Privilege

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We welcome questions, feedback, and constructive criticism from our patients and readers, even if their opinions differ from ours, so long as the comments we receive are respectful. In response to a blog I wrote a few months ago discussing the intersection of nutrition and politics, one reader sent me the following message.

“I believe people’s passions for their careers should be evident. When someone comes through your door, they are seeking you out for your nutrition knowledge. You are brilliant at your job. The appointment is a give and take of information. However, I believe that people’s passions for politics should be kept private unless all parties have mutually agreed to share their views. Our views are slanted by all we know. As a former educator, we used to feel it was our job and it was our responsibility to try to remove our personal view from the workplace.”

Let me go through her points and respond to them one at a time.

“I believe people’s passions for their careers should be evident. When someone comes through your door, they are seeking you out for your nutrition knowledge.”

People seek out dietitians for all sorts of reasons. One person may have high cholesterol and hopes of lowering it via medical nutrition therapy, while someone else might have a history of chronic dieting and envisions building a healthier and more peaceful relationship with food. Some patients stop there, limiting their search for a dietitian to such criteria as perceived knowledge regarding a specific concern, as well as logistical factors, such as geographic location, ease of transportation to and from the office, insurance coverage, and appointment availability.

However, other patients have concerns that extend far beyond such basics. They want to know the person with whom they will potentially be working with and therefore desire some self disclosure on the dietitian’s part. Beyond that, many people value and are seeking a safe space for themselves. They want to know if their prospective dietitian will judge them for their size or behaviors, for example, or if the dietitian holds views on gender identity, ethnicity, religion, sexual orientation, skin color, nation of origin, or physical ability that hinder their ability to provide quality patient care. Sure, nutrition knowledge matters, our reader got that right, but she neglected to consider other factors of importance in a counseling relationship.

“You are brilliant at your job. The appointment is a give and take of information. However, I believe that people’s passions for politics should be kept private unless all parties have mutually agreed to share their views.”

The aforementioned individuals who are searching for a safe space for nutrition counseling need to know that we offer one. Furthermore, people sometimes ask us where we stand on societal issues and what actions are we taking to be a positive force in the world. They want to know what we are doing to combat weight stigma, for example, or to defend their health insurance coverage. Last fall, when we announced that we were donating 100% of the co-pays we collected between Thanksgiving and New Year’s to the Southern Poverty Law Center – an organization that fights hate and teaches tolerance – one ex-patient messaged me out of the blue to voice his displeasure while the rest of the feedback we received was positive.

Our practice’s philosophy is reflected in how we do our work – for example, we believe in collaboration and equality with our patients, which is why I like the symbolism of the round table in my office – and said philosophy also includes that we offer individualized nutrition counseling because we know that what works best for one person might not work so well for someone else. With that in mind, time spent in appointments belongs to my patients and I do not force political discussions on anyone, nor do I initiate them. If someone wants to focus on which fruits are highest in soluble fiber or some other superficial topic of hard science, no problem, fine by me, but my very next patient might be questioning what the point of working on their nutrition even is when they fear being murdered in a hate crime, having their health insurance stripped away, losing a loved one to deportation, etc. so I have to be malleable enough to respond to whatever feels most pressing to the person sitting with me at a given point in time.

“Our views are slanted by all we know.”

Exactly. With that in mind, I respectfully suggest that our reader reconsider the rest of her argument. Politics may have no place in nutrition counseling based on her world view and life experiences, but other people feel quite differently based on their own roads traveled.

“As a former educator, we used to feel it was our job and it was our responsibility to try to remove our personal view from the workplace.”

Just because I was a student does not mean I am an expert in education, but in my layman’s view I can envision issues with educators inserting their own political beliefs into their work. However, I question the parallel between that and nutrition counseling.

Teachers grade their students, sometimes write them recommendations, and are typically called by honorifics such as mister. Given a teacher’s position of power over their students, I can imagine that issues might arise if they reveal their own political leanings. Some of our patients, particularly children and adolescents, may expect a similar power dynamic when they first come to our practice, but we quickly dismantle that and emphasize that we are all on the same plane. We preach equality and collaboration, and nobody ever calls me Mr. Soolman twice.

Public education systems are taxpayer-funded institutions and my layman’s understanding is that they are supposed to accommodate the masses. If a teacher’s political discussion negatively affects the experience of a child who has every right to be there, I can imagine how that would be a problem, especially if said child does not want to or has no means to seek an education anywhere else. As a similar example, consider emergency room doctors who refused to issue the morning-after pill because doing so conflicted with their own beliefs. There was no room for such convictions in a hospital that is supposed to serve everyone, especially when time was of the essence and finding another clinic in short order might have been impractical or impossible.

Soolman Nutrition and Wellness, however, is a private practice, not a public institution, and patients have the choice whether to work with us or not. Sticking with the education theme, perhaps the best comparison would be that of a private school. If a Catholic high school wants to make daily prayer a way of life and take students on a field trip to Washington DC to participate in a pro-life march, so be it; those students and their families knew what they were getting themselves into when they choose to enroll there. If a family desires a more secular education, they can pursue enrollment at another private school or utilize the public school system to which they are entitled.

The reality is that while some people get irked by the occasional mention of politics in our blogs or e-newsletters, others feel comforted by those same inclusions. To feign political neutrality or to sidestep the topic entirely is still in itself to proclaim a stance and we would have to face the ramifications of our silence. We appreciate everybody who comes to our practice, but we cannot be everything to everyone; if we must turn off the privileged in order to welcome the vulnerable, we would rather do that than the opposite.

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