Dispelling nutrition myths, ranting, and occasionally, raving


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Does protecting the public infringe on freedom of speech?

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So, I already blogged about a very similar issue not all that long ago, but I can’t let this article pass without comment.

Essentially people (aka business owners who are hiring unqualified individuals) are pissed off because they won’t be able to hire just anybody to provide nutrition counselling to customers and clients if a NY bill passes. Which means they might actually have to hire qualified nutrition professionals (aka Registered Dietitians) and maybe pay them a semi-decent salary if they want to continue offering nutrition counsel to their clientele.

The bill would define the practice of dietitians and nutritionists and make it illegal for anyone to provide these nutrition services who’s not licenced by the State to practice either dietetics or medicine. The example the article provides to make their case that this is outrageous, in my opinion, actually serves to exemplify precisely why this bill would be a good thing.

The representative of the group attempting to defeat the bill complained that someone who’s not licenced to provide nutrition services would be able to say, “for example, “Fish contains vitamin B12.” But you could not go further to say, “If you’re feeling tired, or lack energy, try foods or supplementing with vitamin B12.”” You see, a RD would know better than to give a recommendation like this because it’s not our job to diagnose. Rather, we might suggest that a person bring their concern to their doctor and ask about having their vitamin B12 level checked. There can be many reasons why an individual is lacking energy and we wouldn’t just push a supplement on someone. I can see why health food store owners might not want to hire us as pushing supplements is what keeps them in business.

Again, what the article fails to mention is the reason for the bill. It’s not for the benefit of Registered Dietitians, although it would likely benefit RDs practicing in NY. No, it’s to protect the public. It’s to ensure that unscrupulous and/or inadequately trained individuals aren’t providing nutrition services to the unwitting public (although there are plenty of exemptions). It’s so that the public aren’t provided unhelpful, or even potentially harmful nutrition advice. It’s so that the public aren’t pushed to buy unnecessary, or even potentially harmful supplements. It’s so that the public aren’t encouraged to follow unhelpful, or even potentially harmful diets. It’s so that the public don’t have to navigate the confusing titles to determine if a professional is qualified to provide them with advice. This bill would serve to ensure that the public is receiving nutrition services from qualified credible regulated professionals.

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No, watching What the Health does not qualify you to provide nutrition counselling

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I saw a couple of RDs I know tweeting about this article a couple of weeks ago and I just had to add my two cents. I honestly think that freedom of speech is being misconstrued in the US and this is not an issue of freedom of speech at all.

So the issue is there’s a “health coach” in Florida who’s mad because she was told that she’s not allowed to provide dietary advice to people because she doesn’t have a licence. She think that impinges on her freedom of speech. Her lawyer claims that “getting a licence is incredibly burdensome”. Well, no frigging shit. Getting a university degree in any field ain’t cheap and then having to complete internships, pay to write the national exam, and then paying annual fees to retain your licence is time consuming and costly. It totally sucks but does that mean we should tell people they can go ahead and practice dietetics without a licence? I think not.

What seems to be lost in this story is the reason why people become licenced dietitians in the first place. That licence is not there for our benefit. It’s there to protect the public, the people who pay to receive credible evidence-based nutrition counselling. It’s not a benefit to dietitians, it’s to protect the public from us. That licence tells anyone seeking counsel from a dietitian that we are qualified to provide that advice and if we screw-up they have legal means by which to hold us accountable.

As registered dietitians we acknowledge our scope of practice and the limitations of our expertise and work within those confines. This “health coach” may be quite knowledgable about nutrition but there’s no accountability. We don’t know what we don’t know and while she may believe that she’s well enough informed to provide nutrition counselling, she’s not in the position to be able to make that assertion. That’s why there are standardized examinations and competencies that must be met by dietitians, to ensure we all meet a certain level of expertise.

Licencing is common in many professions, from doctors to dentists to mechanics to pilots. The reason for that licencing is always the same, to protect the public from charlatans and ensure that these professionals meet a certain standard.

This is not a freedom of speech issue. No one is telling this woman that she can’t talk about nutrition to whomever she wishes. She can proselytize to fellow grocery shoppers in the cereal aisle. She can tweet about her beliefs. This is practicing dietetics/nutrition without a licence. This is making money by providing personalized nutrition advice to individuals without the appropriate qualifications. To allow her to do so would be the same as allowing me to perform bariatric surgery because I’ve read some books and researched it or allowing someone to fly a plane because they flew some in a video game once. To allow a health coach to practice as a dietitian without the appropriate credentials is putting the public at risk.