Princeton Health Systems is located a short walk away from Princeton University’s gorgeous campus. The night before my first day as an extern, Beth and her son, Will, gave me a quick tour of the school grounds and the surrounding town.
On my first day shadowing Beth, it was clear that the scope of her professional life extended much more widely than office consultations. Our first stop was a sanitation inspection for the kitchen of a halfway house that had recently recovered from some severe food safety issues. From there, I observed several of her nutritional consultations at an internal medicine practice that referred clients in need of diet advice to Beth. Her patients were primarily diabetics looking to control their blood glucose levels and lose weight. These consultations intrigued me, as it was interesting to see the huge role diet and other preventative measures play in controlling chronic diseases. She also saw patients in her Princeton office who had a variety of reasons for seeking nutritional help. Our next day involved a combination of her private office patients and patients referred to her by the internal medicine practice. Although they each presented with unique difficulties, there was a fair amount of overlap between the cases as well.
USDA’s “SuperTracker” program is one of Beth’s main tools that she suggests to patients for controlling their diets. This website is easy to use and contains a large database of foods that can be added to daily food journals. SuperTracker also allows patients to analyze the nutrient makeup of their meals after they enter them into the system. This can be vital for patients who are perhaps in need of limiting their sugar or increasing their protein intake. Since people might not be aware of how many calories they are actually consuming, this is a useful first step in learning about healthy eating. If patients are unwilling to use SuperTracker, Beth also suggested the MyFitnessPal app as a second choice.
Despite the usefulness of these programs, it appeared to be challenging to convince people to regularly track their food intake. Even if patients know this can help them, it can be difficult to change their behavior. This is one central barrier that comes about in preventative medicine, particularly in nutritional consulting. Many patients in need of consultations are approaching old age and therefore are highly set in their ways. Even though they may know that changing their diets will help them, actually making the change might be too impactful on their normal routine. Since many patients in today’s society expect to receive a pill from their doctor for a quick fix, expressing the importance of prevention can be complicated. Socioeconomic status is another barrier that patients face in adopting a nutritionally healthy lifestyle. Many people who are struggling with obesity and related diseases are aware that their diet is not healthy, yet they cannot afford to drastically change it or seek help. This was another point that stood out to me while sitting in on consultations with Beth.
Overall, my externship at Princeton Health Systems was both enjoyable and worthwhile. At this point in my academic career, I am not planning to pursue a career in nutrition; however, I will certainly be able to use aspects of this preventative perspective as I work towards my goal of becoming a physician’s assistant.