Nutritional counseling in family medicine in 2010

The proportion of Canadians who meet the criteria for being overweight or obese has increased since 2004 despite the best efforts to address such factors as diet and levels of activity. According to data collected between 2007 and 2009, more than 60% of Canadians are either overweight (37%) or obese (24%).¹ With the emphasis on preventive care and maintaining the long-term health of the population, it is important to recognize the role that primary care providers have in offering nutritional counseling.

Unfortunately, the results from the latest National Physician Survey (NPS) indicate that the number of FPs and GPs providing nutritional counseling as part of their practices has decreased over the past 3 years. According to the 2010 NPS data, nutritional counseling was offered by 38% of FPs and GPs across Canada—a slight decrease from the 42% who reported offering it in 2007 (Figure 1). Regionally, FPs in Nova Scotia (50%) and Prince Edward Island (48%) were the most likely to offer nutritional counseling, while those in Quebec (27%) and Saskatchewan (38%) were the least likely to do so. The NPS results show modest increases in FPs and GPs who offered nutritional counseling in Nova Scotia and New Brunswick (3% and 2%, respectively), while the most substantial decreases (compared with 2007 data) occurred in the western provinces of Alberta and British Columbia (a decrease of 7% in each province). Only 1.1% of FPs and GPs indicated that nutritional counseling was a special focus of their practices.

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Figure 1

Nutritional counseling among current and future FPs and GPs: A) Proportion of FPs and GPs providing nutritional counseling; B) Proportion of family medicine residents planning to provide nutritional counseling.

Data for future primary care providers indicate similar trends. The proportion of family medicine residents who reported that nutritional counseling training was available to them decreased—albeit slightly—from 38% in 2007 to 32% in 2010. A more substantial decrease was notable in intention to provide nutritional counseling as part of their practices. The proportion of family medicine residents who indicated that they planned to provide nutritional counseling decreased from 38% in 2007 to just 16% in 2010 (Figure 1).

One explanation for the findings is that they reflect the evolution of a different pattern of practice. That FPs are less likely to provide nutritional advice might indicate increased collaboration with and referrals to dietitians or nutritionists. Twenty-four percent of FPs and GPs identified dietitians or nutritionists as 1 of the top 3 health professionals they referred patients to—the second highest proportion among all health professionals. Twenty percent of FPs and GPs reported collaborating with dietitians or nutritionists—also among the highest proportions. Asked to rate their patients’ access to these health professionals, 21% of physicians rated it as excellent, 30% as very good, 26% as good, 15% as fair, and 7% as poor.

Given the importance of maintaining a healthy body mass index to an individual’s long-term well-being, patients must have access to nutritional advice either from family physicians or from dietitians or nutritionists.

The NPS is a collaborative project of the College of Family Physicians of Canada, the Canadian Medical Association, and the Royal College of Physicians and Surgeons of Canada. Additional results are available at www.nationalphysiciansurvey.ca. If you would like the opportunity to develop and write a future Fast Fact using the NPS results, please contact Artem Safarov, National Physician Survey Project Manager, at 800 387–6197, extension 242, or asafarov{at}cfpc.ca.

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