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Teaching Patients How to Eat, Fuel, Heal: Applying Principles of Functional Medicine in Your Practice

One of the biggest challenges for doctors in functional medicine is taking the clinical knowledge learned through continuing education, and applying it in their practices when speaking to patients.  At this year’s A4M Spring Congress in Hollywood, there will be plenty of exciting and new clinical teaching going on.

The theme of the meeting is Eat, Fuel, Heal: Nurturing the Second Brain and A4M will be teaching providers clinically how healthful eating and nutrition have the power to prevent, treat and even reverse many chronic diseases.  The courses will show that leveraging evidence-based dietary interventions can combat heart disease, diabetes, certain cancers, and many other health conditions.

This is such a timely theme.  Doctors have been striving to integrate nutrition and lifestyle modification into their practices for some time but with obvious challenges. In a survey conducted by the National Institutes of Health, “77% [of providers] agreed that nutrition assessment should be included in routine primary care visits, and 94% agreed that it was their obligation to discuss nutrition with patients, [but] only 14% felt physicians were adequately trained to provide nutrition counseling.”

In tandem with nutrition, experts in the field of gut health are discovering that our gut actually communicates to our brains through what is known as the vagus nerve whose function is to send information to the brain from various organs including our intestines. This nerve tells our bodies how to feel based off of the environment in the gut. So essentially, when something isn’t right, our brain and gut will be communicating about it.

Hence the tagline, Nurturing the Second Brain. Our gut actually tells us how to feel and think based off of whether or not we’re treating it well.

“How do practitioners bridge the communication gap?”

So the million dollar question is, how do practitioners bridge the communication gap?  How do you take all of this exciting and critical information and implement it in practice when seeing patients?

One place to start is by creating an action plan for guiding your patients through diet, exercise, mindfulness and other lifestyle changes.

Best practices in practice and patient management suggest putting in place the following concepts and systems:

  • Place appropriate importance on surveys and discovering patient history
  • Provide complete educational programs for patients to follow that include daily guidance, including recipes, exercises, videos, downloads, tasks, to do’s and more.
  • Monitor patient’s progress on their care program as often as time permits and use software to automate and streamline that process.
  • Stay connected with patients through Telehealth and HIPAA compliant messaging.
  • Provide patients with connected devices when possible so that you can remotely monitor their food intake, sleep, activity, water consumption and more.

Patient Surveys:

When you sit down with a patient to do intake, instead of solely focusing on their medical history as it relates to prescribing medicine, consider administering a separate section of intake and/or a separate survey that discusses nutritional questions such as what the patient currently eats, sensitivities and preferences so you can begin to fill in the gaps. For example you may find that the patient is vastly under consuming vegetables, and needs assistance in this area. Or perhaps the patient is experiencing digestive issues and may need the assistance of probiotic foods. All of this can be uncovered during your nutritionally focused intake survey.

Assisting Patients with a Personalized Comprehensive Care Program:

Patients are 5 times more likely to follow wellness advice if a doctor provides that counsel and advice to the patient. Typically, when a provider consults with a patient, they only have time (or the tools) to briefly educate the patient on a general overview of healthy eating. But patients leave the office puzzled and to unsure how to implement the doctor’s instructions.  The communication gap between the doctor’s clinical knowledge is caused by primarily a few factors.

There’s only so much time to transfer knowledge.  But why does all of the knowledge have to be transferred at once? That’s not only impossible in a busy practice, but also largely ineffective.  Patients only retain about 10% of what you tell them.   So it’s unlikely that they’ll be able to retain the important wisdom you’re trying to convey in the short time you have with them. And if they don’t remember it, they won’t be able to follow your advice.  That’s why sending patients home with a detailed program that unfolds over time in daily and/or otherwise bite-size increments along with the tools to track and report compliance is the best way to help the patient.  For example, giving patients a meal program in an easy to follow app, that mimics the principles you’ve learned as the provider can greatly assist them as they begin to incorporate better nutrition into their daily life.

Monitor Patient Progress:

While it’s great to schedule follow up visits and keep in contact with patients, modern technology allows us to do so much more, and in real time. If your patients are interested or already have wearable health devices such as a Fitbit or Apple Health, these can effortlessly assist you as the provider to gain insight into their biometric data to evaluate progress and compliance.  You have access to apps that allow you to log in and see patient data on food eaten, activities completed, biometrics measured, as soon as patients track it.  Find a solution that works for you clinically, and that patients will enjoy using.

Telehealth:

In today’s world it’s understandably challenging to get every patient to even schedule a visit, much less come into the office. If it’s a standard follow up, consider keeping in touch with your patient virtually so you can provide continued support for the principles you’re applying from the conference. Telemedicine solutions are widely available. Consider one that allows you and the patient to schedule and / or optionally make payment for the visit.  Ideally, the solution would provide for group visits as well as one-on-one virtual consultations, so that you can address the support mechanism that can be so helpful with managing conditions like chronic stomach issues and severe overweight when appropriate and with proper consent.

Not many softwares will handle all of these solutions for you in one place. Some electronic medical records platforms provide basic education to the patient about their condition, but they rarely give patients a place to follow a complete action plan about what to do before a visit, between visits or after in-office services. There are also practice management platforms that have telemedicine, scheduling and billing, but lack a meaningful way to provide care instructions and guidance in a way that you can customize easily to your practice voice.  For best results in maximizing patient outcomes by bridging the communication gap, focus on a remote care software that makes patient education about their plan of care the primary focus.