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Basic Diet Orders: Teaching Patients Good Health Practices

The hospital is more than a place for treatment. It can be a place for learning. Picture this scenario:

A man arrives at the emergency room after an accident at a construction site. He has a compound fracture and a leg laceration with significant blood loss. After his initial treatment, he is admitted. His improvement is quick, and by day 2, he is medically stable and reasonably comfortable. His doctor arrives for a visit. After checking the wound sites and vital signs, the doctor sits down for a serious talk.

“You are going to come through this accident just fine,” the doctor says. “You’ll be out of the hospital before you know it. I don’t expect any residual problems at all. You’re going to be fine.” Then the doctor’s expression turns more serious. “While you’re here, let’s tackle another problem. As I understand it, you’ve been smoking two packs a day for quite some time now. While you’re here, let me help you stop. These injuries won’t kill you, but tobacco very likely will, and this is as good a time as any to deal with it.”

The patient bites his lip. But he realizes the doctor is right. He had wanted to quit, of course, and now–stuck in a nonsmoking hospital–that is exactly what is going to happen, whether he likes it or not.

Later on, the same doctor sits down with another patient, this one hospitalized for a hip replacement. The patient also has a long–standing weight problem, poorly controlled hypertension, and a high cholesterol level. He has had two prior heart attacks, but has not followed through on suggestions that he change his diet. The doctor’s speech sounded nearly identical:

 “You are going to come through the surgery just fine,” the doctor says. “You’ll be out of the hospital in no time. But while you’re here, let’s tackle a more serious problem. I am going to ask the hospital staff to help you learn some healthy eating habits.”

In the chart, he orders a dietetic consultation and a vegetarian diet. He explains to the patient that this is a chance to try some healthful foods. Whether the patient keeps it up after discharge is his business. But the doctor is going to use the hospitalization to its full advantage.

None of this had anything to do with the man’s hip, of course. But it had everything to do with what threatened his life over the long run.

Both patients told their families about what the doctor had said. And both families were mightily impressed.

These patients came to truly respect their doctor. Yes, they were a bit unsure about quitting smoking and rearranging long–standing eating habits. But, like most patients, they were well aware that they were not tackling their problems on their own. They appreciated a caregiver who looked beyond the presenting complaint to what really threatened their long–term health. The doctor saw the problems they had been unable to solve and helped these patients to address them.


Helping Patients Adopt Healthy Diets >>