Why VA physicians are writing ‘farmacy’ prescriptions for food, not meds

Patients in Massachusetts may soon be receiving “farmacy” prescriptions in lieu of traditional pharmacy scripts.

According to a release from the American Heart Association, the initiative, termed “Varanda” (Veterans Administration Repurposing Agriculture for Nutrition and Diet Awareness), was inspired by a rooftop farm at Boston Medical Center.

“The rooftop farm is this amazing farm operation in a hospital,” Stephanie Moore, a VA staff cardiologist and assistant professor at Harvard Medical School, said in the release. “The doctors could write prescriptions for fresh vegetables and healthy foods that the patients could pick up at the onsite pantry. They would go onto their computers and, much like I would write a prescription for a medication, they would write a prescription for food. And it’s free.”

Moore and two colleagues, cardiologist and epidemiologist Aruna Pradhan and cardiologist and Air Force vet Pei-Chun McGregor, launched Varanda as a preventive health initiative for veterans. The program will reportedly include a food pantry, sustainable produce garden and farmers market for veterans and their families, with a goal of supplying at least 5,000 pounds of fresh produce between April and November. Food stores will be supplemented by food from the Greater Boston Food Bank for year-round distribution.

The physicians said that, as cardiologists, they see a lot of cases where medication is prescribed in place of lifestyle changes, which might be sufficient to quell risk factors on their own. Nutrition plays a key role in cardiovascular health, but it’s “not well-taught or well-received in medical schools,” Moore said. 

Because of that, she and her core team of more than 60 are considering Varanda not just a nutritional lifeline for vets, but an educational imperative. Moore said training at VA medical centers is a big part of many med students’ early careers, so exposing them to nutrition education in the process could be a win-win for public health.

“We strongly believe that future and current physicians should learn how to integrate lifestyle choices into their practice in a real and tangible way,” she said.

Varanda is expected to kick off this year in the Boston suburbs Brockton and Bedford and will prioritize vets in need.

“We’ll be a healthcare facility with a pharmacy and a ‘farmacy,’” Moore said. “Access to Varanda by prescription means access not only to free and nutritious and healthy protein sources, but to a host of educational resources and activities, like cooking classes.

“We’re trying to write the playbook for this, not just make it a one-off. Each aspect of planning and implementation will be framed by the idea of scalability to VA medical centers nationwide.”