

Theme 1: Identifying the Physician’s Role in Nutritional Care

Participants expressed different opinions about the role of physicians in nutritional care. Those with dietitian qualifications were more likely to perceive the physician’s role as facilitating referrals to nutritionists. “I think my role is similar to this ability to facilitate referrals. [how] You know, make that referral as early as possible so a nutritionist can provide you with the best possible care. ” (P7, Nutrition Background).

Recognizing when and how to consult a nutritionist took precedence over specific nutritional knowledge. Those who prioritized approval of referrals believed that different health professionals had a rigorous role in providing nutritional care and recognized dietitians as sole providers of nutritional care.Step on your toes” (P7, Nutrition Background).

Participants highly prioritized nutritional care provided by a nutritionist over providing nutritional care themselves. “I’m going to refer you to a nutritionist so he can spend more time with you and keep you up to date. I’d love to follow that nutritionist’s advice, they’re experts in their field.” (P10, Nutrition Background).

Despite having formal training in nutrition, some participants expressed lack of confidence in providing nutritional care, citing lack of nutrition practice, time, and outdated knowledge. rice field. For these participants, self-confidence and having a role in providing nutritional care appeared to go hand in hand, with participants with lower self-confidence being more likely to consult a nutritionist.

“I consult with nutritionists a lot. I don’t think I can replicate what they are doing. I don’t have enough practice, and I don’t have the time.” (P11, nutrition background)

Conversely, other participants believed that physicians should provide prescription nutritional advice to patients as part of holistic care. and therefore have a responsibility to provide nutritional advice.

“What you all are saying is the reinforcement of that. ” (P5, Nutrition Background).

Theme 2: It is important to understand the interrelationships of social determinants of health and nutritional status

Participants with a nutrition background noted the need for physicians to better understand the social determinants of health when providing nutritional care. We noted the lack of content in medical school curricula on conditions, and the impact and interrelationships of social determinants on health.

“I think [in the dietetics degree] We were like a semester-wide subject on things like the social determinants of health and nutrition. We explored what influences our own dietary choices and what may influence others, which I think is probably poorly understood among the medical community. increase. (P3, Nutrition Background).

Many participants observed that physicians lacked empathy about their patients’ social, emotional, or health conditions. Especially in obese situations, doctors try to minimize symptoms such as muscle pain. “It’s just a very complicated mix of things. Why they might be overweight and why they aren’t. It is clear that there is a lack of (P12, Nutrition Background).

Participants also reported that a lack of understanding of the social determinants of health can make patients feel stigmatized and lead to a lack of trust in health care professionals.

“In fact, many patients have recently asked me, ‘Why do doctors weigh me every time I have a cold? Why are they telling me to lose weight? I don’t think it’s a reaction, I see it all the time.” (P3, Nutrition Background).

Theme 3: Optimization of nutritional care through multidisciplinary collaboration

Participants reported a lack of cooperation between physicians and relevant health care professionals. Many called for stronger professional relationships between physicians and nutritionists to ensure continuity of care. “We need to put more emphasis on communication between teams, including physician and general practitioner support elements, team cohesion and allied care.” (P1, associated with the Special Interest Group on Nutrition).

Those with a nutrition background noted that collaboration between doctors and nutritionists was limited, and that both had preconceived notions and attitudes toward each other’s areas of expertise, suggesting that their respective professional skill sets He cited a lack of understanding and respect for

“It’s really interesting when people and people change their minds and communicate with me as a medical student, like, say, a nurse or an allied medical, who likes to talk about their background.” (P7, nutrition background)

Theme 4: Providing evidence-based nutritional care

Participants believed that nutrition education and advice from physicians should be evidence-based. “Physicians respond to the evidence base, so I think there are a few … I don’t know, what we can do about the long-term risk of cancer, what we can do about the risk. Presents and discovers some groundbreaking research. [of] Long-term heart disease, longevity, things like that. ” (P12 Nutrition Background).

There have been concerns about unfounded nutrition practices and stories of physician colleagues promoting “fads” or unevidenced diets. When asked for a solution to this, many agreed that graduates should have the same skills to critically evaluate the literature on nutrition as they do on other aspects of medicine and should consistently provide evidence-based care. It was recommended that there is

“I’ve personally met a doctor and he said, ‘Oh, keto is really good. You have to try keto. When I change my life I really hope it’s sustainable and B. It’s probably not very good because there’s a lot of saturated fat and stuff like that I might lose weight but how much does it cost does it cost?” (P3, nutrition background)