Overcoming Barriers: Why Clinicians Struggle to Embrace Hippocrates’ Wisdom “May Thy Food Be Thy Medicine and Thy Medicine Be Thy Food”

Hippocrates’ ancient wisdom, “May Thy Food be Thy Medicine and Thy Medicine be Thy Food,” has stood the test of time as a guiding principle for optimal wellbeing. We have made this point in our first article in this series. In our second article, we have also explained how the modern meaning of food has evolved into a complex web of cultural, social, emotional, and commercial influences, which may hinder our patients and clients from fully embracing Hippocrates’ wisdom. However, the barriers are not only for the patients and clients but also for us, clinicians. For despite its profound wisdom, significant barriers are preventing us, clinicians from fully incorporating food as medicine in our practice. In this third article, we delve into four key obstacles that obstruct us from embracing Hippocrates’ wisdom and the challenges we face in prioritizing nutrition as a therapeutic tool in modern healthcare.

Limited Nutrition Education and Time Constraints:

One of the primary barriers is the lack of comprehensive nutrition education during training for physicians and other types of clinicians[1]. As clinicians, we receive minimal formal instruction on nutrition, leading to a knowledge gap that affects our ability to confidently integrate food as medicine into patient care[2]. Further, we often face time constraints during patient consultations. The pressure to address acute physical or mental health issues, fill out checklists, renew treatment plans, and write progress notes may overshadow discussions about nutrition and lifestyle changes. This, in turn, makes it challenging to adequately explore dietary interventions with patients.

Focus on Pharmaceuticals or manualized treatments and Lack of Reimbursement:

The pharmaceutical industry heavily influences medical practice and research[3]. The emphasis on drug-based treatments can overshadow the potential of food as medicine, leading us, clinicians to prioritize pharmaceutical interventions over dietary approaches[4]. While this concept may pertain more to prescribing clinicians, non-prescribing clinicians are not exempt from the responsibility. Our patients and clients deserve a multidisciplinary approach to care, where each clinician prioritizes their best interests. More on this topic later.

In addition, in some healthcare systems, there may be limited or no reimbursement for nutrition counseling or lifestyle interventions. This financial barrier further deters clinicians from investing time in nutrition discussions with patients.

Inadequate Resources, and Patient Adherence and Cultural Barriers:

As clinicians, we may lack access to adequate resources, such as nutrition experts or dietitians, who can provide specialized guidance and support in incorporating food as medicine into patient care[5]. However, encouraging patients to make significant dietary changes can also be challenging, especially when cultural, social, or economic factors pose barriers to adopting healthier eating habits.

Resistance to Change, Lack of Confidence in Nutrition Counseling, and Prevailing Food Culture:

As clinicians, we may face resistance or skepticism from our colleagues, our patients, or even from ourselves, about the effectiveness of food as medicine. This is often a defensive response and makes it difficult to complement our conventional practices. Some of us may feel inadequately trained in nutrition counseling, leading to a lack of confidence in our ability to effectively incorporate dietary interventions into patient care. This, too, may be rather defensive. For where there is a will there is a way.

In sum:

While the wisdom of Hippocrates, ” May Thy Food be Thy Medicine and Thy Medicine be Thy Food,” remains as relevant as ever, notable barriers are preventing us, clinicians, from fully embracing this profound guidance. Overcoming these obstacles requires a collective effort, involving medical schools, graduate schools, healthcare institutions, policymakers, and individual clinicians. Comprehensive nutrition education during medical, graduate, and postgraduate training, increased access to nutrition experts, and policy changes to support nutrition counseling, are essential steps in breaking down these barriers.

As clinicians, we ought to empower ourselves with the knowledge and resources needed to confidently prioritize food as medicine in patient care. Engaging patients and clients in discussions about nutrition, addressing cultural barriers, and advocating for a shift towards a more holistic approach to healthcare can further promote the integration of food as medicine.

By recognizing and addressing these barriers, we can bridge the gap between ancient wisdom and modern medical and mental health practice, bringing us closer to Hippocrates’ vision of harnessing the healing power of food to promote better health and well-being for all. Embracing this wisdom requires a collective commitment to a more comprehensive and patient-centered approach to healthcare, where food truly becomes a powerful tool for healing and wellness.

What’s Next:

1. If you have not already done so, explore our ongoing Physical Wellness Certificate Course, where we delve into the role of nutrition in wellness. Our clinician attendees are eager to master this knowledge to integrate it into their work with patients and clients. As per the SWEET Model, experiencing it firsthand as clinicians is crucial, and we will dedicate several weeks to this. Join us for this eye-opening course segment.
2. Stay on the lookout for article #4 in this series, delving deeper into the world of nutrition and its impact on well-being.
3. Continue to gather more information on the role of nutrition in overall health and wellness, staying updated with the latest research and recommendations.
4. Continue to have more frequent conversations with your clients and patients about nutrition, understanding potential barriers, and helping them overcome obstacles to optimal eating habits.

Remember, as clinicians, having awareness, understanding, insight, and knowledge about nutrition is key to inspiring positive transformations. This series aims to equip you with the essential tools, so you empower yourself and help your patients and clients do the same on their process to optimal well-being.

Until our next article, let us master how to continue our process of discovery and healing through the power of nutrition.

[1] Kris-Etherton, Penny M., et al. “The need to advance nutrition education in the training of health care professionals and recommended research to evaluate implementation and effectiveness.” The American journal of clinical nutrition 99.5 (2014): 1153S-1166S.

[2] Kris-Etherton, Penny M., et al. “Nutrition competencies in health professionals’ education and training: a new paradigm.” Advances in nutrition 6.1 (2015): 83-87.

[3] Feldstein, Paul J. Health care economics. Cengage Learning, 2012.

[4] Berkowitz, Seth A., Hilary K. Seligman, and Niteesh K. Choudhry. “Treat or eat: food insecurity, cost-related medication underuse, and unmet needs.” The American journal of medicine 127.4 (2014): 303-310.

[5] Jortberg, Bonnie T., and Michael O. Fleming. “Registered dietitian nutritionists bring value to emerging health care delivery models.” Journal of the Academy of Nutrition and Dietetics 114.12 (2014): 2017-2022.