Health

PHOTO/EMILY MICUCCI Joan Czarnowski-Hill Registered dietitian J oan Czarnowski-Hill has been working in health care since she was a pre-teen, starting as a volunteer at a Boston-area hospital. The Hyde Park native, now of Natick, graduated with a degree in food and nutrition from Framingham State University in 1977. Czarnowski-Hill ilaunched her independent practice, Hill Nutrition Counseling, 10 years ago. Prior to that, she worked for 18 years as a diabetes educator at the Joslin Diabetes Center in Boston. Czarnowski-Hill recently talked with Central Massachusetts HEALTH about a wide range of topics related to her profession, from the benefits of organic food to the evolving role of the dietitian in the U.S. health care system. Q: How did you get into the field? A: As a kid, I was volunteering at a local hospital. Back in the day they used to be called candy stripers. The dietitian that was working there said when I was old enough and wanted to work, that I could work in the kitchen as a diet aide. That was sort of my pre-high school days. When I got to high school … I started working (in billing) for this doctor and he convinced me that I should go to school for nutrition. While I was typing in his office he said, "Why don't you see if there's a job in the hospital I work at?" I got a job in the diet department, where I worked all vacations. After I graduated (from college), I went back to work there full time. Q: What lead you to launch a private practice? A: As I built up my expertise in diabetes education, people would call and ask me to do professional presentations. On the side I'd do a little bit of work here and there. And then eventually it got to the point where I said, "I think I can support myself." Q: How have the needs of your clients changed over the years? A: We used to see people only if they were sick. And now we're actually seeing people when they're well (and hoping to keep from getting sick). There's so much obesity and obesity ties into diabetes … If we intervene early enough and people are successful in dropping some weight, they're (sometimes) able to prevent even getting diabetes. Q: Is nutrition generally better or worse than it was a generation ago? A: No matter where you go, there's food available ... You pull up to (a gas station) and you have (assorted soft drinks) and then all of the snack packs. Do you really need to eat at that point in time? It's how society has changed; it's not necessarily that people are all making bad choices. Q: Is organic food really better, nutritionally? A: I think if we could all afford it, organic would be the way to go. It's impossible for everyone to afford (all organic). That too will change. Organizations that make money off of people eating will realize that it's going to be mainstream and the way to get there is to make it more affordable. Q: The health care industry is focusing more on managing the health of the population. How is your job changing as a result? A: I have to look at the whole picture. Instead of being (only) a nutrition manager, I am now a health care manager; I look at all aspects of the patient. This interview was conducted and edited for length by Emily Micucci. { Profile } 34 HEALTH • June 15, 2015

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