Last month, I reported on vitamin and mineral supplements that roughly half of all Americans routinely take and are said to make up 5 percent of all grocery sales in the United States. When faced with more than 90,000 dietary supplement products for sale, it is important to choose your sources carefully and with expert help.
Commercially available vitamins, minerals and herbs are all lumped together as supplements and are not regulated by the Food and Drug Administration. You can be assured of a product’s dosage, the correctness of its ingredients and that it does not contain toxins or contaminating organisms if the label shows it is certified as tested by independent labs such as U.S. Pharmacopeia, Consumer Lab or NSF International. Such certification will be visible on the product’s label.
I also tried to make clear that our bodies prefer naturally occurring sources of vitamins and minerals. Studies consistently show that people who eat diets rich in fruits, vegetables, nuts, whole grains and fish consume high levels of vitamins and minerals from them. As a result, they have a lower risk of many diseases, including heart disease, stroke, diabetes and cancer.
But some medical issues predispose people to vitamin deficiencies, which can be treated with various nutritional supplements. That is where targeted supplementation comes in and where some form of expert diagnosis and advice is needed. That advice is likely to come from one of the more than 600,000 physicians in the United States who spend the majority of their time in direct patient care. About a third of these physicians are specialists in primary care.
At least one reader wrote me advising that folks should never listen to doctors about nutrition. In many instances, they may be correct. According to a 2010 report in Academic Medicine, on average, U.S. medical schools offer only 19.6 hours of nutrition education across four years of medical school. According to a 2015 report in the Journal of Biomedical Education, only 29 percent of U.S. medical schools offer students a recommended 25 hours of nutrition education. It is also true that primary-care physicians are the product of a culture that, until recently, has overwhelmingly focused on pharmacologic treatments rather than lifestyle modifications. Not all doctors can be expected to be skilled at health behavior counseling.
New models of care are said to be emerging in efforts to confront the obesity epidemic and place greater emphasis on unhealthy lifestyles in medical training. Yet, according to 2010 research from East Carolina University, a gap remains between good intentions and patients who receive dietary advice from their doctors or are referred to dietitians.
Like it or not, physicians will remain on the front lines of counseling patients about diet, other lifestyle habits, targeted use of dietary supplements and the like. They deserve, if not our support, then certainly our understanding of the challenges they face.
Most primary care physicians have an estimated seven to 22 minutes to spend with a single patient. Medical appointments seem to get shorter by the year. This does not exactly create the best environment for health and lifestyle counseling. We need to know what’s behind these ever-shrinking clinical interactions.
Due to changes in how insurance companies and government pay for medical care, doctors are forced to allocate more of their time to documenting their care on a computer, filling out each patient’s electronic health record, or EHR. One study found that, on average, doctors now spend half their working time on these documents.
Today’s physicians, the product of 10 to 20 years of schooling, are now required to spend half their work time as medical clerks. According to a 2017 National Academy of Medicine paper, as a result, more than half of U.S. physicians are experiencing substantial symptoms of job burnout.
“We are losing the connection to the meaning and purpose in what we do, which is trying to provide care for patients,” Dr. Tait Shanafelt, a national leader in efforts to curb physician burnout, explained to NBC News. “Instead of that, we’re actually trying to please an insurance company.”
At the same time, sleep deprivation has become an issue for medical residents and practicing physicians like, thanks to their jobs’ cognitive and physical demands. According to a survey by Medscape, the suicide rate for physicians is among the highest of any profession – and more than twice that of the general population.
Fulfilling a changing role of providing lifestyle and health counseling while keeping up with the latest nutrition science cannot happen unless we allow doctors to concentrate on seeing patients – and let someone else concentrate on documenting things.
Write to Chuck Norris with your questions about health and fitness. Follow Chuck Norris through his official social media sites, on Twitter @chucknorris and Facebook’s “Official Chuck Norris Page.” He blogs at ChuckNorrisNews.blogspot.com.
