The Doctor Will Feed You Now
A new hunger for all things healthy from hospital cafeteria to patient tray
It began with 24-hour patient room service. Then, a shift to fresh and local ingredients. Scratch cooking, homemade sauces followed. Chefs became less nutritionist, more five-star. Hospital cafes are considered dining destinations in their own right. Welcome to the quietly impactful revolution, happening at a hospital near you.
Restaurant, Inc. talked with two well-regarded professionals at the frontlines, who have borne witness to and played their own key roles in the transformation of foodservice in the healthcare space. Eric Eisenberg, a Le Cordon Bleu-trained chef, ran the acclaimed restaurant Relais in the Seattle area, recognized by Gourmet Magazine as one of America’s Top Tables, before accepting a position as Swedish Medical Center’s executive chef in 2004. He recognized early on the opportunity to ply his skills and make his mark in a completely different setting and by 2008, Chef Magazine named him one of the Top 5 chefs in the country for his work.
For Laura Watson, past president of the Association for Healthcare Foodservice and a clinical dietitian who oversees foodservice operations for all 22 hospitals at the internationally recognized Intermountain Healthcare in Salt Lake City, it’s been immensely satisfying to see her profession gain culinary respect, even acclaim, over her two decades of experience. Both share their thoughts on how the industry is poised to break into phase two of simultaneously delighting and educating a new group of discriminating diners, and why the knowledge exchange between industries will ultimately benefit us all.
Q: WHAT IS DRAWING EXPERIENCED CHEFS TO THE VERY DIFFERENT WORLD OF HEALTHCARE FOODSERVICE?
ERIC: For me, Swedish Medical’s excellent reputation was integral to my decision. This was the first hospital to deliver a 24-hour-a-day patient menu. Kris Schroeder (now the Administrative Director of Support Services at the hospital) brought the entire concept of room service to healthcare. On a personal note, I was also looking for more normalcy in my working life that would enable me to spend time with my family.
LAURA: We’ve come so far since I started in this industry 20 years ago; being a chef today in healthcare is the norm rather than the exception. We’re no longer the brunt of jokes about bad food, but are very sophisticated in our culinary offerings, and the creativity and innovation of executive chefs are the key to our success.
Q: AS ONE OF THE EARLY ENTRANTS INTO THIS INDUSTRY, ERIC, WHAT CHALLENGES DID YOU FACE IN SHIFTING THE FOCUS TO A CULINARY ONE?
ERIC: I was the first chef hired at Swedish Medical; they had many cooks who came from dietetics, and others with catering experience for the retail side, but no actual chefs. The menus, therefore, were driven by registered dietitians and the clinical team, and foods were chosen for their therapeutic value, not from a culinary perspective. We standardized the patient menu across all the hospitals, and it’s comprised entirely of scratch-made foods. There were 36 different dietary menus when I started, and we eliminated more than a dozen, and now include choices from the general diet even on the therapeutic menus. There’s no longer a huge disparity between the two types of menus. On the retail side, we moved away from the standard-cycle menu and focused on more seasonal ingredients, smaller batch cooking and fresh scratch versus value-added items when it makes sense.
Q: WHAT WERE THE RESULTS IN TERMS OF PATIENT SATISFACTION?
ERIC: We’ve always had great ratings around patient satisfaction, so it takes a lot to move the needle … at Swedish, it’s not a matter of inches but millimeters. We’ve noted much more patient enthusiasm and involvement in ordering their meals, and have received excellent feedback about the types of food we offer.
Q: WHAT ARE SOME OF THE MOST NOTABLE CHANGES YOU’VE SEEN IN HEALTHCARE FOODSERVICE OVER THE LAST DECADE?
ERIC: Room service has become the status quo. If you don’t have it, you’re looking to enter into it. It’s not as clearly defined as at the beginning, which was ordering at any time of day; now there are dozens of variations. I’ve also seen our entire industry become competitive, bringing to the table the same types of foods you’d see in restaurants in any market. There’s a whole movement of chefs trying to develop a new definition of what it means to have food in a hospital, and there are very few limitations, resulting in lots of people doing great work.
LAURA: The addition of executive chefs is the biggest thing to happen in healthcare foodservice, bringing great new ideas for sophisticated palates. At Intermountain, we have six executive chefs (who represent each region) who meet and set the direction for menu and recipe development.
Q: WHAT INDICATIONS DO YOU SEE THAT THIS MOVEMENT IS GROWING?
ERIC: More chefs are signing on at hospitals, and they are going into high leadership roles such as foodservice director. Previously the only avenue to that job was as a registered dietitian. But many chefs have learned healthcare now, and we have both elements of experience to offer.
LAURA: Chefs are bringing awareness to the community in so many ways. When we hold health fairs, our executive chefs are always the most popular guests to appear. We were able to create an ongoing spot on our local tv station featuring our executive chefs, who demo how to pull a meal together quickly with fresh, healthy foods.
Q: HOW DO YOU POSITION HEALTHY CHOICES IN AN APPEALING, EDUCATIONAL WAY?
ERIC: People still want to be offered foods that comfort, but we swap out traditional ingredients for better ones. For instance, instead of using ground beef, bread crumbs and ketchup for meat loaf, we use a blend of turkey and beef, oats and diced vegetables that provides the same comfort, in a healthier way. Mac and cheese went from frozen to scratch made with four cheeses and fresh milk. Visitors to our Café 1910 may notice there are no soft drinks or deep-fat fryers, but what they’ll find instead is wood-fired oven pizza, a wok station and grill, and fresh, made-to-order salads.
LAURA: Small incremental changes can add up over time, and we work to provide the information that people need to make these choices. We post our menu boards in the café, and by smartphone app, so customers can easily up their daily nutritionals and be accountable for their health. Hopefully it gives them the tools and awareness to take with them wherever they go. Our LiVeWell plates show how to compose a meal with smaller portions of protein and starch, and vegetables a larger part. We introduce new vegetables and grains that patrons might not normally consider and create recipe cards for a visual look at what a healthy meal should look like.
Q: WHAT ARE SOME OF THE MORE UNEXPECTED ITEMS ON YOUR MENU?
ERIC: Our Mediterranean plate with hummus, olives, roasted veggies, tzatziki, and pita wouldn’t have appeared on a patient tray even a few years ago. Our banh mi sandwich and other southeast Asian flavors are popular, with white bean ragout as a side. All our soups are made from scratch, including lentil and chunky tomato bisque. We also have many more vegetarian items to feed the growing numbers of flexitarians.
Q: WHAT DO YOU FIND MOST REWARDING ABOUT WORKING IN HEALTHCARE FOODSERVICE?
LAURA: This is an exciting time for foodservice and nutrition. Everyone wants to know how they can be healthier, and it’s up to us to engage our communities. For example, we recently developed a 1,900-square-foot organic community garden at Park City Hospital, free and open to the public. When people can see, feel and pick their own tomatoes, corn, squash, berries and apples, it becomes much more meaningful to include these in your meals. This is especially true for underserved communities, where fresh, organic produce carries too high a price to purchase regularly.
ERIC: What we do in healthcare goes so far beyond people saying they ate in the coolest place on Yelp or putting up a picture on Instagram. When people receive a plate of food from us, when the dome gets lifted, for just a minute, they’re transported away from their current situation of lying in a hospital bed. We need to do our very best to make sure we are delivering the whole experience, the very best, most positive one we can.