I saw this article last week and had mixed feelings about it. I know that we were all supposed to read it and be horrified that a doctor was reprimanded for giving patients nutrition advice. After all, shouldn’t doctors be doing more to help patients manage their health through lifestyle changes? But… there’s so much that this article doesn’t tell us.
Just to start by clearing the air, obviously you all know that I’m a dietitian. Of course I’m going to feel a little defensive of my profession. The orthopaedic surgeon in question was undermining recommendations given by dietitians at the hospital where he worked. All because he had studied some nutrition on his own. Can you even imagine the outrage that would occur if the tables were turned and a dietitian undermined advice given by a doctor?! I’m certain that the RD would lose her (or his) licence, not just be given a slap on the wrist and told to stop working outside the scope of their practice.
Everyone think that they’re experts in nutrition simply because they eat (yes that’s hyperbole, please don’t send me your #notalleaters comments). So many people believe that doctors are all knowing. Unfortunately, it would seem that some doctors fall prey to this mode of thought as well. Doctors specialize. A doctor who works in oncology is going to have an entirely different knowledge-base and skill set from a doctor who works in neurosurgery. Doctors should not be expected to know everything. Yes, family doctors should be better equipped to provide nutrition advice but an orthopaedic surgeon should defer to the dietitians on-staff. It takes an incredibly high level of self regard to believe that you are more of an expert in a field in which you did a little self-study than a regulated health professional who studied the subject for over four years, is immersed in it on the job, and who must complete on-going education to maintain their credentials.
There’s some amazing irony in the article as well. The author references a television episode with the doctor in question and celebrity chef Pete Evans. For those who are unaware, Evans is a notorious charlatan and has faced entirely warranted criticism for promoting unsafe infant diets amongst other questionable nutrition practices. A few paragraphs down, the author goes on to say:
In addition there are numerous unqualified “gurus” giving advice about what we should and should not be eating. Surely it is preferable to have a doctor giving nutrition advice rather than unqualified individuals, many of whom have a product or program to sell.
Um HELLO??? Pete Evans is the epitome of the unqualified guru with a product to sell. Just prior to this statement, the author even admitted that the majority of doctors receive very little formal nutrition education. So, no. It’s not preferable to have a wholly unqualified doctor providing nutrition advice to people. In a way, it’s worse than having a self-proclaimed “guru” providing nutrition advice because people trust their doctors.
If the doctors referred to in the article truly cared about the well-being of their patients they would refer to appropriate professionals when needed, including registered dietitians. They should also work together with those professionals to provide the best care possible for their patients. Rather than assuming that they have superior knowledge of a subject which they were not adequately trained in.
How about rather than complaining foul when someone is rightly called-out for practicing outside their scope of practice, we talk about the real problem here. That our healthcare system is designed to treat illness rather than prevent it from developing in the first place.