How’s your cholesterol? Are you getting enough protein? Do you even know? Whether you’re a doctor, a patient, or both, you may be missing out on the powerful benefits of a registered dietitian.
Recently, I received lab results that were concerning, and my doctor suggested adding another medication. I’m focused on reducing medications, so I wanted to explore all possible ways to improve my numbers safely without adding to my pill count.
Though I know a fair bit about nutrition and try to eat “clean,” I still asked my doctor for a referral to a medical dietitian to ensure I wasn’t overlooking any dietary changes that could help.
My physician, Dr. Alex Mosteanu, and I are a great team! He is an amazing doctor in so many ways, and we discuss my health openly to find the best path forward. He agreed to the referral, and I soon found myself sitting down with Ava. She listened carefully to my concerns and offered new insights I hadn’t considered—like how, despite being intentional about my protein intake, I was following outdated guidelines. Ava tailored her advice to my personal health needs, ensuring the changes were both relevant and sustainable.
Our session was so helpful that I had to ask Ava whether she was overwhelmed with referrals. She said they come in waves. We agreed that the value of registered dietitians is often underappreciated by many health care professionals. Dietitians dive deep into nutrition in a way that most clinicians, pressed for time, cannot.
These referrals aren’t just beneficial for patients—they support doctors, too, by providing another expert on the team who can improve outcomes, reduce medication needs, and help patients make long-term healthy choices.
I’m grateful for Ava’s expertise and excited to continue learning.
It is common for us to meet a new patient after they have spent years navigating the health care system around a specific issue. Gastrointestinal issues, weight loss attempts, low energy and fatigue, elevated blood glucose levels, headaches, hypothyroidism, and poor sleep—conditions that are not immediately life-threatening but have a significant negative impact on a patient’s quality of life. Patients have often told us they don’t feel heard when speaking with their clinicians and that it takes months to get an appointment with a specialist, only to be rushed through the encounter in 15 minutes. While these experiences are generally not the fault of any one physician or team member, they do reflect the consequences of an insurance-based health care system focused on efficiencies and profits.
As registered dietitians, we chose to build a private practice due to the positive impact of nutrition therapy in our own lives, as well as the desire to guide meaningful changes in our patients’ lives.
Prior to an initial visit, we have patients fill out an extensive nutrition intake form, maintain a food journal, and request lab work and physician notes when appropriate. For more complicated cases, we often call a referring physician and/or perform a case study review.
At each initial session, we sit down with every patient for 60 to 90 minutes. We ask MANY questions. It’s through these interactions that we learn the details of a patient’s life. We discuss family life, work experiences, hobbies, daily and long-term stressors, sleep cycles, physical activity, hydration, bowel movements, food access, cooking skills, and yes, we focus on what people are actually eating. It’s a lot for an initial session.
During follow-up appointments, we often get into the psychology of food choices and why habits stemming as far back as a patient’s family of origin may be influencing choices today.
Targeted nutrition education is always an important part of the counseling process. We might discuss the differences between physical hunger and psychological hunger or provide education ranging from the definition of a carbohydrate to how visceral hypersensitivity impacts gut function. Yes, we almost always spend time myth-busting the pseudo-science claims found on social media and put forth by influencers.
Private practice registered dietitians are uniquely poised to be active members of the health care team. Dietitians have both a strong evidence-based education rooted in science and lifestyle and behavior change training to support patient goals. We have the privilege of spending time with our patients and gaining insight into the details of their lives through rapport building. This relationship allows our patients to feel heard and builds the trust needed to work toward behavior change. Few practitioners have the time with patients that dietitians do.
We have witnessed the benefits of medical nutrition therapy in many of our patients’ lives. Reduced blood lipid values have allowed some patients to stave off statin use. Significant weight loss has reversed many pre-diabetes diagnoses and other risk factors for heart disease. Being guided through the three phases of the low-FODMAP diet has reduced bloating and distention while improving bowel movements in patients with disorders of gut-brain interaction. Learning to focus on a protein-forward, plant-rich diet, reducing alcohol intake, and adding in weight training has helped many peri- and menopausal women reduce symptoms associated with this phase of life.
These benefits are wonderful for our clients, but they also support our referring clinicians by reducing patient visits for conditions that can be improved through lifestyle factors, as well as improving overall patient outcomes.
As we continue to navigate our personal health journeys, it’s clear that the road to better health isn’t just about pills or quick fixes—it’s about informed choices, personalized care, and lasting lifestyle changes.
Registered dietitians like Ava are a missing link in so many treatment plans, offering not just knowledge but also the time, expertise, and personalized approach that can truly change lives.
If you’re facing health challenges, don’t wait for the next medication to be prescribed—ask your doctor about a referral to a registered dietitian. The path to better health might be shorter than you think, and it could start with a conversation about what you eat!
Ava Safir and Meg Whitbeck are registered dietitians. Kim Downey is a physician advocate and physical therapist.
