Dietitian aims to help reshape Medicare

By Gail Carter Frank

Can I, as a registered dietitian, save your tax dollars and reshape our Medicare program?

On March 18, I visited the congressional offices of three U.S. representatives. My goal was to acquaint California Reps. Ed Royce and Laura Sanchez and Texas Rep. Charles Stenholm with medical nutrition therapy. I live in Royce's district, am co-principal investigator for the Women's Health Initiative at UCI Medical Center, Orange, Calif., in Sanchez' district, and my mother and family live in Stenholm's district in Texas.

Simply called MNT, Medical Nutrition Therapy is prescribed by a physician. I define MNT as a diet assessment, followed by instruction and monitoring. All activities are done by a registered dietitian or a skilled health care professional. For example, a registered dietitian evaluates a patient's health after he or she is diagnosed with a disease, and then the registered dietitian works closely with the patients and their family not only to reduce their medical complications, but also to improve the patient's life with a "science-based eating pattern."

Although it sounds simple, the power of MNT is tremendous. Just focusing on diabetes, we know that seniors with diabetes can eliminate their risk of blindness, amputation and kidney failure by keeping their blood sugar in a normal range. This means following an eating plan tailored to their food likes and nutrient needs and putting exercise into their life to use excess calories while keeping fit.

MNT legislation will be introduced in the U.S. House of Representatives after the spring recess.

When I entered the Longworth Building in Washington, I had three powerful ingredients in support of MNT: a letter, a report and my personal and professional conviction.

First, the letter I carried showed bipartisan support and three initial co-sponsors for the Medical Nutrition Therapy Act of 1997. This act would cover MNT outpatient services in Part B of Medicare.

Second, an impressive Lewin Report based on a recent survey of 48,000 recorded incidents of patients with diabetes and cardiovascular disease who had received MNT. The Lewin Report showed significant cost savings for patients with diabetes who had received MNT from a registered dietitian. This was to the tune of a 23 percent reduction in physician's office visits and a 10 percent reduction in hospitalizations. Significant reductions were also noted for patients with cardiovascular disease who received MNT.

The third powerful ingredient was my conviction, consciousness and concern for hundreds of individuals I had provided with MNT during my 26-year career. They had one or more diagnoses of diabetes, coronary heart disease, obesity, cancer, kidney failure, hypertension or alcoholism.

My visit was productive. Royce said he would support the MNT Act on the floor of the House and would meet with the co-sponsors to explore other options. He and I knew that my immediate family with four registered voters would learn of his support for MNT. Legislative representatives for Sanchez and Stenholm would continue to discuss MNT with their congressmen. Sanchez' legislative correspondent Aylin Kuyumcu knows that I am visible in Orange and Santa Ana to hundreds of women over 50 years of age who are just now experiencing health problems in their lives. As Stenholm shook my hand, he and I both knew that nine members of my immediate family would learn of my visit and his support for MNT.

Yes, as a registered dietitian I believe I can save your tax dollars and can reshape Medicare so it survives to care for our seniors. I tried this month. Will you try as a constituent and let your congressmen know that an ounce of prevention with MNT is really worth pounds of cure and that we can use science-based and medically indicated actions by registered dietitians to improve the quality of life for our seniors?

Dr. Gail Carter Frank, a 1966 graduate of Cooper High School, is a professor of nutrition at California State University in Long Beach and media spokesperson for the American Dietetic Association. She was inducted into Cooper's Hall of Fame in 1996.