Should I go to a Nutritionist? (Post #1)

One way to narrow down the list of medical professionals that I could go to is by looking at what my insurance will cover. This is pretty compelling, since it offers a chance that my out of pocket expenses will be lower. It’s a perverse indication about the healthcare system that this is just a chance, between random denials of coverage, and things like 10% co-insurance on services that cost 15x as much as they should.

But, when I look at “Find Care” under my Aetna website (which is quite a bit better designed than I would have expected, so check it out if you happen to have Aetna), there are 5 categories under “Alternative”:

  1. Acupuncture: Not relevant
  2. Chiropractor: Not relevant
  3. Massage Therapist: Wish I’d checked here before paying for one last year!
  4. Naturopathy: I’m surprised that Aetna is covering this. For all the (often justified) flak that insurance companies get, there’s something to be said for having a voice in the system that says “I really need to see some statistical proof of effectiveness before subsidizing this treatment”. My feelings about naturopathy are here.
  5. Dietician: That’s what we’ll be digging into today

The problem is that the list gives me dozens of choices, but no relevant information to select on. They’re all listed simply as ‘registered dietician’, with no indication of whether they specialize in weight loss (which is not my goal) or something else. And there’s even less information about what I’m really looking for, whether they would work with me over time as an active partner. That’s the sort of thing that would come out in patient reviews, but less than 10% of providers have any, and they’re incredibly focused on the patient experience, not the clinical approach or outcomes. Some examples:

  • Not only do they never postpone my appointment, they always try go get me in as fast as possible.
  • They had plenty of staff members to help me whenever I needed assistance
  • They’ve never used foul language, which bothered me at some other places I’ve been to

This isn’t going to help me find the relatively rare approach that I’m looking for. The next step is going to see if any of them have blogs or other outlets where they discuss their philosophy and see if they think about things besides weight loss, regularly consider the medical literature, and generally appear to think critically and flexibly.

UPDATE: I’ve done that for everyone within a 3mi radius. People are pretty non-specific, saying things like “helping others develop a healthy relationship with food and reach their health and wellness goals” (LinkedIn) While I’d love to find someone who’s tweeting an in-depth literature review around a relevant set of symptoms, the realistic signal that I’m looking for is that they self identify as focusing on scientific and quantitative approaches. Barring that, just some specificity would be great. Here’s a good example: “My expertise & passion is in the prevention and treatment of diabetes.” (LinkedIn) Not a fit for me, but I much prefer to come to a crisp ‘yes/no’ than the endless ‘meh’ that the previous example provokes!

One of them had a website full website, though it was last updated in 2015. She referenced going to a conference at Harvard, which is the best that I’ve found so far. I wish that I had something better to go on, but that puts her well ahead of the pack, so I’ve reached out.

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