The Evaluation Of Physician-to-nutritionist Referrals For Medical Nutrition Therapy For Patients Seen In Family Medicine Centers

Abstract

LEARNING OUTCOME: To examine the physician-to-nutritionist referral process for four disease states seen in a family medicine centers.To determine whether patients with four diet-related diseases were receiving the benefit of medical nutrition therapy in a family practice setting, a retrospective chart review was done. The tour disease states studied included the following: diabetes meilitus. hypertension, hypercholestcrolemia, and obesity. Together these disease states account for the largest proportion of our health-care cost. Data collected included overall number of patients diagnosed with these four diseases, the actual number of referrals made by the physician to the nutritionist for the corresponding diseases, and the number of initial and follow-up visits to the nutritionist via the physicians' recommendations, over a two year period. Results showed the percentage of patients referred for medical nutrition therapy from the total number of patients diagnosed with corresponding diseases was, on the average, 3% for diabetes meilitus, 1% for hypertension. 14% for obesity, and 5% for hypercholesterolemia. In addition, physicians were more likely to refer patients when more than one disease state was present. Furthermore, only 30% of the patients referred presented for an initial visit and of these, the number of follow-up visits is well below what is expected to produce significant changes in eating behavior. Because of the vast majority of the health-care dollars spent on these catastrophic diseases, patients that are able to benefit from medical nutrition therapy should be given the opportunity.