Profile Thomas Campbell, MD
Please describe your professional training. How did you develop your interest in integrating nutrition and lifestyle approaches into your professional work?
I am a board-certified family medicine physician. I went to undergrad at Cornell University and then co-authored “The China Study”, then got a medical degree from University at Buffalo and completed residency training at the University of Rochester, where I currently practice.
Co-authoring “The China Study” and the years of work I did with my dad to create that book developed my interest and passion. I have sought to integrate that knowledge base now to my patient care in a very conventional medical model.
What is your current position or practice?
I am an instructor of clinical family medicine at the University of Rochester. I am an employed family physician with a large primary care group in a university setting. We take all types of insurance. I see patients for 20 minute visits, sometimes 40. In our system, a typical full time primary care physician (I am not full time) will care for 2000-2500 patients.
I am also the executive director for this organization (Center for Nutrition Studies) where I get to indulge my nutrition interests more directly in a variety of ways: writing, lecturing, and creating new course material with eCornell.
If not mentioned above, how do you integrate nutrition and lifestyle teaching into your clinical work?
Most patients I see are not terribly interested in talking about nutritional change, though they often have nutrition-related problems. I try to practice the methods of motivational interviewing with the principles of self-determination theory, allowing the patient to be in control of what we work on to improve lifestyle. For those with chronic disease, I do usually give a little pitch at some point in the early part of the relationship to define what I believe to be the “goal” health promoting diet and how powerful I think it is in order to offer some direction to their efforts. At this point I give them a list of my favorite resources for diet and lifestyle change to go home with.
With motivated patients I review and discuss food diaries and lab tests (mostly a lipid panel).
These are brief conversation tidbits over time, in the setting of many other issues and problems. It is worth mentioning that I recognize the components of mental health and fitness/activity in this lifestyle discussion.
How did you change your own diet and lifestyle, and over what time period?
My family became mostly vegetarian through my teens, then in my early 20s, writing “The China Study,” I began a whole food, plant-based diet. This was a slow process in totality, probably taking a decade or so.
What were the greatest challenges in creating your current position and what were the most helpful resources you used to overcome these challenges?
My clinical position is very conventional. The challenges to integrating nutrition and lifestyle in that setting are numerous and well documented. They include: severe lack of time, lack of supporting personnel with a deep fund of knowledge about the diet I recommend, lack of patient interest, a striking lack of reimbursement. I can refer patients to expensive cardiology interventions all day but I don’t know how I would get reimbursed in any amount to have a group visit to a grocery store, for example. I can only imagine that to do that in our current insurance reimbursement system would probably incur significant legal/liability/paperwork headaches with little to no pay.
In my small way I chip away at some of these challenges by having a concise little pitch that I think is non-threatening, yet descriptive, of the optimal diet and its power. I then gauge a patient’s interest and have a variety of resources I can steer them to. It requires a lot of patient motivation and skills. This is suboptimal for my population at large, but if a patient comes with motivation and openness, it can be a great beginning and useful for the patient.
My wife, Erin Campbell, MD, MPH, is very soon to be a board-certified preventive medicine physician, also with some pediatrics training. She will soon be starting a program with me outside of the traditional insurance system.
Without needing to give specific financials, would you characterize your current compensation from this work as providing the financial equivalent of a ‘side job’, full time job, or several full time jobs?
Because I work in a conventional setting, my pay is the typical pay for primary care physicians in my group.
What advice would you give to other clinical professionals hoping to integrate nutrition or lifestyle into their career?
You must walk the talk. If you don’t live your recommendations, it will never be a compelling message for patients.
Get educated! You also must have a good knowledge base. Read the books, take online courses, attend in-person conferences. Learn the research.
Work to get your name in the community you hope to have an audience with. Give lectures and talks when possible, for example.
Remember the goal. The goal isn’t to turn everyone into eating a certain diet. It is to help people improve their life, including health and happiness. You can’t force change. That means meeting the patient where they are (which, by the way, does NOT mean anyone needs to abandon their understanding of the 100% perfect ‘goal’ diet).
Can individuals reading this practice profile contact you for more information? If so, what is the best way for them to do that?
Unfortunately I do not have time to respond to individual emails.
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