Marty’s Corner - Informatics to Help Achieve Positive Goals
A good friend confided in me recently about how her increased degree of overweight is interfering with normal daily functioning. For example, she is now unable to tie a shoelace or pick things up off the floor without a using a claw tool to grab them. Her COPD interferes with her ability to exercise as much as she’d like. She has begun inquiring about bariatric surgery but was told that one requirement in order to be considered for the surgery is to see a physician regularly for six months for weight loss counseling. Now, we all know that most physicians receive very little nutrition education in medical school, and most readily recognize that a registered dietitian nutritionist (RDN) is far more expert in this area than they are.
Unfortunately, current CMS (Centers for Medicare and Medicaid Services) regulations state that the “primary care practitioner” (physician, physician’s assistant, nurse practitioner), not the dietitian, is the only person qualified (for CMS purposes) to perform weight loss counseling.1 My friend has been seeing a dietitian regularly for the past year, yet those visits don’t “count” in terms of fulfilling her hospital’s requirement that would make her eligible for bariatric surgery. There is a bill before Congress called the Treat and Reduce Obesity Act that would include the dietitian (finally!) as a healthcare professional qualified to perform this service. This bill has been before several sessions of Congress in the past, and, in this writer’s opinion, is certainly one that needs to pass, and should with bi-partisan support.
Even though I work in informatics, I occasionally get asked by friends for my professional opinion related to their intake, as they express their desire to make positive changes in their diet. There’s no greater eye-opener than using a software system to get detailed results of one’s intake. Back when I was a clinical dietitian, one client said she drank an entire 2-liter bottle of regular soda each day. I told her if she switched to diet soda, she would lose weight, with just that one change. (Of course, I taught her much more about what constitutes a healthy diet, but sometimes one change alone can make a huge difference). A software system that can analyze for any nutrient, such as an amino acid like leucine, can serve many purposes in the healthcare environment. Most consumers are familiar with the food label, and so a system that can produce FDA- or Health Canada-compliant nutrition facts labels can also assist them in identifying areas where they could make more appropriate choices. It’s a big task that my friend is taking on with her desire for life-changing surgery, but I’ve been gratified to see other friends’ success with it and am happy to give her all the support she needs.
Article by: Marty Yadrick, MBI, MS, RDN, FAND - Director of Nutrition Informatics and former President of the Academy of Nutrition and Dietetics; Fusion, 2nd Quarter, 2018