Private Practice Dietetics in GI with Tamara Duker Freuman, MS, RD

In this podcast episode, Tamara Duker Freuman, MS, RD, CDN, discusses how the work of gastroenterologists and dieticians can inform each other, approaching GI conditions as new science emerges and more.

•    Intro :02
•    Welcome to this episode of Gut Talk :23
•    The interview/about Duker Freuman :30
•    How did your childhood environment and early education lead you to become a dietician? :41
•    Can you tell us about how your experiences have had an impact on the way you treat your patients as a dietician? 1:47
•    How Duker Freuman’s books, Bloated Belly Whisperer and Regular, provide information about clues that can help providers better understand the causes of patients’ symptoms. 3:22
•    Are dieticians trained differently than doctors when it comes to motivational interviewing versus fact-seeking to learn about patient history? 4:30
•    About the JAMA Network studies on Variations in Processes of Care and Outcomes for Hospitalized General Medicine Patients Treated by Female vs Male Physicians and Comparison of Hospital Mortality and Readmission Rates for Medicare Patients Treated by Male vs Female Physicians  7:12
•    What eventually drew you to dietetics, and then GI dietetics? 7:43
•    When you went into GI nutrition, was it already a recognized specialty? 10:52 
•    Were you an early adopter of the low-FODMAP diet? 13:27
•    How did the GI community react to the news of low-FODMAP at the time? Was this science well-embraced by physicians when it came out? 14:50 
•    With low-FODMAP, are you a top down or a bottom up person? Do you have a preference? 19:03
•    In your book you discuss the ten main causes for bloating. What are the main causes we should be thinking about, and which are the most common in your experience? 20:22
•    You talk about the “food baby twins”, gastroparesis and abdomino-phrenic dyssynergia, in your book. Can you tell us about that? 22:51
•    Do you have any recommendations for abdomino-phrenic dyssynergia, like diaphragmatic breathing, and what has worked that you have recommended to patients? 24:02
•    With the challenges of insurance reimbursement for dietetics and getting patients access to this type of information, can you provide enough value with one visit with a patient, or is multiple visits with a dietician required in order to move the needle? 25:19
•    What do you think about histamine intolerance? How do you identify it and is there a low-histamine diet that people can use now? … What about Mediterranean? 28:27
•    How have you trained yourself and the dieticians that you work with to think about and incorporate cultural and lifestyle sensitivity into dietary recommendations? Are there best practices to embrace that, or is this a challenge of dietetics? 36:01
•    What was it like joining New York Gastroenterology Associates (NYGA) when they became a large group practice? … What was it like bringing on additional dieticians and continuing to grow that part of NYGA’s care delivery? 39:40
•    Thank you, Tamara 43:41
•    Thanks for listening 43:59

Tamara Duker Freuman, MS, RD, CDN, is a New York-based registered dietitian, author and nationally-known expert on medical nutrition therapy for gastrointestinal diseases.

We’d love to hear from you! Send your comments/questions to [e-mail]. Follow us on Twitter @HealioGastro @sameerkberry @umfoodoc. For more from Tamara Duker Freuman, follow @tamaraduker on Twitter and @tamarafreuman on Instagram.
 
Disclosures: Berry, Chey, and Duker Freuman report no relevant financial disclosures.