Medical Nutrition Therapy: A Recipe for Success

Saturday, October 11, 2014 at 11:00 am

LAS VEGAS—Physicians who are looking to kick patient care up a notch may want to consider adding a registered dietitian to the mix. 

In this morning’s presentation, “Outpatient Medical Nutrition Therapy and the Physician-Dietitian Relationship,” Barbara B. Robinson, MPH, RD, CNSC, discusses how physicians can work with registered dietitians (RDs) to enhance chronic disease management and improve patient care.


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“Successful physician-dietitian collaboration can and does work to benefit the patient, the doctor, and the dietitian and can help to best position patients to make lasting behavioral changes,” said Robinson, who is an associate professor in the Culinary Nutrition Program at Johnson and Wales University’s Harborside Academic Center in Providence, RI, and an adjunct clinical teaching associate at the Alpert Medical School of Brown University.

RDs can help patients translate what their physician’s dietary recommendations mean specifically for them. They counsel clients on behavioral and lifestyle changes required to impact long-term eating habits and health, tailoring the information based on the patient’s individual circumstances and needs.

“Dietitians can address needs such as knowledge about food purchasing, label reading, menu planning, and culinary skills, and provide counsel on attitudes toward foods, eating, and weight,” Robinson said. “Patients truly feel empowered when they have the information, skills, and tools to help themselves.”

RDs provide that help through medical nutrition therapy, which can be useful for disease prevention, nutritional support, weight management, women’s and pediatric health, and chronic disease management for a number of conditions, including cardiovascular diseases, diabetes, cancer, gastrointestinal disorders, pulmonary disease, and renal disease.

So just what does medical nutrition therapy involve?

“Comprehensive nutrition assessment based on medical and nutritional status and history; devising personalized nutrition interventions using evidence-based practice; and monitoring and evaluating progress over subsequent visits,” Robinson said.

During her presentation, she illustrates specific examples of medical nutrition therapy through case studies and also highlights various outpatient practice models for establishing financially viable working relationships between physicians and dietitians.

“In most states, insurance reimbursement for the services of a licensed, registered dietitian is good but not great,” Robinson explained. “Many physician offices find it worth their while to offer free space one day or one afternoon per week in their practice, perhaps on a day that fewer PCPs are in the office.”

Some physicians charge RDs to use a room—typically a modest fee of about 25% of what they would charge another physician. And some RDs only see patients in their own offices, but many have offices in more than 1 location.

But regardless of the practice model, the benefits of a successful collaboration are the same.

“Some of the obligation for lifestyle counseling is shifted (from the physician) over to a professional who is specifically trained for that. Focused nutrition counseling helps the patient who, in turn, appreciates the physician who made the referral to the RD, and patient health improves along with patient satisfaction,” Robinson said.

—Colleen Mullarkey