When french young general practitioners commit to healthy eathing

In France, patients usually come to their general practitioner (GP) with 2 or 3 motives during a consult. The average duration of a consultation is 15 minutes, in a fee-for-service context. While GPs are patients’ obvious points of contact for providing nutritional advice, they have little time to do so. We thought it would be worthwhile to explore how they carry out this duty. The PreEGEA symposium, which was held in Lyon in 2018, was an opportunity to issue a call for thesis work among young doctors finishing their specialisation courses in general medicine. This call was successful, and the findings of five theses were presented at Pre-EGEA. Three of them have been covered by articles in this newsletter.

•  The first thesis focused on interns in general practice. It is encouraging to see that these students (with a majority of female respondents) pay attention to the quality of their diet. They try to comply with the National Health and Nutrition Programme (Programme National Nutrition Santé – PNNS) guidelines, despite the constraints of their profession; the obstacles are storage issues and preparation time. They would like for their nutritional training to be improved, with priority given to practical culinary workshops instead of theoretical courses.
•  The second thesis showed that doctor’s personal background, often familial eating habits and physical appearance, influence the way he/she gives advice. Doctors feel they have varying degrees of legitimacy for doing so and claim to have received little nutritional training. General nutritional advice is deemed ineffective; a motivational approach is preferred.
• The third thesis enabled GPs’ practices to be observed in single-blind conditions. Onequarter of the observed consultations gave rise to nutritional advice. This advice was brief, more frequent for men and in a context of secondary prevention. Advices were based on the PNNS guidelines, but mainly restrictive. The briefness of the message is offset by the regular monitoring of patients with chronic diseases, providing opportunities to reiterate and diversify advice across consultations.These theses offer avenues of thought for improving the care of our patients to help them improve their diets. Nutritional advice requires know-how and time, which GPs are lacking the most. Knowhow refers to the quality of the patient-doctor relationship. New forms of practice are emerging in France, with the support of the public authorities: multi-disciplinary health centres, creation of medical assistants, and increase in the number of “Asalée” (Team Health Project in Private Practice) nurses in charge of therapeutic education. These developments should enable GPs to improve the care they provide in the area of prevention, with a special focus on nutritional education.