Questions and answers on professional regulation

Why should dietitians and nutritionists be licensed?
Licensing of dietitians and nutritionists protects the public health by establishing minimum educational and experience criteria for those individuals who hold themselves out to be experts in food and nutrition.  The state has an obligation to protect the health and safety of the public and licensing of dietitians and nutritionists is consistent with this obligation.

Why haven’t states licensed dietitians in the past?
Unfortunately, the vital link between nutrition and health has only recently received the attention it deserves.  In addition, science has proven that nutrition plays an important part in the prevention and treatment of many serious diseases.  Dietitians and nutritionists are now more recognized as healthcare professionals because of their educational background and experience.  This is indicated by the fact that since 1984, 41 states and the District of Columbia have passed laws recognizing dietitians and nutritionists as nutrition experts.

How has the public been harmed by states not licensing dietitians?
With the explosion of interest in healthy eating and nutrition, consumers have been faced with a dizzying array of products and information.  The public deserves to know that the information being given by “experts” is based on science and is being given by individuals with appropriate education and experience.  This is especially true of individuals who have medical conditions, which could be adversely affected by improper nutrition counseling.  Several states have documented cases of unqualified individuals giving improper nutritional advice, which has harmed patients.  Unfortunately, many cases of healthcare fraud are never reported.  A Congressional study on Quackery noted that state offices on aging ranked healthcare fraud (quackery) first as the area of abuse of most concern and with the greatest impact on seniors.  The report also acknowledged that the great majority of cases are never reported.   (Quackery: A $10 Billion Scandal; US Government Printing Office Pub. # 98-135; pp.176-178)

What are the minimum educational requirements for a dietitian?
In order to be recognized as a dietitian or nutritionist, a person should possess a baccalaureate or higher degree in nutritional sciences, community nutrition, public health nutrition, food and nutrition, dietetics or human nutrition from a regionally accredited college or university and satisfactorily complete a program of supervised clinical experience approved by the Commission on Dietetic Accreditation of the American Dietetic Association.

Would licensure prohibit anyone except dietitians from giving nutritional advice?
No.  Licensure would not affect anyone that simply describes the nutritional value of products nor would it affect other healthcare professionals.  It would, however, provide recourse for victims of unqualified and unscrupulous individuals dispensing improper advice.

Aren’t too many professions and occupations already licensed by states?
It is the obligation of state legislatures to determine which professions and occupations should be licensed. A compelling case can be made for licensure of dietitians and nutritionists as healthcare professionals.

Isn’t licensure an attempt to monopolize the nutrition industry?
No.  The first obligation of registered dietitians and nutritionists is to serve the public, not sell products or services.  Licensure is necessary because the public deserves to know which individuals have the educational background and experience to give nutritional advice.  The health food and dietary supplement industry is booming, even in states that have had licensure for many years. The key issue in licensure is accountability.  The monopolization argument is a desperate attempt to obscure the real issues of licensure. 

Will licensing reduce competition or result in costlier services?
No.  Once again, licensure is not an attempt to control any market.  Licensure allows the public to know which individuals are qualified by education and experience to provide nutritional services.  If unqualified individuals disseminate harmful nutrition information, licensure allows the state to take action on behalf of the public against those unqualified individuals.  Competition among open and honest individuals with the public’s health and safety foremost in their minds will continue to grow and the public will continue to be well served by it.

Isn’t it true that if a physician refers me to a dietitian for prevention or treatment of a disease, I am reimbursed for it regardless if the dietitian is licensed?
Many insurance companies require licensure to reimburse healthcare professionals.  They require licensure so that unqualified providers dispensing questionable advice are not reimbursed.  If a state doesn’t license dietitians, services may not be covered regardless of whether a physician orders them.

Won’t licensure cost the state a lot of money?
No.  Fees will provide most of the revenue.  Many states have approved legislation or rules to make licensure revenue neutral.