How do you combine internal medicine, nutrition, culinary arts and public policy into a single career? Ask Michelle Hauser, MD, who has integrated her eclectic training into a unified research program to help improve the health and wellness of people in underserved communities.
Although Hauser always dreamed of being a physician, she began her career as a Le Cordon Bleu chef with a culinary internship at Alice Water’s famous restaurant, Chez Panisse. Hauser then put herself through college at Humboldt State Univeristy by teaching at local cooking schools, before going on to Harvard to earn her MD and MPA.
Hauser is now a postdoctoral research fellow in cardiovascular disease prevention at the Stanford Prevention Research Center and practices primary care at Fair Oaks Health Center, a clinic for those with limited access to health care in Redwood City. She's also on the board of directors of the American College of Lifestyle Medicine. I recently spoke with Hauser about lifestyle medicine and caring for the underserved.
Why did you become a chef when you dreamed of being a doctor?
I grew up poor in rural Iowa, without a support system or parents who had gone to college. My high school guidance counselor actually laughed at me when I told her I wanted to be a doctor. She said, 'Let’s find something more suitable for you to do,' and went on to suggest that I work at a local factory.
So I went to culinary school because I love to cook. And everyone told me that I’d never be a doctor, so I thought maybe they were right. As I finished culinary school, however, I knew that I wasn’t afraid to fail at my dream of becoming a physician. I would, however, regret not trying.
How did you become interested in treating medically underserved patients?
Coming from an underserved background inspired me to focus on medical care for the underserved. Additionally, I became very interested in the prevention of chronic disease —particularly via lifestyle changes — and the disparities in access to preventive care and services.
I'm currently involved with Fair Oaks Health Center’s care transformation project to increase and improve wellness resources for patients with metabolic risk factors for cardiovascular disease and diabetes. All resources and classes are available in Spanish and English. It’s truly rewarding to work with a diverse group of physicians, nurses, dietitians, psychologists and health educators to brainstorm and test new models of chronic disease prevention and treatment in this type of underserved clinical setting.
What is lifestyle medicine?
Lifestyle medicine is a field of medicine that encompasses research, prevention and treatment of disease caused by lifestyle factors such as nutrition, physical inactivity, smoking, excessive alcohol use, poor sleep and chronic stress. These lifestyle factors are currently responsible for nearly 80 percent of both chronic diseases and health-care spending.
A goal of the American College of Lifestyle Medicine, and of lifestyle medicine in general, is to improve personal and population health — adding both life to years and years to life. I was inspired to join the board of directors of ACLM because I fervently believe that health care needs to better address the root causes of disease and not just treat the downstream effects.
How can you motivate people to make lifestyle changes and stick with them?
This question is the elephant in the room. While there are many examples of people — myself included — who have turned their lives around with improved lifestyle habits, we have yet to find the perfect set of instructions for everyone to change their behaviors.
However, there are many promising techniques out there and much research currently being done. For instance, Brian Wansink, PhD, professor and director of the Cornell University Food and Brand Lab, has done a lot of research investigating how we constantly make mindless choices — particularly about what and how much to eat. He has shown that if we swap healthy items for unhealthy ones in the places that we’re most likely to select our food, we won’t even notice that we've suddenly opted to eat healthier.
We also need to change the way preventive care and lifestyle-based treatments for chronic diseases are paid for. Unless government and private insurance programs reimburse these services, most people will not have access to them.
How do you use nutrition and culinary education in your practice?
When I was in medical school, we piloted and evaluated a program that used shared medical appointments that incorporated cooking demonstrations and nutrition classes with primary care management for patients with cardiovascular risk factors. We found the program to be feasible, cost-effective and well received by patients.
I went on to conduct similar group sessions in my residency primary care clinic, and am now working on several projects that utilize cooking skills for disease prevention and treatment in my current practice and research.
With your busy work life, do you still have time to cook for yourself?
Absolutely! I cook most of the meals that I eat. These are not generally the fancy fare that I prepared in restaurants or culinary classes, but satisfying, delicious and healthy, all the same. I occasionally post about these recipes and answer food and nutrition-related questions on my blog, Chef In Residency. Pictures of other quick meals that I make on weekdays can be found on my Chef In Residency Instagram page.
Previously: A medical student calls for increased nutrition education for doctors, Online Stanford nutrition course improves participants’ eating habits, study finds and Creating safer neighborhoods for healthier lifestyles
Photo courtesy of Michelle Hauser