Nutrition Advice Feeds Care Debate

Geeta Sikand complains that Medicare does not recognize nutrition therapy as a covered benefit (Orange County Voices, April 20).

She offered the example of a man who did not consult such a therapist and found himself with an increased cholesterol level to be treated by drugs. But could not the doctor offer simple booklets which give the same information as a “consultation” with a “nutritional therapist”?

I attended a session with one, and received information right out of a booklet, which was given to me at the end of the meeting. Write to your employer, representative, senators to support such service, says Sikand. It is no coincidence that she is president of the California Dietetic Assn., representing “nutritional therapists.”

HARRY SIMMONS

Laguna Niguel

* Sikand is entirely correct in pointing out the current folly in insurance reimbursement on lifestyle counseling.

Whereas an insurer has little objection to paying tens of thousands of dollars for a coronary bypass, it will fight with nails and teeth for counseling on a change in lifestyle which might have prevented the arteriosclerosis in the first place. In addition, the problem will likely recur in a few years without lifestyle modification.

In my allergy practice, I have often been puzzled by managed care outfits’ refusal to authorize even a brief visit to go over the patient’s findings and discuss possible treatment options. Yet they will pay out hundreds and even thousands more for a patient’s medications. Am I missing something in this medical puzzle?

JOHN T. CHIU, MD

Newport Beach