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The Catalyst

Quality patient care isn't one size fits all

By Melissa Macher
Dietetic Intern

It wasn’t very long into my dietetic internship before I realized that not all of our patients’ nutrition problems can be solved by dietetic intervention. Often patients face health problems that cannot be fixed within the confines of a hospital.

The foods, supplements or medications that health care professionals recommend aren’t always easy to come by or affordable. One in six Americans will face food insecurity, according to Feeding America, a non-profit organization dedicated to fighting hunger. Eighteen percent of South Carolinians fall into that category. The percentage is even higher for children in South Carolina, which rises to 28 percent.

One problem health care practitioners face is that it’s not always easy to identify the patients who face such problems. Many of those who are food insecure lack the access to an adequate diet. Food insecure diets may be comprised of cheap high-calorie, high-fat meals or snacks found at gas stations or fast-food restaurants. Transportation to the grocery store or farmers’ market can be a luxury.

While discussing a renal diet with a patient recently, I was quick to label him in my mind as non-compliant when he rattled off all of the foods that he ate regularly. After a bit more questioning, he explained that he is sometimes left with whatever he can get from the food bank. Some of my typical recommendations were not feasible in his case. He may have been non-compliant, but it wasn’t always by choice.

It’s difficult to pause and remember that not all of our patients are on a level playing field, especially with the weight of deadlines and agendas. Some health problems can’t always be remedied in a hospital, but we can be more useful and effective if we take some extra time to get the whole picture.

June 19, 2013

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