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Group Medical Appointments with Cooking Classes to Teach about Disease Treatment & Prevention

April 27, 2016 By Chef Michelle Hauser MD Leave a Comment

It’s been about six months since the my co-authors and I published the journal article “Shared Medical Appointments: A Portal for Nutrition and Culinary Education in Primary Care-A Pilot Feasibility Project” in Global Advances in Health and Medicine.This project was spearheaded by former head of the Clinical Nutrition course at Harvard Medical School, and good friend of mine, Dr. Helen Delichatsios. She is a primary care physician based at the world-renowned Massachusetts General Hospital. When I was a third-year medical student, she and I were at a conference learning about shared medical appointments (SMAs, also called group medical visits), when we began talking about how we could create a new type of SMA that utilized cooking classes to teach about healthy lifestyle, treatment and prevention of chronic diseases related to obesity, inactivity and other unhealthy habits.

Veggie-Packed Fresh Spring Rolls with Peanut Dressing

Definition: Shared Medical Appointments / Group Medical Visits

Are when a group of people see a doctor together for one long visit rather than individuals seeing a doctor at many, separate short appointments. There are many types and structures of SMAs.
After a lot of hard work on Helen’s part to figure out how to introduce a completely new style of visit into her existing clinical practice–including getting buy-in from the clinic, arranging staffing, reserving space, learning how to bill for these types of appointments, and recruiting patients–we worked together to develop content for the visits.

 

How the Our Shared Medical Visits with Cooking Classes Work

Patients arrived, got their vital signs taken, then were escorted to a regular conference room and seated around a long table.Each 90-minute visit ran like this:

  1. They signed a confidentiality agreement and anonymously wrote questions that they had about their condition(s) or how to make healthy changes on an index card.
  2. Once everyone had arrived, Dr. Delichatsios and either myself or another assistant did an icebreaker activity with the patients.
  3. There was a short (10-15 minute) lesson on a health issue important to everyone in the room.
  4. Then, there was a facilitated group discuss/Q&A while I (or another chef) demonstrated how to prepare a simple, inexpensive, healthy dish.
  5. Everyone was given the recipe and the opportunity to taste the food.
  6. At the end of the visit, patients were given instructions about their follow-up visits or health care maintenance items that were due. If anyone had an urgent medical concern, Dr. Delichatsios had a short visit with them individually after the group class (this rarely occurred).

Mexican Quinoa (or Brown Rice) Salad with Citrus VinaigretteCost-effective & Fun!

We hadn’t intended to write about this project for publication, but when we realized that patients loved the visits, they didn’t cost any more than traditional visits, and they didn’t require a special space or a lot of special equipment, we knew that we needed to spread the word that this could be done in ANY primary care clinic as it exists TODAY. Since we started the visits nearly 8 years ago, some specialty clinics and direct primary care clinics have begun to install dedicated teaching kitchens. While this is very exciting (!), we published this last year in an effort to help clinics and practitioners realize that they don’t need to wait for someone to fund an expensive teaching kitchen for their clinic. If you have a conference room, table and a sink, you can run group visits and demonstrate basic, healthy cooking for patients. You also don’t have to be a chef to demonstrate healthy cooking–once I went off to residency and other assistants moved on to other projects, Dr. Delichatsios took over the cooking demonstration piece of the sessions as well!
For more details (and a better picture of the table, below), check out the full article.
 Cooking Classes for Shared Medical Appointments

Successful Visits with Low-Income Patients

Finally, I went on to replicate these type of appointments on my own (without the help of an assistant) in my residency primary care safety-net clinic (a clinic that treats patients regardless of income or ability to pay) with similar results. While I recommend that doctors enlist an assistant, rather than go it alone like I did, I believe that this is a great way to spend an extended amount of time providing lifestyle counseling/coaching to patients. This method also allows patients to learn from each other–both things impossible to do in a traditional primary care visit.

Are you a healthcare professional: why not try these visits in your practice?

Have you dreamed of getting a cooking class at your doctor’s office? Are you a physician who has struggled to get patients to change their eating habits? Why not try this today???
 

Reference:

Delichatsios H, Hauser ME, Burgess J, Eisenberg D. Shared Medical Appointments: A Portal for Nutrition and Culinary Education in Primary Care. A Pilot Feasibility Study. Global Advances in Health & Medicine. 2015;4(6):22-26.

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Chef Michelle Hauser, MD

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Michelle Hauser
Setting up for dinner at our SURG244 (Teaching kit Setting up for dinner at our SURG244 (Teaching kitchen elective for MD & PA students) final-beautiful cello accompaniment by one of our multitalented students. @stanford.med #culinarymedicine
Another fantastic end to a fantastic class! SURG24 Another fantastic end to a fantastic class! SURG244: Teaching Kitchen Elective for MD and PA Students is so inspiring. I am proud of all of my students. They’ve made so much progress over the quarter the food and insights into food and health tonight did not disappoint! Thank you all! #stanfordmedicine #culinarymedicine #foodasmedicine #foodismedicine #stanfordgensurg
Delicious dessert that are healthy, too! Banana Delicious dessert that are healthy, too! 

Banana bread (made egg- and nut-free), and the 3 pleasures—chocolate, fruit & nuts

#CulinaryMedicine #foodismedicine #bananabread #healthycooking #chocolate #fruit #nuts #eggfree #nutfree
Another amazing quarter! The students in the Stanf Another amazing quarter! The students in the Stanford Teaching Kitchen Elective for MD/PA Students never fail to impress. Here is the spread they put on tonight for their final. So humbled and grateful to be part of this journey. #CulinaryMedicine #foodismedicine #stanfordmedicine @stanford.med #teachingkitchen #deliciousandnutritious
It’s been a whirlwind here and I have not been g It’s been a whirlwind here and I have not been good about keeping up with pictures. BUT, Here are some mouthwatering examples of the delicious and healthy breakfast options we created in class this week. Buddha bowl with tofu scramble and lemon tahini dressing, a yogurt parfait, and steel-cut oats piled with toppings. #ChefInMedicine #DoctorIsInTheKitchen #TeachingKitchen #stanfordmedicine #breakfast #eatmoreplants #healthy #nutrition #culinarymedicinecurriculum @aclifemed @stanford.med
Cheesy plant 🌱 based fondue is a total hit with Cheesy plant 🌱 based fondue is a total hit with infants and big kids alike-Served with roasted potatoes, blanched broccoli and green beans, vegan meatballs, artisan bread and mango (which did not get dipped in fondue)

#chefinmedicine #Kidseathealthy #funandhealthy #kidfood #everyonefood #Culinarymedicine #foodismedicine @aclifemed #lifestylemedicine
Figs from the neighborhood-urban foraging #figseas Figs from the neighborhood-urban foraging #figseason #yum #figs #chefinmedicine #urbanforaging #fruit #summerfruit
Veggies and kids: fruit rainbow, polenta sun, bro Veggies and kids: fruit rainbow, polenta sun,  broccoli and cauliflower trees, new colors and textures, kiddo eating the first cherry tomato she grew with me in the garden. Gotta make veggies fun! #cookingwithkids #chefinmedicine #fruitandveg #healthykidsfood #healthykids #playwithyourfood
Stanford Scope covering the culinary med course #c Stanford Scope covering the culinary med course #culinarymedicine #stanford #nutrition https://scopeblog.stanford.edu/2022/05/27/nutrition-meets-health-through-culinary-medicine/
Made in a cooking class with my patients today: Ch Made in a cooking class with my patients today: Chana masala and roasted cauliflower with cumin & coriander; fruit chaat #IndianFood #culinarymedicine #chefinmedicine #chanamasala #fruit chaat #foodismedicine
Mise en place for chana masala with my patients to Mise en place for chana masala with my patients today— Clockwise from the top: garam masala, turmeric, asafoetida, ground cumin, salt, cloves, cinnamon stick, green cardamom, bay leaf, whole cumin seeds, red chili powder (rashampatti) is in the center. #foodismedicine #culinarymedicine #chefinmedicine #indianfood #chanamasala
Gorgeous Buddha Bowls and Steel Cut Oats from toda Gorgeous Buddha Bowls and Steel Cut Oats from today’s Teaching Kitchen course for MD & PA students-photo by the talented @soulfoodsalon (who frequently joins the course as volunteer faculty-thank you!) @stanford.med @chefinmedicine #culinarymedicine
Stanford MD & PA students graduate from the teachi Stanford MD & PA students graduate from the teaching kitchen with honors-so much delicious food shared at the final potluck tonight. Everything had a story, showcased a lesson from the course and students reflected on what they learned that would most help them counsel patients on dietary changes. #culinarymedicine #stanfordmedicine @stanford.med #meded #teachingkitchen @soulfoodsalon #worldflavors #unapologeticallydelicious #healthycooking
Fruit forward desserts prepared by Stanford MD & P Fruit forward desserts prepared by Stanford MD & PA students-SURG 244 The Doctor is In (the Kitchen)—teaching kitchen elective. So delicious 😋-thanks to Drs. Elizabeth Shepard, Sue Kim, and Christopher Gardner along with Lindsay Kennedy, PA and for volunteering to share the overlap of their work and culinary medicine with the students! #CulinaryMedicine #FoodIsMedicine #Dessert #TeachingKitchen #FruitForward #DessertFlip #Nutrition #MedicalEducation #MedEd #stanfordmedicine
The Dietary Spectrum: When Food Becomes Medicine-- The Dietary Spectrum: When Food Becomes Medicine--Keynote presentation filled with tips on guiding patients to make dietary behavior changes. #LM2021 #nutrition #foodasmedicine #behaviorchange #obesitymedicine #culinarymedicine lmconference.org/2021/LM21/index.asp
Just finished a fantastic session with @spiceboxtr Just finished a fantastic session with @spiceboxtravels on implementing culinary medicine in clinical practice! Check out the rest of the American College of Lifestyle Medicine 2021 Annual Conference for a recording and other lifestyle medicine CME opportunities. #LM2021 @aclifemed #CulinaryMedicine #LifestyleMedicine #ObesityMedicine
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