Prior to the pandemic, Anna Binder-McAsey, RD, LD, owner of Rethink Nutrition in Manhattan, Kansas, saw the vast majority of her clients in person and just 5 to 10 percent virtually. (Binder-McAsey specializes in working with people who have gastrointestinal [GI] disorders and immune system conditions.) Now, she estimates that she sees about 90 percent of her clients virtually. There are distinct benefits to working with people online. “Virtual visits have given us the ability to work with someone from the comfort of their own home, when it’s convenient for them, and in a more relaxed environment,” she says. Importantly, Binder-McAsey adds that clients who are in active flares may be worried that their symptoms will flare up while they’re traveling to an appointment. The ability to stay at home for their nutrition session can give them some much-needed peace of mind. Along with medication and social support, nutritional therapy — an individualized nutrition plan that ensures you’re meeting all of your nutrition needs and can identify foods that are difficult to tolerate during flares — can help reduce your symptoms, according to the Crohn’s & Colitis Foundation. This is where a registered dietitian (RD) who specializes in GI conditions comes in. An analysis published in March 2019 in the journal Gastroenterology & Hepatology concluded that people with IBD should consider working with an RD, who can offer tailored dietary recommendations and nutrition advice. The authors write that confusion about how food affects IBD symptoms can cause people to follow questionable diets, some of which may lead to nutritional deficiencies.
Direct messaging If you have a question for your dietitian while you’re in between appointments, you may be able to message them through a secure client portal.Food and symptom trackers One of the tools that Binder-McAsey’s practice uses is food and symptom logging software. (This is often found within the client portal, but each practice is different.) You can record as much or as little information as you’d like, including which symptoms arise, when, and if you had a flare. Your RD can access this info and then talk to you about what may be causing the problem — and it’s all confidential.Supplemental resources Some RDs offer videos, information sheets, and checklists that can help you manage your condition at home.
What to Know Before Working With an RD for your IBD
If you’re used to in-person appointments, a virtual visit will feel very similar, says Binder-McAsey. Rather than driving to their office, though, you’ll talk to the RD face-to-face over a computer or smartphone. Before you get started, here are a few things to consider.
The dietitian’s location Virtual care can allow you to access healthcare located far away, but you may want to start your search locally, since some dietitians may not be able to treat out-of-state people. If you do find an RD who works out of your state, Binder-McAsey recommends reaching out to ask if they can work with you.Your insurance policy Ask the RD which insurance plans they take, if any. This information may also be available on their website.The care platform Before the pandemic, providers had to use a HIPAA-compliant platform to assure their services were secure, but that rule changed during the pandemic. Now, providers are allowed to use a variety of communication apps in an effort to expand the availability of medical services, according to the U.S. Department of Health & Human Services, including FaceTime, Facebook Messenger, Google Hangouts, Zoom, and Skype. Ask the dietitian which platform they use, and think about whether you’re comfortable using it.
While the pandemic may have stalled medical care initially, Binder-McAsey says she was surprised that so many people took this opportunity to be proactive with their health. “With people working from home, they had more time to fit virtual appointments into their schedules,” she says. Even as people return to offices, this shift looks like it’s going to last. “Virtual visits are here to stay,” she says.
