ISSA SFN Final Exam
Essay: State Statutes
In the State of California, there is currently no freestanding practice act covering dietetics or medical nutrition therapy, as there is in other states. Further, there is no uniform credentialing provision or board of licensure for Registered Dieticians*, such as there are with other health-related professions in the state. This leaves a curious gap in between the legal definitions of the practice of medical dietetics and the practice of nutrition counseling. The small bit of legal language pertaining to the subject can be found in a section in the California Business & Professions Code (2585-2586) that states a Registered Dietician is “… authorized to provide nutritional and dietary counseling, conduct nutritional and dietary assessments, and develop nutritional and dietary treatments including therapeutic diets for individuals or groups.” and their clients “…must be referred by a health care provider who will provide the patient's diagnosis and the desired objective of dietary treatment (statute 2586a)”.
According to the code, the aforementioned activities, nutritional and dietary counseling, conduct nutritional and dietary assessments, etc., are considered “medical nutrition therapy” by definition and can only be administered by licensed physicians, Registered Dieticians or Dietetic Technicians under the direct supervision of an RD, licensed Nurse Practitioners, licensed Advanced Practice Nurses, and Registered Nurses with advanced certification in medical dietetics, such as diabetes educators and bariatric nurse specialists. Clearly, there is overlap in the fields of dietetics and nutrition counseling, at least in a legal sense, and the best protection against accusation of professional impropriety is to know the right terminology, professional definitions of practice, practice boundaries, and “when in doubt, refer ‘em out”...
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