Who Contributes More to Your Health – Doctors or Dietitians?

Benjamin Franklin once said that an ounce of prevention is worth a pound of cure. Let’s frame that quote into the context of this country’s current obesity crisis.

According to recent reports, obesity is responsible for about 10% of healthcare costs in the US, an estimated $147,000,000,000 (that’s 147 billion) annually.

And while our highly trained, very capable doctors can help cure, fix, and medicate a patient, a good dietitian may help a client avoid the illness in the first place. (Notice the nomenclature – patient vs client).

If you think your doctor can give you some diet tips, know this – the average physician does not receive a single credit’s worth of nutrition education while at medical school.  So when a doctor tells you to lose some weight, she does not necessarily have the tools to help you make it happen.

The US has over 550,000 doctors but less than 70,000 dietitians. The average annual salary of a physician in the US is $200,000, but the average dietitian will see less than a quarter of that amount, $49,000.

Using some very crude math, let’s assume that 10% of healthcare cost translates to 10% of doctors or 55,000 MDs. What if we magically retrained those doctors and added a nutrition degree to their quiver of skills? Would this reduce  the number of obesity related diseases by 10%?

This is all wishful thinking, because in the US today there is no direct incentive to engage in even half an ounce of prevention. It’s much more profitable to create health problems (fast food industry, junk food manufacturers) and then spend billions to cure them (Medical bills, pharmaceuticals). It’s a profitable business cycle for corporations, but not a sound proposition for consumers.

This is not in any way meant to be a lash out at doctors, who do their jobs tirelessly and loyally. It’s just that doctors are great at helping sick people, mostly after the fact. Pre-emptive care is undervalued today because there is no financial incentive in the current business ecosystem to help keep people lean and fit. In fact, dietetic consultations are not necessarily covered by health insurance.

What can be done?

Policymakers should create financial incentives for industries to prevent people from getting fat and sick. Medical schools should see find ways to integrate nutrition education into their syllabus.

If you are a young, talented and ambitious college student who wants to help people be healthy, where do you think you’ll have more impact? Shoot away in the comments below.

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  • Monica

    i don’t think that its going to work out. the pharmaceutical companies would hate it if more money is put into prevention than cure.

    I for my part planning to be a dietitian, hopefully prevent someone from getting sick in the first place.

  • http://www.betterschoolfood.org Dr. Susan Rubin

    I wish I could say hip hip hooray for dieticians, but I’ve met so many with a low Food IQ! Marion Nestle did a great job in explaining part of the reason why dieticians are not as great as they could be in her book, Food Politics.

    We need to re-think education for most nutrition professionals. They need to learn more than macro/ micro nutrients. Understanding what to eat and HOW to actually select and prepare food is essential (and missing in most RD training).

    The big picture is important too. By that, I mean systems theory. You’ve got to understand the reasons why the USDA Food Pyramid is faulty and also other contemporary issues like GMO/ world trade. ( I actually met a recent grad from a prestigious state university that had zero discusssion of GMO food in her 4 years of studying nutrition….that is completely unnacceptable!)

    I’ll be teaching a few classes this spring to 4th year medical students on food as part of a course on “alternative and complementary medicine”. Why an entire semester on FOOD ( not nutrition) is not a requirement, I’ll never know. The wheels of progress turn very slowly in academia!

  • Christel

    Excellent article. Really gets you thinking about prevention and the lack thereof in Health Care. I agree that though its partly political and partly economical: but every single person is responsible for their own choices.
    I would hate to see this attention be derived into a way to place blame again.
    Good job on this one fooducate! :D

  • Heather Streeter

    @Dr. Susan Rubin
    I absolutely agree that you need to make sure that any nutritional advisor that a person consults with must be FULLY educated. My friend and fully educated Holistic Healing Counselor, just got through sitting down with me for 2 1/2 hours on Friday explaining that just because I’m allergic to certain foods, it could be actually the way they are prepared. She went to specifically explain types of food I should be eating and how to prepare them, what to exclude or try. It was very in depth. She was well educated on all of the details (as I call them) and made sure that I in turn understood them. I’ve had too many other “professionals” just say, “well don’t eat that”. But what am I left with after you cut out fish, chicken, soy, pork, and several other basics? When you are stuck with a lifetime habit of eating a certain way, then you need some specific guidance on where to go from there. Too many don’t give that. A fully educated practicioner would be able to and be more inclined to. That includes all health care practitioners, not just doctors and nutritionists.

  • http://www.notprocessed.com Lynn Parks

    Heather….have you read Nutrition and Physical Degeneration by Dr. Weston A Price, DDS.? Dr. Price has been called the Einstein of nutrition. You might want to check it out.