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| Food for thought |
9-Aug-2006 |
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The lunch break is the ideal time for registrars to feed their appetite and sharpen their skills.
By Bianca Nogrady.
FOR many Australian registrars, lunch seems to be a concoction of dubious nutritional value eaten when and where time permits.
For some lucky ones it is a stroll along the beach followed by a wholemeal salad roll paid for by the clinic.
Another clinic even provides a lunch of fresh salads, bread, cheese and roast chicken in-house every day for doctors and registrars.
Many practices use lunchtime as more than just food. Supervisors see it as a valuable teaching and learning opportunity.
Dr Patricia Stuart, a supervisor in Toowoomba, Queensland, says her practice schedules two lunch sessions a week — one with food provided — for the doctors to discuss cases or go through learning materials with the registrars.
“I think it gives them the chance to act as colleagues, getting to know each other and being able to ask questions and talk about everything,” Dr Stuart says.
On the other days, the doctors bring in their own meals, which can occasionally spark prandial jealousy. “We have a lot of Malaysian and Chinese registrars and they bring the most delicious-looking things,” Dr Stuart says.
Supervisor Dr Simon Young’s practice in Blacktown, Sydney, has a similar approach, except the entire working day is structured around lunch. The structure also allows Dr Young to schedule regular tutorials with his registrars between 1pm and 2pm when they all bring their own lunch, usually sandwiches or leftovers.
Unfortunately, not all practices have the time or space for doctors to have a respectable lunch break.
Space is at a premium at the busy clinic in the heart of Melbourne where registrar Dr Marlene Tham works. “We’ve been lobbying for a tea room, but there’s not really enough room in a CBD practice,” she says, which makes a relaxed lunch somewhat elusive.
Dr Tham, an academic registrar researching obesity and nutrition at the University of Melbourne, says that in a sedentary job such as general practice, getting out and about for lunch is extremely important. Rather than queue to buy her lunch then eat at her desk, Dr Tham brings in her own food and eats on the hoof as she explores Melbourne’s alleyways and shops.
Lunch is usually leftovers or sandwiches, but Dr Tham always includes low-GI carbohydrates to give her enough energy to get through the day.
GP supervisor Dr Nicole Avard, from Gosford, NSW, also finds it hard to set aside a decent period for a relaxing lunch. “The doctors are scheduled for an hour lunch but that never happens. We normally end up getting half-an-hour, 15 minutes if we’re lucky.”
The practice tried to initiate a cook-in on Mondays to encourage the doctors to have lunch together. The clinic would buy the ingredients and everyone would pitch in to help prepare it. “That was good for the practice, getting all the staff to eat together even though the doctors were only there for 15 minutes, and the food was always really healthy,” Dr Avard says.
But then the practice discovered this had “tax implications” and now it is developing a scheme where everyone chips in money to buy the ingredients.
Although GPs preach the benefits of healthy diet and lifestyle to patients, it seems many are not willing or able to follow their own advice. It can be hard for busy registrars to find time to prepare and eat a lunch as well as fit in exercise.
Registrar Dr Rachael Sutherland, chairwoman of General Practice Registrars Australia, says GPRA advocates for registrars to be in a working environment where they have the opportunity to eat meals appropriate to their shifts, but acknowledges it’s an ongoing challenge. Dr Sutherland says that at her practice in Melbourne a lunch break is set aside but the demands of the day can encroach on it.
However, most important are the contents of lunch. Dr Sutherland is a big fan of leftovers, but otherwise says she loves a cheese and salad sandwich with avocado. It’s a good example of a healthy, balanced lunch.
Clinical nutritionist Dr Sharleen O’Reilly, from DeakinUniversity in Victoria, recommends lunches that are low in carbohydrates, and include plenty of fresh vegetables or salad, some protein and low-fat additions for flavour.
Dr O’Reilly suggests registrars go for quick and easy options such as sandwiches, ideally with wholegrain bread, pita breads and wraps that include a vegetable filling such as salad and a protein such as meat or fish, with chutney or low-fat dressing such as tzatziki.
“Ideally stick with something that is low GI but also something that’s not going to have a high fat concentration,” Dr O’Reilly says.
Most importantly, she warns against eating at the desk. “The desk is one of the most unhygienic places … you spend such long times at your desk, shedding hair and skin cells, and coughing.”
LIFE
’
S A BEACH
REGISTRARS at the Point Lonsdale Medical Group in Victoria have it pretty good, according to one, Dr Stacey Harris. Every Monday the practice gets together for a healthy gourmet lunch at a local cafe within spitting distance of the beach, paid for by the clinic.
The aim of the gathering is partly business, partly pleasure, but Dr Harris says the biggest plus is the chance to get to know the doctors. “We get to hear what they’re up to and we can ask them advice, [and] talk about different patients and interesting patients.”
It’s also the chance to get away from work for an hour. “You can have a really stressful morning then have a walk along the beach and a debrief at lunchtime,” she says.
Dr Mike Birrell, a GP at the clinic, says they have been doing the lunches for years because it puts “a nice little buffer” in the day and enables the doctors and registrars to get some sunlight and talk casually about work. “Things become much more open if you can talk over lunch … all sorts of things crop up.”
A FREE SPREAD EVERY DAY
GP supervisor Dr Vincent Roche admits he and his two registrars at the Moss Vale Medical Centre in NSW are “nutritionally challenged” but in this case, the problem is having slightly too much of a good thing.
The clinic provides lunch for its doctors every day for free — putting on a healthy spread of fresh salads, olives, tomatoes, cheese, wholemeal bread rolls and roast chicken in the tea room.
“We’d look at that as being a condition-of-work cost, and it’s part of keeping staff happy,” Dr Roche says.
The practice encourages the doctors to take lunch at the same time, where possible. “It is an important time from the point of view of practice communication and cohesion,” he says.
TIPS FOR A HEALTHY LUNCH
* Eat plenty of fresh vegetables and salad.
* Include a small amount of protein such as cold meat or tuna.
* Avoid too many carbohydrates and keep to low-GI carbs, preferably wholegrain breads.
* Limit fatty foods.
* Add low-fat additions and flavourings such as lite mayonnaise, tzatziki or chutney.
* Try not to eat at your desk. If you have to, go for a walk afterwards.
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