Dispelling nutrition myths, ranting, and occasionally, raving


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Are pharmacists the new dietitians?

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The other day I was in a grocery store when a recording came over the PA system encouraging customers to speak to the in-store pharmacist about making healthy food choices. Naturally, I was like “what the fuck??”. People wonder why dietitians are so defensive of our profession. This. This sort of thing is exactly why. Because everyone seems to think that they’re qualified to dole out nutrition advice despite the fact that dietitians are the only professionals who spend over four years studying nutrition in university and must indefinitely continue our education to maintain our licensure.

It’s not cool of the chain to be asking pharmacists to provide dietary counselling. If you want to offer that service, hire yourselves some damn dietitians. It’s also not cool of the pharmacists to accept that added responsibility.

Yes, pharmacists are a wealth of knowledge when it comes to medications and they can be hugely helpful in advising customers about potential drug-nutrient interactions regarding medications that customers are taking. They more often than not, likely have a greater knowledge about nutrients in food than your average person. However, none of this equips them with the expertise to provide nutrition counselling.

The scope of practice for pharmacists in Canada contains no mention of nutrition or dietary counselling. Store owners may not know that this service is outside the scope of practice for pharmacists. Therefore, I believe that the responsibility lies with the pharmacists on-staff to let the company know that they are should not be providing this service to their customers. As allied health professionals they should recognize the limitations of their own scope of practice and defer to RDs in matters of nutrition counselling.

When I worked in a grocery store we had an in-store dietitian as well as pharmacists on-staff and everyone worked together to provide customers with the best service possible. Pharmacists have enough to do without having to get into nutrition counselling with customers, which, when done appropriately, can be quite time-consuming. Do you really want to wait longer to pick up your prescription? Setting aside the issue of expertise, do pharmacists really have the time to devote to counselling customers on nutrition? Let dietitians, who are actually trained to provide individualized dietary advice, provide this service so that pharmacists can focus on their own area of expertise.

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Would you go to a self-taught doctor?

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My friend sent me a link to this opinion piece: Who is qualified to give nutrition advice? last week. I found myself growing increasingly frustrated as I was reading. One of the biggest frustrations I find working in the field of nutrition is that everyone’s an expert. I get it, we all eat, and many non-nutrition professionals pay attention to what they’re putting in their bodies. Nutrition information is everywhere and it’s not hard to seek out general, and even specific, nutrition facts. However, there are a couple of problems when it comes to receiving nutrition advice.

 

I don’t mean advice like your aunt telling you how to tweak your lasagna recipe or your friend telling you ways to get your kids to eat their veggies. We all give each other friendly advice like this, regardless of our educational backgrounds. It’s a whole other kettle of fish when you’re paying someone to provide you with a service. I don’t want to say that registered dietitians are the only professionals who are qualified to give nutritional education. But… At this point we are the only regulated nutrition professionals who have accountability. What do I mean by that? We have to register with our provincial regulatory body (in Nova Scotia that’s the Nova Scotia Dietetic Association). As part of our continuing competency program we have to demonstrate ongoing learning and set learning goals for ourselves every year. The NSDA also ensures that we are practicing within our scope of practice (i.e. not performing duties that we’re not properly trained for) and they deal with any complaints about us. We must all hold liability insurance so that if for some reason we’re sued we’re covered. Someone who is “self taught” may know a fair bit about food and nutrition but there is no one to ensure that is actually the case. If they give you inaccurate or unsafe counseling there is no recourse for you to be compensated and for them to be held accountable. If, as dietitians, we cause you harm through our professional practice, we can potentially lose our licences and be barred from providing nutritional counseling.

 

The other problem with obtaining nutrition information from someone who is self-taught is that you don’t know what they actually know. Yeah, I know that’s a little odd sounding. What I’m saying is, with a registered dietitian, you know that they’ve received specific education. We have to take a number of specific courses such as macro- and micro-nutrients, nutrition through the life-cycle, medical nutrition therapy, organic chemistry, biochemistry, etc. We also have to successfully complete a recognized internship program and then a national exam. Someone who is self-taught would not have had these experiences.

 

Dietitians also learn about treating people with various disease states and conditions. We can continue on in our education to specialize in things like diabetes management, oncology, pediatrics, weight management, eating disorders, mental illness, and on and on. None of us would dare claim to be experts in every area and we should be able to recognize our limitations and refer on to someone more knowledgeable when a client/patient presents with a problem outside of our realm of expertise. Just as you wouldn’t (I hope!) go to a self-taught medical doctor, dentist, pharmacist, or any other health care professional, why would you go to a self-taught nutritionist when you could go to a professional dietitian?

 

So… Matt MacDonald… While you may know a lot about nutrition there are a number of reasons why you are not qualified to provide nutrition counselling and why registered dietitians are. By marketing yourself as a nutrition counsellor (or whatever it was you were advertising your services as) you are leading the public to believe that you have a certain level of knowledge and credentials. Perhaps you do know a great deal about nutrition. However, that’s not the issue. The issue is that you are misleading the public and you are potentially putting them at risk.