Nutrition and Medical Education
By Susan L. Valentino, Ph.D.

Medical education quite often falls short when it comes the nutritional aspects of health and disease Currently, 74% of all medical schools have no nutrition requirement. Unfortunately, since 1985 the percent of schools with programs in nutrition has been on the decline.

In 1969 Family Medicine was approved as a medical specialty, and nutrition has been an integral party of the Family Medicine curriculum. Until now the significance of this even has not been fully appreciated. A new age is on the horizon and America's health care system will demand fundamental changes in the way health care professionals are educated. The curriculum differences in Family Medicine were a good beginning. Medical knowledge is augmented by problem solving, counseling, family structure, and includes therapeutic and preventive nutrition concepts.

The shift from disease based care to preventive care will require the integration of nutrition education into all health science curricula. The problem with the lack of nutrition training and the absence of nutrition as a distinct medical specialty is that many physicians are unaware of the vital role that nutrition plays in health. Prevention and treatment of disease, normal growth, wound healing, and support of the immune system are areas where nutritional treatment protocols are invaluable. Another problem lies in the fact that the general public often considers the physician to be very knowledgeable about nutrition. Inadequate nutritional education in medical training also contributes to the emergence of so many self-proclaimed experts. Often there is little or no refutation from the medical community because it is ill equipped to respond to nutrition claims. This lack of understanding has also prevented many physicians from making regular use of health professionals in the field of nutrition.

The health education system in the United States must shift toward prevention and wellness. Eighty five percent of the illness experienced by the elderly can be prevented by nutrition and lifestyle intervention.

Often the reluctance of physicians to turn to nutrition services is due in part to the lack of adequate reimbursement for these services. For the most part doctors are ill equipped to provide nutritional guidance to their patients yet they continue to be viewed as experts in the area. The phrase "seek the advice of your doctor before starting this or any other diet" serves the public only in cases where a serious medical condition exists. Still, most individuals prefer to receive nutrition information from their doctor, and now doctors are jumping on the nutritional supplement bandwagon. Doctors who already have a large patient base and make 7digit salaries are increasing their annual incomes by selling supplements and nutraceuticals, once again pushing nutritionists out of the picture. The American Medical Association continues to lobby against the licensure of nutritionists while many doctors now make additional monies off the business of nutrition.

In a time during which scientific progress in the understanding of the interactions between nutrition and health is exploding and doctors could benefit from collaboration with nutritionist's, doctors continue to be arrogant in their assessment of patient needs. Even with the development of new devices, and laboratory methods for assessing nutritional status doctors are, for whatever reason, hesitant to consult with nutritionists.

Public demand together with advances in nutritional science and biomedical technology is gradually increasing the pressure on medical professionals to learn how to incorporate nutrition into their practice. However, instead of adding nutritionists to their staffs or contracting for nutritional consultation they attempt to understand nutritional physiology and biochemistry with no formal training. The medical community has dubbed this new profession "Nutritional Medicine". This puts me as an unlicensed "Medical Nutritionist" unnecessarily at odds with doctors when we should be allies. I don't practice medicine and doctors, in my opinion, should not practice nutrition.