Chris Kresser: Yeah, there are a couple of different ways you could do it. I kind of evaluate it on a case-by-case basis. If a patient is really already quite familiar with Paleo, they read my book, and they don’t seem intimidated by it, then I don’t necessarily refer them to Kelsey or Laura for further help. If the patient seems to me to be kind of overwhelmed by it or they’re really new to Paleo or they just ask me, they say, Look, I know I’m going to need help with this, then I will refer them to Laura or Kelsey, or I might refer them to 14Four, as well, as a rule. I think there are different ways you can do it. Where we might typically use the nutritionist or the dietitian more is if once we’ve done the case review and then the patient has to follow a specific version of Paleo—autoimmune or low-FODMAP or some combination—and they feel often really overwhelmed with that, then that’s where the dietitian or nutritionist can really come in handy.
However, Mark Hyman, who is a friend of mine and I’m sure all of you know, does things a little bit differently. I know that just as a rule that he actually includes a visit with the staff nutritionist as part of their initial visit fee. It’s included and it’s not optional. Every new patient that goes through their clinic sees the clinician there and then they also see the nutritionist afterward.
So it’s up to you. There are different ways of doing it. So far, we haven’t made it mandatory, and we’ve just offered it as a service for people who feel like they need it.