What Did You Have For Breakfast?

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We have posted on great opening lines in the past, but just learned a new one. Steven Newman on OD’s on Facebook asks ‘What Did You Have For Breakfast’ to encourage discussions on eye health. What I think- promoting eye health and talking diet can help you compete with online eyecare retailers.

The other is speaking about eye health leads to Nutritional Supplement Sales. You can get those from Biosyntrx and Theralife.

This is an edited part of the discussion and if you would like to participate in OD’s on Facebook, please let us know and we can add you to the group.

Steven Newman:  My conversations often start with a food related question, but end up on their need for digital progressive lenses with Transitions and AR coatings. If the conversation in the exam room doesn’t start out with me showing an interest in their health, it may not end up with a symbiotic transaction in my optical. We ask what medications they take, why not ask what their diet is like. You’ll be surprised to hear the responses.

Steve Silberberg For children I have a standard line when doing direct opth. I look in and say “You had cereal for breakfast”. More often than not I am right and the kid thinks I’m a genius. When wrong I bang the scope against my thigh and say I have to get this fixed

Walter Mayo- It’s amazing to me how many of my diabetic patients NEVER had any nutritional counseling. Ask ’em if they know what glycemic index is and you’ll get blank stares.

Steven M Newman- That’s great, I may steal that one. I typically ask my adult patients to look up after checking pupils. While they’re looking up, I simultaneously shine the light at their conjunctiva and ask them if they drink enough water on a daily basis. The peak at the conj has nothing to do with this, but the impression that I’ve been able to diagnose dehydration so easily and quickly gains a bit of trust. The fact that we’ve been talking casually about diet and exercise throughout the history helps. The main difference is that my conversation is with the person holding the purse strings. That’s what makes it more symbiotic in the optical.

Steven M Newman Americans are being led to believe that their vote can somehow change the healthcare system. What they need to realize is that their choice at the supermarket and restaurant have a better chance of fixing things long-term than any President, Senator, Congressman, Physician or Pharmaceutical Company combined.

Nathan Bonilla-Warford I don’t directly do nutritional counselling with my patients but for every potential vision therapy case, I ask if they have examined diet and say that many past patients have found tremendous improvement in all areas just by improving diet. I listened to a lecture on tape from and OD in the 70’s discussing the role of diet in VT cases about how much it helped. Seriously, we’ve been talking about this for 40 years and have gone BACKWARD in progress…..

Steven M Newman I am advocating nutrition reform. I believe that if over 30,000 optometrists would simply ask a couple of simple questions in their history taking process, eyes will begin to open. I am fully aware of the lobbying interests against proper eating habits, but still feel that each day, I can change one person’s life. Multiply 1 by 30,000 and we, as a profession, have changed 600,000 lives per month. That’s 4.8 million a year. This is one of my goals and I do personally lobby Washington, albeit my financial statement pales in comparison to Big Pharma.

Steven M Newman These are not easy attitudes to break. Immediately after taking their Rx medication history (yes, I do this myself), I ask the question that I started the post with…”What did you have for breakfast today?” After listening to them tell me how the delicious their McMuffin was, I get personal with them. If they are there with their son and 6 year old granddaughter, I ask them if they would like to dance at their granddaughter’s wedding. When they reply “yes”, I ask them how they’re going to do that missing 3 toes?. I do this for shock value and I have had patients say to me “Doc, I just came here for an eye exam, not for a lecture on diabetes”. I reply “If you don’t care about yourself, how do you expect doctors to care about you. You are one person while they have 10,000 diabetics to worry about.” I have refused to see a patient if they adamantly refuse a DFE and I feel they are at risk, this is still our right.

Steven M Newman The words look harsh in print but combined with the right combination of body language and inflection, my points tend to be very well received. The point is not to make someone feel bad about how they treat themselves, only that it affects others also, like family members. I take my job as a parent very seriously and I try to lead by example, ie eating right, exercising regularly and taking my supplements. What type of lesson are we teaching our children when we knowingly eat poorly then pop an extra metformin before bedtime. Arming patients with more healthy options may be the straw that breaks their camels back. Letting diabetics know that their doctor is more concerned with their longevity while they (the patient and their family members) are in control of the quality of life. Making the right choices more often (not every time, let’s be realistic) will make a significant difference. Moderation is better than deprivation.

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1 COMMENT

  1. Were I to see a specialist, The last thing that I want is for him/her to pontificate on a subject not germane to the reason for my visit. It’s tantamount to my dentist counseling me on how often I should change the oil in my car. That’s different from the dentist questioning me on how long and often do I floss.
    If Dr. Newman wants to tell me how he thinks I can keep my car running better for longer, he should ask me first whether or not I care to hear his opinions on the subject. If he is so cavalier to ask dietary questions in a routine eye exam, he must be willing to accept my, “It’s none of your business” reply.

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