When a terrified 10-year-old boy walked into Colleen Sloan's pediatric practice in tears, she discovered he'd been monitoring his weight obsessively after another provider warned he'd "need needles in his stomach" if he didn't lose weight. This moment exemplifies everything wrong with how healthcare approaches nutrition conversations—and sparked a mission to change it.
As both a pediatric physician assistant and registered dietitian nutritionist, Colleen brings rare dual expertise to the critical intersection of medicine and nutrition. Her journey from clinical dietetics working with critically ill children to PA school while raising a child showcases her remarkable determination and passion for comprehensive patient care. What makes her approach revolutionary is her commitment to compassionate communication when discussing sensitive topics like weight, diet, and body image.
Most medical professionals receive merely 2% of their training in nutrition, despite its relevance to virtually every condition they treat. Through her platform Exam Room Nutrition, Colleen equips clinicians with practical tools to confidently navigate these conversations using techniques like "ask, offer, ask"—a framework that respects patient autonomy while providing expert guidance.
"Being curious is a really great characteristic of an excellent clinician," Colleen explains, advocating for questions like "What's making this hard for you?" rather than judgmental directives. This approach not only improves patient outcomes but also helps prevent provider burnout by fostering genuine connection instead of frustration.
Colleen's CME-approved course for healthcare providers fills a crucial education gap, covering everything from nutrition fundamentals to counseling skills for specific populations. By transforming how we discuss nutrition in the exam room, she's creating a future where medical care nourishes both body and spirit.
Looking to enhance your approach to nutrition conversations? Connect with Colleen on Instagram or LinkedIn @ExamRoomNutrition or through her podcast on Apple and Spotify.
More at her website www.examroomnutrition.com
Virtual shadowing is an important tool to use when planning your medical career. At Shadow Me Next! we want to provide you with the resources you need to find your role in healthcare and secure your place in medicine.
Check out our pre-health resources. Great for pre-med, pre-PA, pre-nursing, pre-therapy students or anyone else with an upcoming interview!
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Ashley (00:00):
Hello and welcome to Shadow Me Next, a podcast where
I take you into and behind thescenes of the medical world to
provide you with a deeperunderstanding of the human side
of medicine.
I'm Ashley, a physicianassistant, medical editor,
clinical preceptor and thecreator of Shadow Me Next.
It is my pleasure to introduceyou to incredible members of the
(00:22):
healthcare field and uncovertheir unique stories, the joys
and challenges they face andwhat drives them in their
careers.
It's access you want andstories you need, whether you're
a pre-health student or simplycurious about the healthcare
field.
I invite you to join me as wetake a conversational and
personal look into the lives andminds of leaders in medicine.
(00:44):
I don't want you to miss asingle one of these
conversations, so make sure thatyou subscribe to this podcast,
which will automatically notifyyou when new episodes are
dropped, and follow us onInstagram and Facebook at Shadow
Me Next, where we will reviewhighlights from this
conversation and where I'll giveyou sneak previews of our
upcoming guests.
Today, we are joined by ColleenSloan, a pediatric physician
(01:07):
assistant and registereddietician nutritionist who has
spent over a decade blendingnutrition expertise with
pediatric care.
Colleen's journey began inclinical nutrition, where she
worked with critically illchildren, before realizing her
desire to expand her scope ofpractice by becoming a PA.
Since then, she's been making alasting impact in pediatrics,
(01:31):
seeing patients from infancy toadulthood.
What's truly unique aboutColleen's approach is her
dedication to incorporatingnutrition into every aspect of
patient care.
She's the creator of Exam RoomNutrition, a platform designed
to help clinicians confidentlydiscuss nutrition with their
patients, emphasizing theimportance of compassionate
(01:54):
communication, especially whenit comes to sensitive topics
like weight management.
In this episode, we'll diveinto Colleen's journey from
dietetics to becoming a PA, hercommitment to lifelong learning
and the tools she's developed tosupport fellow healthcare
providers.
She'll also share her insightson how clinicians can navigate
(02:17):
difficult conversations withpatients around weight, all
while fostering trust andempowerment.
Please keep in mind that thecontent of this podcast is
intended for informational andentertainment purposes only and
should not be considered asprofessional medical advice.
The views and opinionsexpressed in this podcast are
those of the host and guests anddo not necessarily reflect the
(02:40):
official policy or position ofany other agency, organization,
employer or company.
This is Shadow Me Next withColleen Sloan.
Hey, colleen, thank you so muchfor joining me on Shadow Me
Next today.
You have such an incrediblestory I cannot wait to hear
about what you have to say.
Thank you for joining us.
Thank you so much, ashley, forhaving me on.
(03:02):
I think my journey is relatablefor a lot of people, so I'm
excited to just give someinsights for any of your
listeners.
Absolutely so relatable, andthere's so many of these
conversations that I'm excitedabout all of them.
There are certain elements ofsome that I know I am going to
learn a lot about a certainelement of medicine, and this is
one of them.
And I think when you and Iinitially met and started
(03:32):
talking, I told you that Ireally did not have a great
understanding of nutrition untilI was a clinician, and it
wasn't because of my practice,it was because of me as a person
.
I was just more interested init, and the amount that I did
not know as a clinician, as a PA, was really eye-opening.
So thank you for what you do,thank you for the education you
provide, thank you for whatyou're going to tell us today.
I can't wait.
So tell us your titles, first ofall, is this cool?
(03:56):
And then a little bit aboutwhat drove you to pursue both of
these titles.
You're not alone in yourfeeling and your sentiment, and
it's so true, whether you're anMD, do, np, pa, like any of the
medical professionals we got,maybe 2% of all of our training
had to do nutrition, and I thinkit's wild because really most
(04:18):
of the conditions that we treatand we see in practice have
something related to diet andnutrition, whether it's in
weight management, which iseverything, but even when you
think about it migraines you cando some elimination diets and
find out their trigger foodanything in the gut, cardiac.
So everything we do aspractitioners does have some
part of nutrition and I thinkhaving that education is so key.
(04:41):
So you're not alone and that'sreally why I created my platform
, which we'll get more into.
But I want to bring it way back.
My credentials are I'm apediatric physician assistant
and a registered dietitian, andwhat came first was becoming a
registered dietitian.
Oh, like you said way back,tell us a little bit about what
(05:02):
the schooling, what thateducation process was for
becoming a registered dietitian.
And then maybe it was there.
Did you have a light bulbmoment?
What did that look like for you?
Yeah, I love sharing my journeyon this because it's a lot of
people are really curious aboutit because there's not a lot of
RDPAs.
When I was in college, I knew Iwanted to do something in
medicine.
I loved helping people, I lovethe science of medicine, but I
(05:24):
did not want to major in biology, which is what most pre-med
students major in.
So I'm sitting at TGI Fridayswith my dad one day and he's
like you're so smart, you shouldabsolutely become a doctor.
And I'm like, yeah, I get, Ithink so, but I just don't know
what to major in.
So my mom at the time was acollege textbook sales rep and
she's like why don't you comedown to FIU with me?
(05:45):
I live in South Florida, soit's Florida International
University.
I have to call on a lot of thedifferent colleges and nutrition
happens to be one of them.
Okay, so I walked the halls ofthe nutrition department, meet
some of the professors, and thatwas the first time I actually
even heard about a registereddietitian.
I didn't even know what theywere or that they existed, and I
told my mom this is what I wantto do.
(06:07):
This sounds really cool.
And it just so happened thatall of the prerequisites,
science classes and everythingwere exactly what I needed to
apply to medical school, and soI completely changed my path.
I transferred over to FIU and in2010, I graduated with my
bachelor's in nutrition anddietetics.
(06:28):
And you could have just I couldhave just stopped at that, but
I was sold on nutrition.
I was like I love this, I wantmore and I want to do this with
my patients Plus.
Now this is a little peek intomy personal life, but I think
it's.
I like sharing this part of mystory because I think it's
relatable for a lot of peopleand I want to encourage people
(06:50):
in that when you hit mishaps andthings happen in your life that
think are going to derail, youdo not give up because you
continue.
I actually got pregnant in mylast year of college and what
probably could have completelystopped my career trajectory
Honestly, I didn't skip a beatat all, and so I share that
(07:12):
because just because you're amom, just because you're
divorced, just because you andput on a blank, don't let that
be your crutch or your excuse tonot do something that you are
deeply passionate about, and I'ma firm believer in that.
So I continued on school.
I completed without missinganything and it was great that I
was a nutrition, becauseeveryone was very pro
(07:33):
breastfeeding and I was pumpingon campus.
It was hard, but I had suchsupport with my colleagues and
my student friends at the time,and so I became a registered
dietitian.
And so in order to become that,just because I have that
bachelor's degree, you have toalso do an internship and then
sit for state boards.
And so now it's a little bitdifferent.
(07:55):
You have to also get a master'sdegree, but back in the day you
did not, but it's the samething.
So you can do a master's.
You have to do an internshipand then become board
credentialed, board certified.
And so I became a dietitian in2011.
And I worked in clinical forabout three years.
I worked in the trauma ICU, soyou do a lot of tube feeding and
(08:15):
TBN calculations as a dietitian.
I also worked some of theregular floor, so you do the
cardiac education, dialysiseducation.
Then I got a little bit boredof inpatient nutrition and so I
started my own private practice.
So I was doing diabeteseducation and weight management,
and then I got bored with that.
A colleague and friend of mine,lucille Bessler, is a very
(08:38):
well-known dietitian among thefield.
She ran the pediatricoutpatient dietary services for
big children's hospital downhere in South Florida Joe
DiMaggio Children's Hospital andshe said hey, why don't you
come on with me?
I need a partner to run theseclinics.
I'm like, okay, but you need toteach me pediatrics because
I've only ever done adult.
And so we ran the cysticfibrosis clinic, the pediatric
(09:01):
dialysis and the cleft andcranial facial clinic, and it
was here that I was badly inlove with two things One is
pediatrics and two is medicine.
I reverted back to where I wasin college, where I'm like I
want to be caring for patientsand I just had this deep desire
(09:21):
to do more, to offer more, toeven know more than just
nutrition, because at that pointI had done so many things in my
career over the five-year spanthat I'm like I feel capped out
and I feel like I still have gasin the tank that I want to
pursue.
And I thankfully, with all ofthese different areas that I
(09:42):
worked in, I was able to talk toMDs and PAs and MPs, because I
was at this crossroads what do Ido?
I'm a dietitian, but I don'tknow what to do next.
And over and over again, it waslike PA, pa.
I met incredible PAs and everysingle one loved what they did
and they're like yeah,absolutely do it.
The decision has to be verypersonal.
(10:03):
So I have a lot of dietitianfriends who asked me this
question what made you decide PAversus MP or why not MD?
It's a.
It has to be a very personaldecision, but for me it all
worked out in favor of PA.
I already had all of theprerequisites so I didn't have
to retake any classes.
I also had all of the clinicalexperience, so I really I didn't
(10:24):
need to do any shadowing.
Thankfully, because of mydietetics career.
And why I didn't want to becomean MD is I was already a mom at
this point.
I really didn't want to be inschool for six plus years to be
an MD, and I also didn't want tobe an NP because I also didn't
want to go back to school to getmy RN first.
So it just all of that madesense and so I applied to one
(10:49):
school here locally in SouthFlorida.
I got in.
I do not recommend that forcurrent applying PA students.
It was competitive then and itis even more competitive now.
It's one of the top careers toget into, so you've got to be on
your game Now.
It's one of the top careers toget into, so you've got to be on
your game, but I got in to NovaSouth Eastern university in
2015 and graduated in 2017, ofwhich are the two hardest years
(11:14):
of my life.
Pa school is insane, and being amom, right.
So again, I'm like a firmbeliever and I will preach it
from the mountains Do not letyour age, your marital status,
like any, your health, like noneof that, hold you back.
If you are committed to doingsomething, you can absolutely do
it.
And so now I've been a PA since2017 and I stayed with my true
(11:38):
love of pediatrics.
I got my first job out of PAschool in general pediatrics,
and I have been with thatcompany ever since, so about
eight years now.
First of all, it's amazing thatyou have been with the same
company for eight years.
I think that alone, perhaps forthose who are not as familiar
with the PA professionespecially, a lot of people do
end up shifting after the firstone, two or three years just
(11:59):
because we're generalist trained.
Usually, some of us enterspecialty like dermatology, for
example.
I went into OBGYN first.
It's a little bit more of ageneral specialty, but it's not
very often that you hear ofsomebody sticking with the same
job that they've had since thebeginning, when they first
started work as a PA.
I want to touch on that becauseburnout is not a hot topic right
(12:21):
now, but I think that's a greatword because it's prevalent.
Any healthcare professionalhonestly, any career right now
we're feeling burnout.
We have less staff, so everyoneis just doing more.
We're getting paid less, and soit is real, and I know a lot of
my colleagues, or a few of mycolleagues, who are PAs coach
people through burnout and Ikind of chuckle to myself that I
(12:44):
never felt that and I feel soblessed and proud of that.
That I don't feel like that.
I actually, and to this day, canstill say I love getting up and
going to work and I reallythink it's because I pursued
something that I'm deeplypassionate about.
I love kids and every patient.
I pick them up, I kiss theircheeks.
(13:05):
We just have so much funbecause I respect that role as
the general pediatrician intheir life and I love the
opportunity to watch that childgrow from zero to 21.
It is the coolest opportunitythat you can get, and so I think
for people trying to figurethat out, you really do need to
love your job.
(13:25):
And that's not to say what I dois easy.
I'm at a very high volumeclinic.
I see from eight to five, 40kids in a day.
So that's my template.
So it has all the reasons tohave burnout.
But because I'm so in love withwhat I'm actually doing, it
feels easy to me, it's fun to meand I think that's important
(13:48):
when you're choosing a job.
It is absolutely because lifeand medicine really becomes your
identity and there's nothingwrong with that and I don't hate
saying that and I agree withyou a hundred percent.
I think that if you reallyinvestigate, know yourself, know
what works for you, and youfind that job that you can pour
(14:08):
into but that at the same timealso pours into you.
I'm really glad you said thatand I think it's a testament to
how hard you have worked and howmuch thought you have put into
where you're at.
It's like you said, you reallyhave to love it, but not only
love it, but you really have tounderstand why you've chosen it.
(14:29):
When you were saying about thatfive-year mark, you get to this
five-year mark and either you dostart to feel that burnout.
I think a lot of people switchor change or do things, and you
were a dietitian for five years.
I think there's somethinginteresting about that five-year
mark and if you think about it,as PAs we used to board certify
every seven years, so aroundthat five-year mark we're
starting to think about ourrecertification.
(14:50):
Then they bumped it out to 10years.
So it'd just be reallyinteresting to gauge how much of
us are able to actually sitdown and look at what we're
doing and evaluate these sortsof feelings that we're feeling
at a five-year mark and say do Ineed to pivot?
Do I need a big pivot?
Do I want to pick up somethingextra?
That I've been thinking about,I think pushing out our board
certification 10 years.
It's been really interestingfor that.
That's actually really.
That's a really interestingpoint.
(15:11):
I think you're right.
Most of my PA friends they arejob switching and there's
nothing wrong with that.
I think that's the beauty andthat's also.
What drew me to being a PA isbecause as a diitian I switched
every year or so.
I either picked up somethingnew or just completely switched
gears, and so I wanted thatflexibility.
(15:32):
I was nervous if I became an MDand GI, like that's it, you're
certified in that and you'restuck in that.
That kind of scared me and Ilove that about being a PA, but
I also think that if you'refeeling that itch at that,
whatever year it is reallydetermined, is it the job itself
or are you just itching forsomething new, like a new brain
(15:53):
stimulant?
And for me, what I actually did, looking back, is almost three
years ago.
I started a podcast and Istarted to talk about nutrition
more and I wanted to teachclinicians more about talking
about nutrition.
And so I think that talk aboutnutrition more and I wanted to
teach clinicians more abouttalking about nutrition, and so
I think that having thatcreative outlet whether it is a
side gig, maybe a side weekendjob at an urgent care where
you're getting a different pacein the clinic or, yes, a big
(16:16):
pivot I think that's okay and Ithink there is beauty in that.
And as PAs, we like to learn,we are lifelong learners and I
think that's the key to a lot ofprevention of burnout.
Absolutely, and that is aperfect segue.
Colleen, you have Exam RoomNutrition, which is just turned
into this incredible platform.
Tell us a little bit more aboutwhat that looks like for you.
(16:37):
We've talked about how it began, but are you enjoying doing
this?
Tell us about it.
This lights me up.
I'm so passionate about themission behind examiner
nutrition, which, yes, is aplatform.
Now it's a podcast, but it'salso social media and we'll talk
about eventually too.
It's a course and it reallystemmed from one Saturday when I
(17:02):
was in clinic, and it was justa day that stamped the approval
of what I had been thinking thatI want to do.
I'm walking down the hall myfirst patient.
I'm rushing because I'm knownto be like 10 minutes late every
morning and I look at the chartand it says rash is a sick
visit, and anybody who's inpediatrics knows oh, thank God,
(17:22):
like this is going to be quick,I'll get back on time at no time
.
But no, I walk in and the childwas crying, and which is this
is not abnormal in pediatrics.
Most kids are crying andscreaming.
It's a lot of drama in theoffice, but it wasn't.
He knew he wasn't here for acheckup and he was also about 10
years old.
So I just sat down and I saidoh, sweetheart, why are you
crying?
What is wrong?
(17:43):
The mom began to talk and sheshared the story of how, six
months ago, when he did hischeck, the clinician who I don't
know if it was an MD, pa, mp,it doesn't really matter.
Clinician had said you need tolose weight and if you don't
lose weight by the next time youcome in here you're going to be
having to do needles in yourstomach because you're going to
have diabetes.
(18:03):
A lot of fear, right.
So this child mom told me hadbecome obsessed with his weight.
He began restricting his foodsand they were of Asian descent,
so they had a lot of culturalfoods that he stopped eating.
He weighed himself multipletimes a day and that when he
jumped, stepped on the scale andthe office that morning, he had
(18:27):
gained three pounds and in hismind he's a failure and now he's
going to have to.
You know he's got diabetes andhe needs to take this shot in
his stomach that he wasthreatened with and he was
besides himself.
And when I heard that story myheart dropped because it could
have gone so differently.
(18:49):
This child actually was very ageappropriate in his growth
trajectory.
He was not considered obese oroverweight.
He had gained some weight, butif you look at the stage that he
was in in puberty, he'sprepubescent.
We expect boys and girls to puton weight during this time.
This is natural.
This is normal.
We also know from science thatall bodies come in different
(19:15):
shapes and sizes, and so hemight be settling into a larger
body, which is fine.
So I spent a few minutestelling him about what his body
should be doing at this point,how food is nourishing to our
bodies, and that we don't needto be weighing and restricting
foods and we can be enjoying thefoods and enjoying our bodies
for what they can do.
And I left that visit and at theend of the day, I sat in my car
and I started crying becauseI'm like there has to be a
(19:37):
better way, because I'm sure theclinician meant no harm in that
flippant comment.
They probably really meant forit to be positive and to be
motivating and encouraging andlike we're supposed to do.
We have to have hardconversations as providers.
We have to have those.
Hey, your weight might become aproblem.
(19:59):
We need to get this undercontrol.
That's probably what they meantto do, but they just didn't
have the language in order toportray that.
And so I'm like you know what?
I have that knowledge.
I, as a dietitian, know how toframe these conversations.
I know how to discuss weight ina very compassionate, inclusive
(20:20):
, sensitive way.
I know how we can approach thisand I want to share that with
the community, and so that wasreally the birth of the podcast.
But I also, as a dietitian,really wanted to feature
registered dietitians as thenutrition experts, because they
are, and I feel they are notrespected in the medical field
(20:40):
as much as they should be, norare they utilized as much as
they should be.
So I wanted to give them amicrophone and really highlight
them for looking at what theyknow, look at the time that they
can spend with your patients.
Let's use them, let's bringthem alongside in our team so
that we can better the health ofour patients and a society at
large.
Well, colleen, my heart hurts.
(21:02):
My heart hurts so bad for thatchild and I'm so glad that you
were his follow-up.
I think we were put in veryspecific places for very
specific purposes and to me yourwhole background was leading up
to that one exact moment.
But it's just such a reminderabout how powerful our words are
and our words matter and weneed to be very intentional with
(21:25):
what we're saying to certainpeople.
And I think as clinicians,sometimes that can be hard,
because I think a lot of timeswe are trying to communicate a
concept to someone and we haveto realize that the way we're
communicating that concept ishow the person sitting across
from us is going to interpretthat concept.
Tell us a little bit about howclinicians and for pre-health
students as well this is a greatexercise, but tell us about how
(21:49):
they can discuss the topic ofweight period whether it's
overweight, underweight, etcetera with compassion.
Before we hear Colleen'sresponse and the quality
question that came from it, keepin mind that there's more
interview prep, such as mockinterviews and personal
statement review over onshadowmenextcom.
There you'll find amazingresources to help you as you
(22:12):
prepare to answer your ownquality questions.
Colleen just mentioned apowerful topic that's relevant
for anyone working in patientcare and one that makes an
excellent quality question.
Share a time when you had tonavigate a difficult
conversation with another person.
What approach did you take toensure it was compassionate and
(22:33):
effective?
As Colleen pointed out, theseconversations can be incredibly
tough, but the key is creating acompassionate environment,
listening actively and ensuringthe patient knows you're on
their side and not judging themeffectively and ensuring the
patient knows you're on theirside and not judging them.
Approach these conversationswith empathy, understanding the
(22:54):
emotional layers involved andoffering solutions that empower
the patient rather than makingthem feel helpless.
Gosh, yeah, I have.
Probably.
Every day I have a story.
That is like jarring to me thatsomeone said this to a child.
I posted a reel the other daythat the parent came in and was
like oh yeah, I'm reallyconcerned about the weight, um,
and she looks at her daughter,who was eight, and told her I
know, honey, this upsets you,but you need to be on a diet
(23:16):
Right.
And she looks at me saying andI'm like no, we're not even
using that word at all.
And this actually came fromschool, because in schools, at
least in Florida I cannot speakfor other schools but the school
system does height and weightscreenings and if they are above
a certain percentage then theyget a note sent home and they
have to come in and see thephysician or the provider and
(23:37):
get it signed off on.
I sign one of those probablyevery single day.
And I look at the parent.
I say we're not even going totalk about this because I am not
concerned.
I know your child, I've beenfollowing their weight and she
is fine and I just think we arein such a weight focused and
obsessed culture that I'm hopingis switching and we're
(23:58):
transitioning from that, but wereally are still so focused on
that that we can't seem toaccept that just because a child
is a little bit larger, itstill means that they're fine,
they're healthy.
And so I think the first placethat we can start is, first of
all, the very first thing thatany clinician can do in this
build rapport and shows that youdeeply respect the patient is
(24:18):
ask for permission before youtalk about weight or before you
even start talking about diet ornutrition, because sometimes
the patient might not want totalk about their weight, and
I've heard countless adults tellme that they came into the
doctor because their ankle hurtand the first thing that the
doctor said was like, oh, maybeyou should lose some weight.
And they're like well, can youhelp me with my ankle?
(24:40):
I twisted it, I'm worried thatit's broken.
Like they weren't being heardfor their chief complaint.
And so it is so important thatwe ask permission, and the
easiest way to do that is justto say hey, are you comfortable
or is it okay If we talk about?
And if it's a weight visit, ifyou're in primary care and
that's what you need to talkabout you're to wait today.
(25:00):
Or even if you're in a specialty.
Let's say you're in pulmonologyand you have a patient who has
asthma and it seems to beuncontrolled.
If you're on all thesedifferent medications, they're
already on controllermedications, they're on
biologics, you've tried a lot ofdifferent medicines.
This might be a greatopportunity, especially if they
(25:21):
are overweight or in a largerbody, to maybe bring that up and
say, hey, we've tried a lot ofdifferent medications.
I'm just wondering if you thinkit would be okay if we talked
about your diet a little bit tosee if this might manage your
asthma a little bit more.
Framing it that way puts thatdecision in the patient's hands.
They get to choose, if it'sokay, if they're interested at
all, before you just rattle offhey, you should lose some weight
(25:44):
, why don't you eat some morefruits and vegetables?
That's not going to stick withanyone at all.
But if they choose, but it'sokay, yeah, I'm open to that,
I'm interested in that.
That's a beautiful opportunityfor you then to share a few
options.
Now a strategy and motivationalinterviewing is called ask,
offer, ask.
The first ask is to askpermission.
Then we have an offer and whatwe're doing is we are offering a
(26:07):
menu of options.
So, for example, you could say.
For some of my patients, whathas worked has been to eat an
apple before lunch because thatkind of helps them feel fuller.
But I have other patients whoreally like to take a walk after
dinner.
This really helps with theirdigestion, helps them get some
physical activity.
And then I do have somepatients that they've carried
(26:27):
around a water bottle becausetheir goal was to increase their
hydration.
Which one do you think soundslike something you could try?
So we offered those threesuggestions.
But that final question that'sthe second ask is another way
that we're welcoming the patientand their life and their
experience and their desiresinto the conversation.
Which do you think would workfor you?
(26:49):
And it's easy as that.
And they say oh, you know what?
I don't want to do anythingwith my diet, I don't want to
drink more water, but I think Icould walk.
Okay, that sounds great, let'swork on that and that's it.
So it's a beautiful way ofrespecting the patient, giving
them autonomy but also bringingthem into the plan, because it
is a partnership.
You're not just dictatingeverything as the provider.
No, there's so much goodnessthere and, as you're saying it,
(27:14):
it's like this world is openingup in front of me Now I just
want to go see a patient realquick to practice.
But first of all, it'sconversational.
It does not feel like an attack, and I think so often, and
probably most of us.
It doesn't necessarily have tobe weight-based, but I think a
lot of us have had a question atleast once in medicine where we
felt like we were beingscrutinized or attacked for
(27:35):
something that our body wasdoing, which we can always help.
But it is, it's conversational,it's disarming, it allows the
clinician to continue to guideand lead the appointment, but
also gives the patient options,which is great.
I think that is so incredible,colleen.
How do you measure the successof these conversations you get
(27:56):
to see your patients over andover that might look different
from somebody perhaps thatdoesn't have that continuity of
care.
How do you measure success whenit comes to nutrition and
conversations like this?
So it depends what you'retrying to measure, if you're in
weight management and if you'reultimately are measuring weight
loss success, which I have myown opinions on that, because I
think there's so many betterthings that we can measure that
(28:17):
are non-scale victories.
That would mean even more to apatient.
But that's time for anotherpodcast episode.
Honestly, I measure the smilesthat patients leave when they
walk out the office.
Probably the best thing that Ican hear is when they're walking
down the hallway after theyleave my room and the kiddo says
that was so much fun.
I want to see her every timeI've done my job.
(28:39):
If they leave feeling like thatand I think as adults even if
you're an adult medicine you canleave your patients feeling
like that too.
They should leave feeling likeman here.
She was so cool, like shelistened to me, she got me.
I have a plan and I feel like Ican do it, and I think that to
me, is a measure of success,more than biomarkers, more than
(29:02):
weight, more than any of that is, and that really comes from
having that type of conversation.
Sometimes we have to beprescriptive.
Yes, if they have pink eye, youneed to give eye drops.
If they have pneumonia, we needto give antibiotics.
But when it comes to somethingso deeply personal as a person's
relationship with food andtheir body, we have to be
(29:23):
curious and that is probably thebest approach to take.
It is really just askingquestions like what's been your,
your dieting history?
Where do you feel like you'vestruggled?
Or one of my favorite questionswith patients who we like to
label non-compliant which I alsohate that word.
But those patients who you'relike oh my goodness, they've
come in four years, they'recontinuing to gain weight every
(29:46):
single time, like what ishappening?
They're not listening to me.
I love to just pause and becurious, like some something's
happening, we're missing themark here and I love to just ask
what is making this hard foryou?
And listen and just let themtell you because we have 10
minutes, maybe a peek into theirlives.
(30:08):
And they're living their lives24 seven.
I don't know what triggeredthem to eat Twinkies.
Maybe they got super stressedout at work and that was their
trigger.
Maybe they are celebrating araise and that was their trigger
.
Allow the patient to tell you,because I also find that's a
great way to prevent burnout.
Asking the patient to problemsolve is like what's making this
hard for you?
(30:28):
And they tell you like oh, forexample, medication, if I can't
swallow these pills, they're sobig Like I can't get my vitamins
in.
I gag every time oh great, I'vegot gummies, we got powders, we
got options.
Whereas if you didn't know thatpiece of information, you would
probably spend two to fiveminutes rattling off like your
knowledge and things that maybewon't even help them in that
(30:51):
situation.
So being curious is a reallygreat characteristic of an
excellent clinician.
It is, and that's one of thereasons we went into medicine in
the first place is whether wewere curious about the disease
processes or curious about thebiology or curious about how
those things affect the person.
Ultimately, we're just curiouslifelong learners, like you
(31:14):
mentioned earlier.
When you stop being curious withyour patients, when you stop
wondering, then it causescynicism because then you quit
asking why they're not doingwhat you asked them to try and
do and then blame.
The blame game begins.
And I think if you invite thoseconversations with your
curiosity, then you can figureout, like you said, you can get
(31:37):
to the root of this and then youcan be motivational because you
know the root and I do gosh, Ilove being motivational with my
patients.
This also works, not if you'retrying to get your patient on
board with a plan, but this alsoworks if you have a patient
that's really defensive or verynervous or very scared.
I had this conversationrecently with another gal who
said she had a patient she wastrying to do a scary procedure
(32:00):
but he had canceled and canceledmultiple times, and so
eventually she just called himand said come to the office, not
for the procedure, we're justgoing to talk.
I just want to know why youdon't want to schedule this.
And it turned out it waschildhood trauma, and I think
that I think we can get so muchfarther just by that tiny
element of curiosity.
(32:20):
Hey, you seem really guardedtoday.
Why you seemed really angry atcheck-in.
Do you want to talk about it?
You want to talk about it?
And I think that that's a scaryquestion to ask our patients,
because, especially if you'relike five, 10 minutes and then
you're going to be like, okay,we just talked about this for 10
minutes, let me do your, let medo your exam real fast.
But that is what, that's whatthey're going to remember.
They're not going to rememberthat you felt their lymph nodes
(32:41):
in their neck or that you lookedin between their toes.
They're going to remember howyou made them feel better and
motivated at the end of thatappointment.
Yeah, and I think it's alsopart of motivational
interviewing.
Is that fixing reflex is we arevery much used to?
Here's the recommendation dothis.
And what ends up happening iswe play ping pong with the
patient and there's nothing moreexhausting than doing that, and
(33:05):
that, I think, is the numberone way to burn out of.
Okay, why don't you try tominimize your sweets?
Oh I can't, I really lovesweets.
Okay, why don't you try to takea 10 minute walk every day?
Oh I can't, because my kneeshurt.
Okay, why don't you try todrink more water?
Oh, I don't like water.
Everyone listening has beenthere.
When you just ask them what doyou think out of these three
options, two options would besomething you could try.
(33:27):
You're not going back and forthwith the patient and you're not
wasting precious time.
And also, then the patient feelreally equipped and capable.
Colleen, you have so much goodadvice for everybody.
These are great pieces of lifeadvice, but especially for
clinicians.
You created this CME-approvednutrition course for providers.
Tell us a little bit about this.
(33:47):
I'm so excited about this.
This has been my project forabout six months.
I started the idea andexploring how to even get things
CME-approved.
As an individual, I'm notaffiliated with a university or
hospital, so that's in and ofitself has been really
exhausting, frustrating thing tofigure out.
But I am so proud of this andso excited to release this to
(34:11):
the public and to clinicians,because there's nothing like it
out there.
There are tons of webinars onGLP-1s and weight management and
you get an hour and they'regreat.
You've got tons of golden tipsand advice, but there's nothing
very comprehensive of like fromthe beginning nutrition
education to nutritioncounseling, like how do we do
(34:32):
motivational interviews andintuitive eating, how do we
bring and bridge the educationwith the counseling piece and
then throwing in there thedifferent populations.
So what if I have a patientwho's had bariatric surgery?
Or what if I have a woman who'sin midlife and she's going
through menopause?
We also need to know aboutthose specific populations, and
so this course is covering allof that.
(34:54):
So it walks you through thenutrition basics, what you need
to know how do you choose a dietfor a patient all the way
through some counseling skillsand behavior change models, goal
setting, all the way throughthose different populations and,
additionally, you're not juststuck there in no man's land.
I've also created this to bevery much in a strong community,
because I find that webinarsare great and courses are even
(35:17):
great, but we're lacking thatsupport from each other.
Oh, I have a quick question.
Or I had this patient.
I know what to do, or havingthat forum and that community.
So that is another really coolaspect of the course that when
you are part of that, you'realso joined into a membership, a
Facebook group to, where we canjust connect and meet each
(35:37):
other and network.
I'm hoping it will grow intosomething even bigger, that
maybe we'll have live in-personevents at some point down the
road.
But I'm really excited for thisand I've brought in a lot of
different speakers.
It's not just me teaching,because I'm not an expert on
menopause and I'm also not anintuitive eating expert, so I
brought in dietitians, doctorsand psychologists to really make
(35:58):
this a very robust course forclinicians.
If you are listening and you arehopeful to go into medicine,
what Colleen is describing, whatshe's doing, this is why we go
into medicine.
You're going to answer allthese interview questions about
why you love the team model orwhy you want to lead a team of
medical innovators, but what youare doing that is why we do
(36:18):
this.
You are pulling together thebest and the brightest, not for
your edification although I'msure you've learned a lot but
not for you.
It's for your patients and it'sfor my patients.
So thank you because it's goingto benefit so many people.
This is not just for this isnot just for primary care.
In dermatology, I do skin exams,and in order to see your skin,
(36:41):
you have to disrobe is what wesay in medicine.
You have to take your clothesoff, and for a lot of people who
are very weight conscious,getting naked in front of me can
be really traumatic.
So we do end up talking aboutweight and a lot of times it's
because a patient will make astatement and will say something
to the tune of you know, insertnegative comment about my own
(37:04):
body here and it hurts my heartbecause I do.
I every.
Like you said, bodies are madedifferent.
Everybody is beautiful.
The fact that she walked intomy office smiling that day is
what I'm going to remember.
The fact that he cracked ahilarious joke while he was
sitting there, I was doing askin.
That's what I'm going toremember.
Your body and the shape of yourbody is not what determines my
opinion on you, so let's noteven bring it up.
(37:25):
But those things happen indermatology too, not just
primary care.
We have weight conversationsall the time.
So this is for every clinicianwho sees patients.
Yeah, I agree, and it's alsolike like it's not just
dietitians, like I have a lot ofpeople who are like I'm just
going to refer to dietitians,which 100% yes and amen all the
(37:46):
time.
However, I actually talk somuch more about nutrition, like
hours wise, as a PA than I didas the dietitian.
I know it sounds crazy, becauseyou're a dietitian, that's all
you talk about, but the volumeof patients and the questions
that they're coming to me for Ias a dietician, I would never
get referred.
A patient who was like oh, oh,by the way, can my baby drink
(38:08):
water?
Now, like that's just a randomquestion that they ask you at
the end of the visit oh, Iforgot to mention, I'm really
constipated.
What Forgot to mention?
I'm really constipated.
What foods can I eat?
I don't want to take medication.
So those are like little simplethings we've got to be equipped
for as clinicians and asdietitians.
This will even deepen yourknowledge and nutrition
(38:29):
counseling than you've evenlearned in school, because
you're getting hands-on tips andtricks from clinicians who've
been doing this for years.
That's so true, and, colleen,that leads us to a perfect
wrap-up question, and usually Iask if you have any advice for
pre-health students that areinterested in a career in
medicine, generally speaking.
But I want to tweak it a littlebit and my question, my wrap-up
question to you would be forsomeone interested in medicine
(38:51):
if they want to start to includea nutritional element to their
education, then talking collegekids, postgraduate students,
things like that where wouldthey start?
What would they do?
I think you've got to do twothings.
I think you have to do theeducation because you do need to
know the basics.
Like it is really important intoday's environment that we live
(39:12):
in that you understand what afat is and the difference
between saturated fat andunsaturated fat, and that news
flash like seed oils are notgoing to kill you and create all
these medical problems.
Right, like fruit is not asugar bomb.
Like you need the basicnutrition science that the sugar
and fruit is fructose it's notthe same as sucrose as a simple
(39:36):
sugar.
Right, like that basicunfortunately right now is so
misconstrued on social media sothat you do need a very strong
background in that firmunderstanding of nutrition
science.
Once you have that and you'reconfident in that, if you're
going to work with patients,you've got to get some good
counseling skills under yourbelt and that just means like
(39:58):
how to ask good questions, howto be curious, but also practice
listening.
We love to talk as clinicians.
We love to preach and share allof this knowledge and the
goodness that we know that wesometimes, a lot of the times,
forget to listen, and I get it.
We're very we're in a fastpaced environment.
(40:19):
We got to get to the pointsthat we need to get to and
complete our checklist, butsometimes it's okay not to do
that checklist and it's also askill that you'll learn as you
go how you can truly and deeplylisten to the patient, because
they will tell you, they willtell you what's wrong, they will
tell you what's bothering them,and it makes your job as a
clinician so much easier to helpthem solve it.
That is so good.
(40:39):
Thank you for the work thatyou're doing in nutrition.
It's huge, it's so importantand years from now, we're going
to look back and say, look,she's a pioneer.
She was one of the people thatpioneered this in medicine.
Thank you so much.
Where can we find you Exam RoomNutrition on Instagram.
Is that the best place?
Okay, ashley, seriously, thankyou so much for saying that,
because this is a labor of loveand I've poured blood, sweat and
(41:02):
tears into it just because I'mso passionate about helping
clinicians feel more confidenttalking about nutrition while at
the same time, helping patientslike feel that they can love
their bodies again.
So thanks for all your support.
Yes, I'm on social media,specifically Instagram and
LinkedIn, at exam room nutritionI also you can find my podcast
(41:22):
on Apple or Spotify, examnutrition and if anyone wants to
just shoot me an email orconnect with me, you can send me
an email at Colleen at examnutritioncom and then, if you're
interested in the course itwill be launching, hopefully mid
to end May.
We're just finishing up withsome of the legal stuff with the
accreditation, but if you'reinterested in getting on the
(41:42):
wait list, you can go toexamroomnutritioncom slash
course.
Colleen, thank you so much foreverything you've done.
Thank you for joining us onShadow Me Next today.
We can't wait to see your nextsteps.
Thank you, ashley.
Thank you so very much forlistening to this episode of
Shadow Me Next.
If you liked this episode or ifyou think it could be useful
(42:02):
for a friend, please subscribeand invite them to join us next
Monday, as always.
If you have any questions, letme know on Facebook or Instagram
access.
You want stories you need.
You're always invited to shadowme next.
Hello and welcome to Shadow Me Next, a podcast where
I take you into and behind thescenes of the medical world to
provide you with a deeperunderstanding of the human side
of medicine.
I'm Ashley, a physicianassistant, medical editor,
clinical preceptor and thecreator of Shadow Me Next.
It is my pleasure to introduceyou to incredible members of the
(00:22):
healthcare field and uncovertheir unique stories, the joys
and challenges they face andwhat drives them in their
careers.
It's access you want andstories you need, whether you're
a pre-health student or simplycurious about the healthcare
field.
I invite you to join me as wetake a conversational and
personal look into the lives andminds of leaders in medicine.
(00:44):
I don't want you to miss asingle one of these
conversations, so make sure thatyou subscribe to this podcast,
which will automatically notifyyou when new episodes are
dropped, and follow us onInstagram and Facebook at Shadow
Me Next, where we will reviewhighlights from this
conversation and where I'll giveyou sneak previews of our
upcoming guests.
Today, we are joined by ColleenSloan, a pediatric physician
(01:07):
assistant and registereddietician nutritionist who has
spent over a decade blendingnutrition expertise with
pediatric care.
Colleen's journey began inclinical nutrition, where she
worked with critically illchildren, before realizing her
desire to expand her scope ofpractice by becoming a PA.
Since then, she's been making alasting impact in pediatrics,
(01:31):
seeing patients from infancy toadulthood.
What's truly unique aboutColleen's approach is her
dedication to incorporatingnutrition into every aspect of
patient care.
She's the creator of Exam RoomNutrition, a platform designed
to help clinicians confidentlydiscuss nutrition with their
patients, emphasizing theimportance of compassionate
(01:54):
communication, especially whenit comes to sensitive topics
like weight management.
In this episode, we'll diveinto Colleen's journey from
dietetics to becoming a PA, hercommitment to lifelong learning
and the tools she's developed tosupport fellow healthcare
providers.
She'll also share her insightson how clinicians can navigate
(02:17):
difficult conversations withpatients around weight, all
while fostering trust andempowerment.
Please keep in mind that thecontent of this podcast is
intended for informational andentertainment purposes only and
should not be considered asprofessional medical advice.
The views and opinionsexpressed in this podcast are
those of the host and guests anddo not necessarily reflect the
(02:40):
official policy or position ofany other agency, organization,
employer or company.
This is Shadow Me Next withColleen Sloan.
Hey, colleen, thank you so muchfor joining me on Shadow Me
Next today.
You have such an incrediblestory I cannot wait to hear
about what you have to say.
Thank you for joining us.
Thank you so much, ashley, forhaving me on.
(03:02):
I think my journey is relatablefor a lot of people, so I'm
excited to just give someinsights for any of your
listeners.
Absolutely so relatable, andthere's so many of these
conversations that I'm excitedabout all of them.
There are certain elements ofsome that I know I am going to
learn a lot about a certainelement of medicine, and this is
one of them.
And I think when you and Iinitially met and started
(03:32):
talking, I told you that Ireally did not have a great
understanding of nutrition untilI was a clinician, and it
wasn't because of my practice,it was because of me as a person
.
I was just more interested init, and the amount that I did
not know as a clinician, as a PA, was really eye-opening.
So thank you for what you do,thank you for the education you
provide, thank you for whatyou're going to tell us today.
I can't wait.
So tell us your titles, first ofall, is this cool?
(03:56):
And then a little bit aboutwhat drove you to pursue both of
these titles.
You're not alone in yourfeeling and your sentiment, and
it's so true, whether you're anMD, do, np, pa, like any of the
medical professionals we got,maybe 2% of all of our training
had to do nutrition, and I thinkit's wild because really most
(04:18):
of the conditions that we treatand we see in practice have
something related to diet andnutrition, whether it's in
weight management, which iseverything, but even when you
think about it migraines you cando some elimination diets and
find out their trigger foodanything in the gut, cardiac.
So everything we do aspractitioners does have some
part of nutrition and I thinkhaving that education is so key.
(04:41):
So you're not alone and that'sreally why I created my platform
, which we'll get more into.
But I want to bring it way back.
My credentials are I'm apediatric physician assistant
and a registered dietitian, andwhat came first was becoming a
registered dietitian.
Oh, like you said way back,tell us a little bit about what
(05:02):
the schooling, what thateducation process was for
becoming a registered dietitian.
And then maybe it was there.
Did you have a light bulbmoment?
What did that look like for you?
Yeah, I love sharing my journeyon this because it's a lot of
people are really curious aboutit because there's not a lot of
RDPAs.
When I was in college, I knew Iwanted to do something in
medicine.
I loved helping people, I lovethe science of medicine, but I
(05:24):
did not want to major in biology, which is what most pre-med
students major in.
So I'm sitting at TGI Fridayswith my dad one day and he's
like you're so smart, you shouldabsolutely become a doctor.
And I'm like, yeah, I get, Ithink so, but I just don't know
what to major in.
So my mom at the time was acollege textbook sales rep and
she's like why don't you comedown to FIU with me?
(05:45):
I live in South Florida, soit's Florida International
University.
I have to call on a lot of thedifferent colleges and nutrition
happens to be one of them.
Okay, so I walked the halls ofthe nutrition department, meet
some of the professors, and thatwas the first time I actually
even heard about a registereddietitian.
I didn't even know what theywere or that they existed, and I
told my mom this is what I wantto do.
(06:07):
This sounds really cool.
And it just so happened thatall of the prerequisites,
science classes and everythingwere exactly what I needed to
apply to medical school, and soI completely changed my path.
I transferred over to FIU and in2010, I graduated with my
bachelor's in nutrition anddietetics.
(06:28):
And you could have just I couldhave just stopped at that, but
I was sold on nutrition.
I was like I love this, I wantmore and I want to do this with
my patients Plus.
Now this is a little peek intomy personal life, but I think
it's.
I like sharing this part of mystory because I think it's
relatable for a lot of peopleand I want to encourage people
(06:50):
in that when you hit mishaps andthings happen in your life that
think are going to derail, youdo not give up because you
continue.
I actually got pregnant in mylast year of college and what
probably could have completelystopped my career trajectory
Honestly, I didn't skip a beatat all, and so I share that
(07:12):
because just because you're amom, just because you're
divorced, just because you andput on a blank, don't let that
be your crutch or your excuse tonot do something that you are
deeply passionate about, and I'ma firm believer in that.
So I continued on school.
I completed without missinganything and it was great that I
was a nutrition, becauseeveryone was very pro
(07:33):
breastfeeding and I was pumpingon campus.
It was hard, but I had suchsupport with my colleagues and
my student friends at the time,and so I became a registered
dietitian.
And so in order to become that,just because I have that
bachelor's degree, you have toalso do an internship and then
sit for state boards.
And so now it's a little bitdifferent.
(07:55):
You have to also get a master'sdegree, but back in the day you
did not, but it's the samething.
So you can do a master's.
You have to do an internshipand then become board
credentialed, board certified.
And so I became a dietitian in2011.
And I worked in clinical forabout three years.
I worked in the trauma ICU, soyou do a lot of tube feeding and
(08:15):
TBN calculations as a dietitian.
I also worked some of theregular floor, so you do the
cardiac education, dialysiseducation.
Then I got a little bit boredof inpatient nutrition and so I
started my own private practice.
So I was doing diabeteseducation and weight management,
and then I got bored with that.
A colleague and friend of mine,lucille Bessler, is a very
(08:38):
well-known dietitian among thefield.
She ran the pediatricoutpatient dietary services for
big children's hospital downhere in South Florida Joe
DiMaggio Children's Hospital andshe said hey, why don't you
come on with me?
I need a partner to run theseclinics.
I'm like, okay, but you need toteach me pediatrics because
I've only ever done adult.
And so we ran the cysticfibrosis clinic, the pediatric
(09:01):
dialysis and the cleft andcranial facial clinic, and it
was here that I was badly inlove with two things One is
pediatrics and two is medicine.
I reverted back to where I wasin college, where I'm like I
want to be caring for patientsand I just had this deep desire
(09:21):
to do more, to offer more, toeven know more than just
nutrition, because at that pointI had done so many things in my
career over the five-year spanthat I'm like I feel capped out
and I feel like I still have gasin the tank that I want to
pursue.
And I thankfully, with all ofthese different areas that I
(09:42):
worked in, I was able to talk toMDs and PAs and MPs, because I
was at this crossroads what do Ido?
I'm a dietitian, but I don'tknow what to do next.
And over and over again, it waslike PA, pa.
I met incredible PAs and everysingle one loved what they did
and they're like yeah,absolutely do it.
The decision has to be verypersonal.
(10:03):
So I have a lot of dietitianfriends who asked me this
question what made you decide PAversus MP or why not MD?
It's a.
It has to be a very personaldecision, but for me it all
worked out in favor of PA.
I already had all of theprerequisites so I didn't have
to retake any classes.
I also had all of the clinicalexperience, so I really I didn't
(10:24):
need to do any shadowing.
Thankfully, because of mydietetics career.
And why I didn't want to becomean MD is I was already a mom at
this point.
I really didn't want to be inschool for six plus years to be
an MD, and I also didn't want tobe an NP because I also didn't
want to go back to school to getmy RN first.
So it just all of that madesense and so I applied to one
(10:49):
school here locally in SouthFlorida.
I got in.
I do not recommend that forcurrent applying PA students.
It was competitive then and itis even more competitive now.
It's one of the top careers toget into, so you've got to be on
your game Now.
It's one of the top careers toget into, so you've got to be on
your game, but I got in to NovaSouth Eastern university in
2015 and graduated in 2017, ofwhich are the two hardest years
(11:14):
of my life.
Pa school is insane, and being amom, right.
So again, I'm like a firmbeliever and I will preach it
from the mountains Do not letyour age, your marital status,
like any, your health, like noneof that, hold you back.
If you are committed to doingsomething, you can absolutely do
it.
And so now I've been a PA since2017 and I stayed with my true
(11:38):
love of pediatrics.
I got my first job out of PAschool in general pediatrics,
and I have been with thatcompany ever since, so about
eight years now.
First of all, it's amazing thatyou have been with the same
company for eight years.
I think that alone, perhaps forthose who are not as familiar
with the PA professionespecially, a lot of people do
end up shifting after the firstone, two or three years just
(11:59):
because we're generalist trained.
Usually, some of us enterspecialty like dermatology, for
example.
I went into OBGYN first.
It's a little bit more of ageneral specialty, but it's not
very often that you hear ofsomebody sticking with the same
job that they've had since thebeginning, when they first
started work as a PA.
I want to touch on that becauseburnout is not a hot topic right
(12:21):
now, but I think that's a greatword because it's prevalent.
Any healthcare professionalhonestly, any career right now
we're feeling burnout.
We have less staff, so everyoneis just doing more.
We're getting paid less, and soit is real, and I know a lot of
my colleagues, or a few of mycolleagues, who are PAs coach
people through burnout and Ikind of chuckle to myself that I
(12:44):
never felt that and I feel soblessed and proud of that.
That I don't feel like that.
I actually, and to this day, canstill say I love getting up and
going to work and I reallythink it's because I pursued
something that I'm deeplypassionate about.
I love kids and every patient.
I pick them up, I kiss theircheeks.
(13:05):
We just have so much funbecause I respect that role as
the general pediatrician intheir life and I love the
opportunity to watch that childgrow from zero to 21.
It is the coolest opportunitythat you can get, and so I think
for people trying to figurethat out, you really do need to
love your job.
(13:25):
And that's not to say what I dois easy.
I'm at a very high volumeclinic.
I see from eight to five, 40kids in a day.
So that's my template.
So it has all the reasons tohave burnout.
But because I'm so in love withwhat I'm actually doing, it
feels easy to me, it's fun to meand I think that's important
(13:48):
when you're choosing a job.
It is absolutely because lifeand medicine really becomes your
identity and there's nothingwrong with that and I don't hate
saying that and I agree withyou a hundred percent.
I think that if you reallyinvestigate, know yourself, know
what works for you, and youfind that job that you can pour
(14:08):
into but that at the same timealso pours into you.
I'm really glad you said thatand I think it's a testament to
how hard you have worked and howmuch thought you have put into
where you're at.
It's like you said, you reallyhave to love it, but not only
love it, but you really have tounderstand why you've chosen it.
(14:29):
When you were saying about thatfive-year mark, you get to this
five-year mark and either you dostart to feel that burnout.
I think a lot of people switchor change or do things, and you
were a dietitian for five years.
I think there's somethinginteresting about that five-year
mark and if you think about it,as PAs we used to board certify
every seven years, so aroundthat five-year mark we're
starting to think about ourrecertification.
(14:50):
Then they bumped it out to 10years.
So it'd just be reallyinteresting to gauge how much of
us are able to actually sitdown and look at what we're
doing and evaluate these sortsof feelings that we're feeling
at a five-year mark and say do Ineed to pivot?
Do I need a big pivot?
Do I want to pick up somethingextra?
That I've been thinking about,I think pushing out our board
certification 10 years.
It's been really interestingfor that.
That's actually really.
That's a really interestingpoint.
(15:11):
I think you're right.
Most of my PA friends they arejob switching and there's
nothing wrong with that.
I think that's the beauty andthat's also.
What drew me to being a PA isbecause as a diitian I switched
every year or so.
I either picked up somethingnew or just completely switched
gears, and so I wanted thatflexibility.
(15:32):
I was nervous if I became an MDand GI, like that's it, you're
certified in that and you'restuck in that.
That kind of scared me and Ilove that about being a PA, but
I also think that if you'refeeling that itch at that,
whatever year it is reallydetermined, is it the job itself
or are you just itching forsomething new, like a new brain
(15:53):
stimulant?
And for me, what I actually did, looking back, is almost three
years ago.
I started a podcast and Istarted to talk about nutrition
more and I wanted to teachclinicians more about talking
about nutrition.
And so I think that talk aboutnutrition more and I wanted to
teach clinicians more abouttalking about nutrition, and so
I think that having thatcreative outlet whether it is a
side gig, maybe a side weekendjob at an urgent care where
you're getting a different pacein the clinic or, yes, a big
(16:16):
pivot I think that's okay and Ithink there is beauty in that.
And as PAs, we like to learn,we are lifelong learners and I
think that's the key to a lot ofprevention of burnout.
Absolutely, and that is aperfect segue.
Colleen, you have Exam RoomNutrition, which is just turned
into this incredible platform.
Tell us a little bit more aboutwhat that looks like for you.
(16:37):
We've talked about how it began, but are you enjoying doing
this?
Tell us about it.
This lights me up.
I'm so passionate about themission behind examiner
nutrition, which, yes, is aplatform.
Now it's a podcast, but it'salso social media and we'll talk
about eventually too.
It's a course and it reallystemmed from one Saturday when I
(17:02):
was in clinic, and it was justa day that stamped the approval
of what I had been thinking thatI want to do.
I'm walking down the hall myfirst patient.
I'm rushing because I'm knownto be like 10 minutes late every
morning and I look at the chartand it says rash is a sick
visit, and anybody who's inpediatrics knows oh, thank God,
(17:22):
like this is going to be quick,I'll get back on time at no time
.
But no, I walk in and the childwas crying, and which is this
is not abnormal in pediatrics.
Most kids are crying andscreaming.
It's a lot of drama in theoffice, but it wasn't.
He knew he wasn't here for acheckup and he was also about 10
years old.
So I just sat down and I saidoh, sweetheart, why are you
crying?
What is wrong?
(17:43):
The mom began to talk and sheshared the story of how, six
months ago, when he did hischeck, the clinician who I don't
know if it was an MD, pa, mp,it doesn't really matter.
Clinician had said you need tolose weight and if you don't
lose weight by the next time youcome in here you're going to be
having to do needles in yourstomach because you're going to
have diabetes.
(18:03):
A lot of fear, right.
So this child mom told me hadbecome obsessed with his weight.
He began restricting his foodsand they were of Asian descent,
so they had a lot of culturalfoods that he stopped eating.
He weighed himself multipletimes a day and that when he
jumped, stepped on the scale andthe office that morning, he had
(18:27):
gained three pounds and in hismind he's a failure and now he's
going to have to.
You know he's got diabetes andhe needs to take this shot in
his stomach that he wasthreatened with and he was
besides himself.
And when I heard that story myheart dropped because it could
have gone so differently.
(18:49):
This child actually was very ageappropriate in his growth
trajectory.
He was not considered obese oroverweight.
He had gained some weight, butif you look at the stage that he
was in in puberty, he'sprepubescent.
We expect boys and girls to puton weight during this time.
This is natural.
This is normal.
We also know from science thatall bodies come in different
(19:15):
shapes and sizes, and so hemight be settling into a larger
body, which is fine.
So I spent a few minutestelling him about what his body
should be doing at this point,how food is nourishing to our
bodies, and that we don't needto be weighing and restricting
foods and we can be enjoying thefoods and enjoying our bodies
for what they can do.
And I left that visit and at theend of the day, I sat in my car
and I started crying becauseI'm like there has to be a
(19:37):
better way, because I'm sure theclinician meant no harm in that
flippant comment.
They probably really meant forit to be positive and to be
motivating and encouraging andlike we're supposed to do.
We have to have hardconversations as providers.
We have to have those.
Hey, your weight might become aproblem.
(19:59):
We need to get this undercontrol.
That's probably what they meantto do, but they just didn't
have the language in order toportray that.
And so I'm like you know what?
I have that knowledge.
I, as a dietitian, know how toframe these conversations.
I know how to discuss weight ina very compassionate, inclusive
(20:20):
, sensitive way.
I know how we can approach thisand I want to share that with
the community, and so that wasreally the birth of the podcast.
But I also, as a dietitian,really wanted to feature
registered dietitians as thenutrition experts, because they
are, and I feel they are notrespected in the medical field
(20:40):
as much as they should be, norare they utilized as much as
they should be.
So I wanted to give them amicrophone and really highlight
them for looking at what theyknow, look at the time that they
can spend with your patients.
Let's use them, let's bringthem alongside in our team so
that we can better the health ofour patients and a society at
large.
Well, colleen, my heart hurts.
(21:02):
My heart hurts so bad for thatchild and I'm so glad that you
were his follow-up.
I think we were put in veryspecific places for very
specific purposes and to me yourwhole background was leading up
to that one exact moment.
But it's just such a reminderabout how powerful our words are
and our words matter and weneed to be very intentional with
(21:25):
what we're saying to certainpeople.
And I think as clinicians,sometimes that can be hard,
because I think a lot of timeswe are trying to communicate a
concept to someone and we haveto realize that the way we're
communicating that concept ishow the person sitting across
from us is going to interpretthat concept.
Tell us a little bit about howclinicians and for pre-health
students as well this is a greatexercise, but tell us about how
(21:49):
they can discuss the topic ofweight period whether it's
overweight, underweight, etcetera with compassion.
Before we hear Colleen'sresponse and the quality
question that came from it, keepin mind that there's more
interview prep, such as mockinterviews and personal
statement review over onshadowmenextcom.
There you'll find amazingresources to help you as you
(22:12):
prepare to answer your ownquality questions.
Colleen just mentioned apowerful topic that's relevant
for anyone working in patientcare and one that makes an
excellent quality question.
Share a time when you had tonavigate a difficult
conversation with another person.
What approach did you take toensure it was compassionate and
(22:33):
effective?
As Colleen pointed out, theseconversations can be incredibly
tough, but the key is creating acompassionate environment,
listening actively and ensuringthe patient knows you're on
their side and not judging themeffectively and ensuring the
patient knows you're on theirside and not judging them.
Approach these conversationswith empathy, understanding the
(22:54):
emotional layers involved andoffering solutions that empower
the patient rather than makingthem feel helpless.
Gosh, yeah, I have.
Probably.
Every day I have a story.
That is like jarring to me thatsomeone said this to a child.
I posted a reel the other daythat the parent came in and was
like oh yeah, I'm reallyconcerned about the weight, um,
and she looks at her daughter,who was eight, and told her I
know, honey, this upsets you,but you need to be on a diet
(23:16):
Right.
And she looks at me saying andI'm like no, we're not even
using that word at all.
And this actually came fromschool, because in schools, at
least in Florida I cannot speakfor other schools but the school
system does height and weightscreenings and if they are above
a certain percentage then theyget a note sent home and they
have to come in and see thephysician or the provider and
(23:37):
get it signed off on.
I sign one of those probablyevery single day.
And I look at the parent.
I say we're not even going totalk about this because I am not
concerned.
I know your child, I've beenfollowing their weight and she
is fine and I just think we arein such a weight focused and
obsessed culture that I'm hopingis switching and we're
(23:58):
transitioning from that, but wereally are still so focused on
that that we can't seem toaccept that just because a child
is a little bit larger, itstill means that they're fine,
they're healthy.
And so I think the first placethat we can start is, first of
all, the very first thing thatany clinician can do in this
build rapport and shows that youdeeply respect the patient is
(24:18):
ask for permission before youtalk about weight or before you
even start talking about diet ornutrition, because sometimes
the patient might not want totalk about their weight, and
I've heard countless adults tellme that they came into the
doctor because their ankle hurtand the first thing that the
doctor said was like, oh, maybeyou should lose some weight.
And they're like well, can youhelp me with my ankle?
(24:40):
I twisted it, I'm worried thatit's broken.
Like they weren't being heardfor their chief complaint.
And so it is so important thatwe ask permission, and the
easiest way to do that is justto say hey, are you comfortable
or is it okay If we talk about?
And if it's a weight visit, ifyou're in primary care and
that's what you need to talkabout you're to wait today.
(25:00):
Or even if you're in a specialty.
Let's say you're in pulmonologyand you have a patient who has
asthma and it seems to beuncontrolled.
If you're on all thesedifferent medications, they're
already on controllermedications, they're on
biologics, you've tried a lot ofdifferent medicines.
This might be a greatopportunity, especially if they
(25:21):
are overweight or in a largerbody, to maybe bring that up and
say, hey, we've tried a lot ofdifferent medications.
I'm just wondering if you thinkit would be okay if we talked
about your diet a little bit tosee if this might manage your
asthma a little bit more.
Framing it that way puts thatdecision in the patient's hands.
They get to choose, if it'sokay, if they're interested at
all, before you just rattle offhey, you should lose some weight
(25:44):
, why don't you eat some morefruits and vegetables?
That's not going to stick withanyone at all.
But if they choose, but it'sokay, yeah, I'm open to that,
I'm interested in that.
That's a beautiful opportunityfor you then to share a few
options.
Now a strategy and motivationalinterviewing is called ask,
offer, ask.
The first ask is to askpermission.
Then we have an offer and whatwe're doing is we are offering a
(26:07):
menu of options.
So, for example, you could say.
For some of my patients, whathas worked has been to eat an
apple before lunch because thatkind of helps them feel fuller.
But I have other patients whoreally like to take a walk after
dinner.
This really helps with theirdigestion, helps them get some
physical activity.
And then I do have somepatients that they've carried
(26:27):
around a water bottle becausetheir goal was to increase their
hydration.
Which one do you think soundslike something you could try?
So we offered those threesuggestions.
But that final question that'sthe second ask is another way
that we're welcoming the patientand their life and their
experience and their desiresinto the conversation.
Which do you think would workfor you?
(26:49):
And it's easy as that.
And they say oh, you know what?
I don't want to do anythingwith my diet, I don't want to
drink more water, but I think Icould walk.
Okay, that sounds great, let'swork on that and that's it.
So it's a beautiful way ofrespecting the patient, giving
them autonomy but also bringingthem into the plan, because it
is a partnership.
You're not just dictatingeverything as the provider.
No, there's so much goodnessthere and, as you're saying it,
(27:14):
it's like this world is openingup in front of me Now I just
want to go see a patient realquick to practice.
But first of all, it'sconversational.
It does not feel like an attack, and I think so often, and
probably most of us.
It doesn't necessarily have tobe weight-based, but I think a
lot of us have had a question atleast once in medicine where we
felt like we were beingscrutinized or attacked for
(27:35):
something that our body wasdoing, which we can always help.
But it is, it's conversational,it's disarming, it allows the
clinician to continue to guideand lead the appointment, but
also gives the patient options,which is great.
I think that is so incredible,colleen.
How do you measure the successof these conversations you get
(27:56):
to see your patients over andover that might look different
from somebody perhaps thatdoesn't have that continuity of
care.
How do you measure success whenit comes to nutrition and
conversations like this?
So it depends what you'retrying to measure, if you're in
weight management and if you'reultimately are measuring weight
loss success, which I have myown opinions on that, because I
think there's so many betterthings that we can measure that
(28:17):
are non-scale victories.
That would mean even more to apatient.
But that's time for anotherpodcast episode.
Honestly, I measure the smilesthat patients leave when they
walk out the office.
Probably the best thing that Ican hear is when they're walking
down the hallway after theyleave my room and the kiddo says
that was so much fun.
I want to see her every timeI've done my job.
(28:39):
If they leave feeling like thatand I think as adults even if
you're an adult medicine you canleave your patients feeling
like that too.
They should leave feeling likeman here.
She was so cool, like shelistened to me, she got me.
I have a plan and I feel like Ican do it, and I think that to
me, is a measure of success,more than biomarkers, more than
(29:02):
weight, more than any of that is, and that really comes from
having that type of conversation.
Sometimes we have to beprescriptive.
Yes, if they have pink eye, youneed to give eye drops.
If they have pneumonia, we needto give antibiotics.
But when it comes to somethingso deeply personal as a person's
relationship with food andtheir body, we have to be
(29:23):
curious and that is probably thebest approach to take.
It is really just askingquestions like what's been your,
your dieting history?
Where do you feel like you'vestruggled?
Or one of my favorite questionswith patients who we like to
label non-compliant which I alsohate that word.
But those patients who you'relike oh my goodness, they've
come in four years, they'recontinuing to gain weight every
(29:46):
single time, like what ishappening?
They're not listening to me.
I love to just pause and becurious, like some something's
happening, we're missing themark here and I love to just ask
what is making this hard foryou?
And listen and just let themtell you because we have 10
minutes, maybe a peek into theirlives.
(30:08):
And they're living their lives24 seven.
I don't know what triggeredthem to eat Twinkies.
Maybe they got super stressedout at work and that was their
trigger.
Maybe they are celebrating araise and that was their trigger
.
Allow the patient to tell you,because I also find that's a
great way to prevent burnout.
Asking the patient to problemsolve is like what's making this
hard for you?
(30:28):
And they tell you like oh, forexample, medication, if I can't
swallow these pills, they're sobig Like I can't get my vitamins
in.
I gag every time oh great, I'vegot gummies, we got powders, we
got options.
Whereas if you didn't know thatpiece of information, you would
probably spend two to fiveminutes rattling off like your
knowledge and things that maybewon't even help them in that
(30:51):
situation.
So being curious is a reallygreat characteristic of an
excellent clinician.
It is, and that's one of thereasons we went into medicine in
the first place is whether wewere curious about the disease
processes or curious about thebiology or curious about how
those things affect the person.
Ultimately, we're just curiouslifelong learners, like you
(31:14):
mentioned earlier.
When you stop being curious withyour patients, when you stop
wondering, then it causescynicism because then you quit
asking why they're not doingwhat you asked them to try and
do and then blame.
The blame game begins.
And I think if you invite thoseconversations with your
curiosity, then you can figureout, like you said, you can get
(31:37):
to the root of this and then youcan be motivational because you
know the root and I do gosh, Ilove being motivational with my
patients.
This also works, not if you'retrying to get your patient on
board with a plan, but this alsoworks if you have a patient
that's really defensive or verynervous or very scared.
I had this conversationrecently with another gal who
said she had a patient she wastrying to do a scary procedure
(32:00):
but he had canceled and canceledmultiple times, and so
eventually she just called himand said come to the office, not
for the procedure, we're justgoing to talk.
I just want to know why youdon't want to schedule this.
And it turned out it waschildhood trauma, and I think
that I think we can get so muchfarther just by that tiny
element of curiosity.
(32:20):
Hey, you seem really guardedtoday.
Why you seemed really angry atcheck-in.
Do you want to talk about it?
You want to talk about it?
And I think that that's a scaryquestion to ask our patients,
because, especially if you'relike five, 10 minutes and then
you're going to be like, okay,we just talked about this for 10
minutes, let me do your, let medo your exam real fast.
But that is what, that's whatthey're going to remember.
They're not going to rememberthat you felt their lymph nodes
(32:41):
in their neck or that you lookedin between their toes.
They're going to remember howyou made them feel better and
motivated at the end of thatappointment.
Yeah, and I think it's alsopart of motivational
interviewing.
Is that fixing reflex is we arevery much used to?
Here's the recommendation dothis.
And what ends up happening iswe play ping pong with the
patient and there's nothing moreexhausting than doing that, and
(33:05):
that, I think, is the numberone way to burn out of.
Okay, why don't you try tominimize your sweets?
Oh I can't, I really lovesweets.
Okay, why don't you try to takea 10 minute walk every day?
Oh I can't, because my kneeshurt.
Okay, why don't you try todrink more water?
Oh, I don't like water.
Everyone listening has beenthere.
When you just ask them what doyou think out of these three
options, two options would besomething you could try.
(33:27):
You're not going back and forthwith the patient and you're not
wasting precious time.
And also, then the patient feelreally equipped and capable.
Colleen, you have so much goodadvice for everybody.
These are great pieces of lifeadvice, but especially for
clinicians.
You created this CME-approvednutrition course for providers.
Tell us a little bit about this.
(33:47):
I'm so excited about this.
This has been my project forabout six months.
I started the idea andexploring how to even get things
CME-approved.
As an individual, I'm notaffiliated with a university or
hospital, so that's in and ofitself has been really
exhausting, frustrating thing tofigure out.
But I am so proud of this andso excited to release this to
(34:11):
the public and to clinicians,because there's nothing like it
out there.
There are tons of webinars onGLP-1s and weight management and
you get an hour and they'regreat.
You've got tons of golden tipsand advice, but there's nothing
very comprehensive of like fromthe beginning nutrition
education to nutritioncounseling, like how do we do
(34:32):
motivational interviews andintuitive eating, how do we
bring and bridge the educationwith the counseling piece and
then throwing in there thedifferent populations.
So what if I have a patientwho's had bariatric surgery?
Or what if I have a woman who'sin midlife and she's going
through menopause?
We also need to know aboutthose specific populations, and
so this course is covering allof that.
(34:54):
So it walks you through thenutrition basics, what you need
to know how do you choose a dietfor a patient all the way
through some counseling skillsand behavior change models, goal
setting, all the way throughthose different populations and,
additionally, you're not juststuck there in no man's land.
I've also created this to bevery much in a strong community,
because I find that webinarsare great and courses are even
(35:17):
great, but we're lacking thatsupport from each other.
Oh, I have a quick question.
Or I had this patient.
I know what to do, or havingthat forum and that community.
So that is another really coolaspect of the course that when
you are part of that, you'realso joined into a membership, a
Facebook group to, where we canjust connect and meet each
(35:37):
other and network.
I'm hoping it will grow intosomething even bigger, that
maybe we'll have live in-personevents at some point down the
road.
But I'm really excited for thisand I've brought in a lot of
different speakers.
It's not just me teaching,because I'm not an expert on
menopause and I'm also not anintuitive eating expert, so I
brought in dietitians, doctorsand psychologists to really make
(35:58):
this a very robust course forclinicians.
If you are listening and you arehopeful to go into medicine,
what Colleen is describing, whatshe's doing, this is why we go
into medicine.
You're going to answer allthese interview questions about
why you love the team model orwhy you want to lead a team of
medical innovators, but what youare doing that is why we do
(36:18):
this.
You are pulling together thebest and the brightest, not for
your edification although I'msure you've learned a lot but
not for you.
It's for your patients and it'sfor my patients.
So thank you because it's goingto benefit so many people.
This is not just for this isnot just for primary care.
In dermatology, I do skin exams,and in order to see your skin,
(36:41):
you have to disrobe is what wesay in medicine.
You have to take your clothesoff, and for a lot of people who
are very weight conscious,getting naked in front of me can
be really traumatic.
So we do end up talking aboutweight and a lot of times it's
because a patient will make astatement and will say something
to the tune of you know, insertnegative comment about my own
(37:04):
body here and it hurts my heartbecause I do.
I every.
Like you said, bodies are madedifferent.
Everybody is beautiful.
The fact that she walked intomy office smiling that day is
what I'm going to remember.
The fact that he cracked ahilarious joke while he was
sitting there, I was doing askin.
That's what I'm going toremember.
Your body and the shape of yourbody is not what determines my
opinion on you, so let's noteven bring it up.
(37:25):
But those things happen indermatology too, not just
primary care.
We have weight conversationsall the time.
So this is for every clinicianwho sees patients.
Yeah, I agree, and it's alsolike like it's not just
dietitians, like I have a lot ofpeople who are like I'm just
going to refer to dietitians,which 100% yes and amen all the
(37:46):
time.
However, I actually talk somuch more about nutrition, like
hours wise, as a PA than I didas the dietitian.
I know it sounds crazy, becauseyou're a dietitian, that's all
you talk about, but the volumeof patients and the questions
that they're coming to me for Ias a dietician, I would never
get referred.
A patient who was like oh, oh,by the way, can my baby drink
(38:08):
water?
Now, like that's just a randomquestion that they ask you at
the end of the visit oh, Iforgot to mention, I'm really
constipated.
What Forgot to mention?
I'm really constipated.
What foods can I eat?
I don't want to take medication.
So those are like little simplethings we've got to be equipped
for as clinicians and asdietitians.
This will even deepen yourknowledge and nutrition
(38:29):
counseling than you've evenlearned in school, because
you're getting hands-on tips andtricks from clinicians who've
been doing this for years.
That's so true, and, colleen,that leads us to a perfect
wrap-up question, and usually Iask if you have any advice for
pre-health students that areinterested in a career in
medicine, generally speaking.
But I want to tweak it a littlebit and my question, my wrap-up
question to you would be forsomeone interested in medicine
(38:51):
if they want to start to includea nutritional element to their
education, then talking collegekids, postgraduate students,
things like that where wouldthey start?
What would they do?
I think you've got to do twothings.
I think you have to do theeducation because you do need to
know the basics.
Like it is really important intoday's environment that we live
(39:12):
in that you understand what afat is and the difference
between saturated fat andunsaturated fat, and that news
flash like seed oils are notgoing to kill you and create all
these medical problems.
Right, like fruit is not asugar bomb.
Like you need the basicnutrition science that the sugar
and fruit is fructose it's notthe same as sucrose as a simple
(39:36):
sugar.
Right, like that basicunfortunately right now is so
misconstrued on social media sothat you do need a very strong
background in that firmunderstanding of nutrition
science.
Once you have that and you'reconfident in that, if you're
going to work with patients,you've got to get some good
counseling skills under yourbelt and that just means like
(39:58):
how to ask good questions, howto be curious, but also practice
listening.
We love to talk as clinicians.
We love to preach and share allof this knowledge and the
goodness that we know that wesometimes, a lot of the times,
forget to listen, and I get it.
We're very we're in a fastpaced environment.
(40:19):
We got to get to the pointsthat we need to get to and
complete our checklist, butsometimes it's okay not to do
that checklist and it's also askill that you'll learn as you
go how you can truly and deeplylisten to the patient, because
they will tell you, they willtell you what's wrong, they will
tell you what's bothering them,and it makes your job as a
clinician so much easier to helpthem solve it.
That is so good.
(40:39):
Thank you for the work thatyou're doing in nutrition.
It's huge, it's so importantand years from now, we're going
to look back and say, look,she's a pioneer.
She was one of the people thatpioneered this in medicine.
Thank you so much.
Where can we find you Exam RoomNutrition on Instagram.
Is that the best place?
Okay, ashley, seriously, thankyou so much for saying that,
because this is a labor of loveand I've poured blood, sweat and
(41:02):
tears into it just because I'mso passionate about helping
clinicians feel more confidenttalking about nutrition while at
the same time, helping patientslike feel that they can love
their bodies again.
So thanks for all your support.
Yes, I'm on social media,specifically Instagram and
LinkedIn, at exam room nutritionI also you can find my podcast
(41:22):
on Apple or Spotify, examnutrition and if anyone wants to
just shoot me an email orconnect with me, you can send me
an email at Colleen at examnutritioncom and then, if you're
interested in the course itwill be launching, hopefully mid
to end May.
We're just finishing up withsome of the legal stuff with the
accreditation, but if you'reinterested in getting on the
(41:42):
wait list, you can go toexamroomnutritioncom slash
course.
Colleen, thank you so much foreverything you've done.
Thank you for joining us onShadow Me Next today.
We can't wait to see your nextsteps.
Thank you, ashley.
Thank you so very much forlistening to this episode of
Shadow Me Next.
If you liked this episode or ifyou think it could be useful
(42:02):
for a friend, please subscribeand invite them to join us next
Monday, as always.
If you have any questions, letme know on Facebook or Instagram
access.
You want stories you need.
You're always invited to shadowme next.
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