Do You Know When to Refer Your Patient to a Dietitian?

By Jamie Marchetti, MS, RDN, LD
August 12, 2020

During my tenure as a dietitian in a rural community hospital, I provided all the outpatient nutrition counseling for the facility. Sometimes patients sought out my guidance on their own, but most often, they were referred to me by a physician. While most referrals were made in a manner that was timely and appropriate for the diagnosis, some were not.

This post, therefore, is a dietitian’s perspective on best practices for physicians referring patients for nutrition care that can be delivered in a way that is helpful to support medical care. Continue reading “Do You Know When to Refer Your Patient to a Dietitian?”

How Physicians Can Prepare for Emerging Trends in Health Care Delivery

By Christopher Ugo Oseh, MBBS
July 23, 2020

This trend clearly indicates the need for physicians who are both clinically and technologically savvy to provide health care in the future.

Health care delivery services have been transformed by advances in health technology, and technology-based health care seems to be gaining ground. According to a McKinsey survey taken in April 2020, the adoption of telehealth services by United States citizens increased from 11% in 2019 to 46% in 2020. Although much of this accelerated adoption has been linked to restricted health care access caused by the coronavirus pandemic, experts are projecting a further increase in telehealth service adoption post-pandemic as many clients realize they prefer to access health care remotely rather than consulting in person with their doctors in a hospital. Continue reading “How Physicians Can Prepare for Emerging Trends in Health Care Delivery”

Best Practices for Patient Engagement with Telehealth

Ted James, MD, MHCM
June 2, 2020

“In an age where the average consumer manages nearly all aspects of life online, it’s a no-brainer that healthcare should be just as convenient, accessible, and safe as online banking.”

— Jonathan Linkous, CEO of the American Telemedicine Association

Health care organizations are actively leveraging telemedicine as a natural solution to connecting with patients while addressing new social distancing realities. Honestly, I found it difficult at first to establish an effective rapport with patients using telehealth, especially for new patient consults. Many physicians report difficulty making the transition to virtual patient encounters.

The learning curve was more than I had expected, and my first few telehealth visits seemed disengaged and sterile. Not to mention having to deal with technical problems. In response, I looked for resources about making meaningful connections with patients, despite the loss of physical presence. I also looked at how to apply the basics of patient-centered communication to this new digital platform. As it turns out, you can learn techniques to become more comfortable and improve your ‘web-side manner.’ Continue reading “Best Practices for Patient Engagement with Telehealth”

COVID-19: Quarantine Tips from a Dietitian

By Jamie M. Marchetti, MS, RDN, LD
March 20, 2020

As grocery store options grow sparse and many face the possibility of being quarantined to their homes in the wake of COVID-19, neither you nor your patients may be able to eat the way you normally do. As your typical foods may be unavailable or perishable, consider these tips when choosing new options from the grocery store, and share this information with your patients as well. Continue reading “COVID-19: Quarantine Tips from a Dietitian”

The Role for Health Coaching in Primary Care

By Monique Tello, MD, MPH
July 25, 2019

It’s remarkable to me that while overweight and obesity are major epidemic medical problems resulting in many clinical complications, and we have solid scientific evidence showing us safe, effective interventions that actually help people to lose weight, we are not yet incorporating these methods into primary care. What’s our problem?

Want to know more about what works for weight loss? I’ll tell you: behavioral change support, in the form of a health coach. Continue reading “The Role for Health Coaching in Primary Care”

Dispelling Common Myths about Opioid Use Disorder in Pregnancy

By Sarah Bernstein, MD and Jessica Gray, MD
March 21, 2019

The opioid crisis and rise in overdose deaths in recent years has received a great deal of media attention. Though the media has helped to raise awareness, it has also contributed to stigmatization of individuals struggling with addiction. Pregnant and parenting women are among those who have been severely affected by the epidemic and perhaps most shamed by society for their use. Sadly, at a time when many women feel motivated to connect with the health care system and make healthy choices, women with addiction often avoid interacting with providers due to feelings of shame and mistrust. There are many misconceptions regarding the risks and benefits of medical treatment for women with substance use disorders as well as the treatment of neonatal withdrawal. We hope to dispel some of these myths and provide a better understanding of the evidence supporting the treatment of substance use disorders in the setting of pregnancy as well as neonatal withdrawal. Continue reading “Dispelling Common Myths about Opioid Use Disorder in Pregnancy”

Promoting and Implementing Size Inclusivity in Health Care

By Jamie M. Marchetti, MS, RDN, LD
March 14, 2019

Beth was obese. She had been bigger her whole life, so this was not news as she reached her late-twenties. Beth ( her name has been changed to protect her privacy) was getting married and ready to start a family, so she went to her obstetrician/gynecologist to have her intrauterine device (IUD) removed and to discuss the implications of her polycystic ovarian syndrome (PCOS) on fertility. The doctor scoffed and stated, “I don’t know how we’re going to get it out. At your size, I’m not even sure how they managed to get the IUD into you.” Further, it was discovered that Beth had grapefruit-sized cysts on both ovaries, and the doctor told her that neither he nor any doctor would do surgery to remove the cysts given her body size. Beth was desperate, so through her hurt and anger, she chose a crash diet to follow, which resulted in acute renal failure within weeks. Heartbroken and at the end of her rope, Beth found herself crying in a dietitian’s office, convinced that the well-balanced diet she was already eating must be harming her since doctors insisted she must not be nourishing herself properly if she wasn’t losing weight. Beth explained that she was content with her body, but that she was tired of seeking medical care and being treated poorly because of her size. Continue reading “Promoting and Implementing Size Inclusivity in Health Care”

Addressing the Urology Doctor Shortage: Implications For Patient Care

By Kevin R. Loughlin MD, MBA
February 14, 2018

Health care issues continue to receive extensive coverage in the lay press, however the current and future physician manpower issues which significantly impact patient care have been largely ignored. I would like to review the urologic workforce issues and their consequences. Continue reading “Addressing the Urology Doctor Shortage: Implications For Patient Care”

Caring for Patients Using Sign Language: The ADA Legacy of George H.W. Bush

By Ami Bhatt, MD, FACC
December 6, 2018

On July 26, 1990, President George H. W. Bush signed into law the Americans with Disabilities Act. The ADA was touted for promoting health as well as civil rights.

I learned first-hand about the experience of patients with disabilities by caring for patients with concomitant congenital deafness and congenital heart disease. I am fortunate to have cared for a cadre of these patients with a dedicated sign language interpreter over the past decade. She represented me to the patients and the patients to me. Importantly, in addition to translating language, she expressed the tone of voice and achieved the delivery of emotions which are essential to effective and compassionate communication. She was also a trusted partner in my practice of medicine. Since she also knew my patients’ histories, I could trust her to accompany the patient at other doctors’ visits, to help the patient communicate what I had shared, and vice versa. Continue reading “Caring for Patients Using Sign Language: The ADA Legacy of George H.W. Bush”