Bring Nutritional Care Home

In last Sunday’s New York Times, op-ed contributor, Doctor Jack Resnick, wrote an article titled, Bring Health Care Home, in an attempt to push Medicare to issue the rules needed to create the Independence at Home Organizations mandated by last year’s health care reform act. Doctor Resnick’s patients are the home-bound elderly and people immobilized by accidents, multiple sclerosis and respirators.  Independence at Home helps to keep patients away from unnecessary hospitalizations and exposure to antibiotic-resistant super bugs.

Nutrition House Call Visits

Some of you know that I made the decision to see patients again – it’s the most authentic thing I can do – but, this time, I don’t plan to have a bricks and mortar office. Instead, I plan to visit patients in their homes. And why not?  A nutritionist needs almost no equipment and the service should be near to the food supply.  Here are a few more reasons why I embrace nutritional care at home:

  1. It Cuts Down on Lying
    Let me put it another way. Research shows that it’s easier for people to bend the truth when they are detached from their interlocutor. Let’s face it: it’s hard to look someone in the eye and tell them a lie. But lying is so expected in nutrition histories that it has a name, the Eye-Mouth Gap. The phenomenon explains why obese people report only half to one third of what they eat. Communications research shows that people fib in writing and email more than on the telephone and there is more fudging on the phone than there is face-to-face. Look, I just want to set the stage for an honest, long-term relationship. We can follow-up by telephone and email and with home re-visits as needed but, for now, let me see your cupboards and fridge. Busted!
  2. Everyone Can Be There
    Spouse/partner, children, parents, and friends – we are in this together. By meeting informally with every stake holder, everybody owns his part (including no part if we all agree that is best.) Group visits are great for filling-in the nutrition history and tying-in the genetic and environmental components. There’s something about the camaraderie that alleviates stress and builds understanding.  People get a lot from group visits and, again, we can follow-up by telephone and email.
  3. It Helps Older Folks
    As Doctor Resnick wrote, a lot of people just can’t get around, and so it’s better to travel to them. One thing I love about Brooklyn Heights, my new practice area, is the population of senior citizens there. Older people with chronic medical conditions are my specialty, and they shouldn’t be walking on those uneven sidewalks anymore often than need be.
  4. The Office is in My Computer
    My office is actually an iPad. Handouts, homework, articles to read; I used to be at Staples all the time.  But now, I have a digital office at Organized Wisdom. All of my papers are in one place ready for you to read. If you happen to need a printed copy, I’ll pop into Staples, or better yet, your loved one can copy it at work.

Finally, and this is not your concern, but getting out of the office helps me. I have reached my lifetime quota of being seated at a desk hunched over a computer screen. My hips need to recover and I need fresh air. Walking in one of America’s Most Beautiful Neighborhoods to see my patients suits me well.

And so that’s why I want to bring nutritional care home. I’ve limited my visit area to zip code 11201 because I can’t go running hither and yon.  For everyone else, it’s digital and telephone visits. I just hope my patients don’t lie.

Your thoughts:  Would you want a Nutrition House Call Visit?