Current Position Information
Family Practice Physician, Mid-Atlantic Permanente Medical Group, Hyattsville, Maryland
Scholarly Research Project
Physician’s Attitudes Toward Nutrition Education and USDA MyPlate as a Dietary Tool in a Primary Care Setting.
Jihyun Jun, DO; Rowena Pingul-Ravano, MD
Obese females face higher risks for medical complications not limited to gynecologic cancers; obesity rates are as high as 66.9% nationally. Physicians have varying comfort levels with dietary counseling, and one study found that fewer than 33% of patients received nutrition counseling from their physicians. This QI project introduced USDA MyPlate into clinical practice at Shadyside Family Health Center (SFHC), aiming to improve physician comfort and increase dietary counseling rates.
A pre-intervention data report was obtained to quantify obesity rates among female patients and billing for dietary counseling. A post-intervention report of the same data was requested through Epic Care Support.
Physician education on utilizing USDA MyPlate online tools, implementation during patient visits and billing Z71.3 for dietary counseling was provided through an in-person educational presentation and five infographics posted in clinical areas. Physicians were surveyed using a modified validated 5-question survey, Nutrition in Patient Care Survey (NIPS), on their attitudes towards nutrition counseling and MyPlate before and after the educational interventions.
From July 2016-February 2020, 36.25% of the patients seen were female patients with BMI ≥30 and ages 18-70 years old, and 3.35% of these encounters had a Z71.3 as a diagnosis. The final results of dietary counseling rates are pending receipt of Epic Report.
Survey response rates were 73% pre-intervention (30/41) and 63% post-intervention (26/41). After educational sessions, more physicians said they felt they could influence patient dietary behavior (pre 83%; post 92%) and more felt comfortable providing nutrition strategies (76%; 80%). However, fewer providers felt comfortable elaborating beyond the MyPlate rubric (73%; 65%).
Introducing a dietary tool was associated with increased physician’s comfort in delivering dietary counseling, however, because EPIC report data for Z71.3 trends is not yet available it is difficult to distinguish if the tool led to increased frequency of dietary counseling encounters. Further investigation is required.