The Academy of Nutrition and Dietetics
(AND) almost succeeded in becoming the only profession to handle the
duties of a dietitian for hospitals receiving money from the Centers
for Medicare and Medicaid Services (CMS). In the last week,
nutritionists not members of AND were added to the list of people
allowed to direct nutrition in hospitals and other institutions
receiving money from CMS.
This might take the attitude out of
some of the members of AND and I think this is overdue. The local
hospital dietitian is still sputtering about the meals A.J. received
while he was in the hospital. She finally admitted that the doctor
was right for the patient receiving a liquid diet as he is now off
the liquid diet and on soft food for several days before he will be
allowed regular food. He did have a second operation to repair
something missed during the first operation. He will be in the
hospital for at least another week, as they keep watch, to see how he
is healing.
A.J. has been moved to a nursing home
and is getting the meals he asks for and enjoys. He will remain
there until the arm casts are removed and he is capable to taking
care of himself. He admits he is tired of being fed by others and
wants the casts off. The doctor Tom says it will be at least another
four weeks. This did not sit well with A.J. A couple of days later,
he was in a better mood as doctor Tom had part of the cast on his
left arm removed so that he could bend his elbow. He still could not
feed himself, but with this, he was happier.
For several years now, the AND's main lobbying efforts have been to introduce licensure laws on 'scope of
practice' that prevent qualified non-AND nutrition professionals from
practicing. These laws are then enforced by state health boards and
state dietetics boards dominated by pro-AND dietitians.
This covers the AND's activities in
four states:
Maryland – The AND sought and
received authority in April 2014 to expand the state dietetic board's
power to send nutrition professionals cease-and-desist letters (a
right usually restricted to the state Attorney General) and to
increase penalties for non-compliant professionals.
California – AND is seeking
the right to provide independent medical nutrition therapy without
the supervision of a physician or surgeon, and to receive insurance
reimbursement for this.
New Jersey - AND has bills that
would only allow licensed RDs to engage in medical nutritional
therapy. This would be an exclusive right.
New York - An almost identical
bill is moving through the New York legislature.
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