Dispelling nutrition myths, ranting, and occasionally, raving

Doctors giving nutrition advice probably shouldn’t reference Pete Evans

13 Comments

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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.

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Author: Diana

I'm a registered dietitian from Nova Scotia, living and working in Ontario, Canada. My goal is to help people relearn how to have a healthy relationship with food.

13 thoughts on “Doctors giving nutrition advice probably shouldn’t reference Pete Evans

  1. Insightful and well-spoken…

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  2. There is no easy answer to the problem of a health care system that primarily treats the symptoms and not the cause of our overall poor health. Dieticians could have a dramatic impact on peoples health outcomes but not until they take a leadership role in promoting that fact and convince the Ontario government that their services should be covered by OHIP.

    We live in a time when people turn to the internet for information on almost everything. There is a tremendous amount of good information coming forward from Dieticians and yes even Doctors that are making people rethink their food and lifestyle choices. This is a good thing in my mind and should not be discouraged. I would rather that Doctors were dispensing advice instead of drugs which is what Dr Gary Fettke is trying to do.

    It is all about the outcome and not what got us there. I think we all want to see less disease and poor health surrounding us. How do we get there?

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    • In certain circumstances, it makes sense for doctors to be providing nutrition advice. Doctors should also receive more nutrition education. However, in the example in the article, the doctor in question was out of line. Healthcare professionals need to recognize their scope of practice and respect their fellow healthcare providers. Working collaboratively and realising the limitations of our knowlege as professionals is important in providing the highest standard of care to patients.

      I agree that all too often drugs are used as a first line of treatment and symptoms are addressed rather than seeking out the root cause of health conditions. However, there is still value in many medications for many conditions. There has to be a balance between the two approaches.

      I wish I knew how we could get to the point where we could start approaching healthcare as promoting wellness and preventing disease, rather than treating illness. I think it will take a massive overhaul of our current medical system.

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      • We will have to agree to disagree on wether the doctor in the article (Dr. Gary Fettke) is out of line or not. When an Orthopaedic surgeon is frustrated by the number of limbs that he has to amputate as a result of poor diet recommends dietary changes to his patients, that is a good thing. The fact that he established a clinic in his home town staffed exclusively by Registered Dieticians, Nutritionists and a Credentialled Diabetes Educator says a lot for his desire to encourage change for the better.

        As for our health care system moving to promoting wellness and preventing disease I think that will be driven by the people that use the health care system. People are starting to realize that our health is worsening when we should in fact be getting healthier. Knowledge is power and people are becoming more knowledgeable about the effects that food have on their health. You see it in the whole foods plant based philosophy that many are adopting and the organic non GMO food availability. I do not believe that we can count on any level of government to make change happen. It will be driven by economics more then anything.

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      • He was out of line. If he wants to give nutrition counselling to patients at the hospital, he can study nutrition, become a registered dietitian, and take a position as a dietitian. His establishment of a clinic staffed by RDs and nutritionists is irrelevant to the matter at hand. His providing nutrition advice is like if I decided to provide mental health counselling just because I have a degree in psych.

        Unfortunately, people think they are becoming better informed about nutrition by reading misinformation on the internet and watching sensationalistic documentaries.

        It’s very frustrating to work in a profession that is constantly undermined by charlatans so it really gets under my skin to see other medical professionals doing so.

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      • Thats not really agreeing to disagree thats saying my opinion does not count. I apologize for getting you riled up and will refrain from commenting.

        I do hope that you continue to promote good nutrition as we need more of that.

        Rob

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      • No need to apologise. I’m not riled up. It just seemed from your response that my point may not have been clear. You are welcome to comment anytime.

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  3. The surgeon in question seems to stray outside his scope of practice in other areas as well, he also makes some interesting comments in regards to cancer, he appears to claim superior knowledge to oncologists and researchers. In particular, he claims that sugar causes cancer growth.

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  5. The claim in the article that he is simply “discussing in broad principles the health benefits of reducing sugar and processed foods” needs to be put into the context of his definition of “sugar”.

    http://www.nofructose.com/introduction/carbohydrate/

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  6. So my oncological surgeon shouldn’t have advised me to exercise, my GP shouldn’t have taught me to meditate and my dentist shouldn’t have told me to avoid sugar and refined carbohydrates. When in hospital, the “nutritionist” tried to fed me watery porridge with skim milk, orange juice and toast with margarine (the evening meals were no better). I wouldn’t feed that to my dog.

    Fortunately, my beautiful wife knows what a healthy diet entails and fed me properly,

    Thanks for your input Rob; I’m right behind you here. I have listened to the good doctor and he makes total sense.

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    • There’s a difference between giving general healthy lifestyle recommendations that are within scope of practice and providing advice that is outside of one’s expertise. The examples you provide are perfectly reasonable recommendations given by healthcare professionals.

      I can’t speak directly to your experience without knowing the details. However, hospital food is notoriously poor, unfortunately. For the most part dietitians have very little control over that. I’m sorry to hear that you had that poor experience but please don’t let it negatively influence your opinion of all dietitians.

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