Understanding the Role of Dietitians
Registered dietitian nutritionists are healthcare professionals who specialize in nutrition and dietary management. They are trained to provide evidence-based nutrition guidance and help manage various health conditions through medical nutrition therapy.
Can Dietitians Diagnose Medical Conditions?
No, dietitians cannot diagnose patients with medical conditions. Dietitians are knowledgeable about the criteria for diagnosing nutrition-related diseases, such as obesity and eating disorders, but providing the diagnosis is not within a dietitian’s scope of practice. They also cannot prescribe medications.
Nutrition Diagnosis
While dietitians cannot provide a medical diagnosis, they can provide a nutrition diagnosis. Nutrition diagnoses are made by dietitians as part of the Nutrition Care Process.
Examples of nutrition diagnoses:
- Excessive energy intake
- Inadequate fluid intake
- Swallowing difficulty
- Underweight
- Unintended weight gain
- Food and nutrition related knowledge deficit
These nutrition diagnoses are then used, along with their supporting etiology and signs and symptoms, to create what is known as a PES statement. PES statements are written in the following format:
[Problem/nutrition diagnosis] related to [Etiology], as evidenced by [Signs/symptoms].
Example PES statements:
- Inadequate fluid intake related to fear of urinary incontinence as evidenced by poor skin turgor, estimated fluid intake of 16 oz daily.
- Moderate chronic disease or condition related malnutrition related to ovarian cancer as evidenced by 5% weight loss in last month, estimated energy intake <75% of calculated needs.
Nutrition Diagnosis Versus Medical Diagnosis
A nutrition diagnosis is created by a nutrition professional to describe a nutrition-related issue. It can generally be resolved, or at least improved, through a nutrition intervention. A medical diagnosis is generally made by a physician to describe the pathology of a medical condition or disease.
Here are some examples of medical diagnoses and their corresponding nutrition diagnoses:
- If the medical diagnosis is dehydration, a potential nutrition diagnosis could be inadequate fluid intake.
- If the medical diagnosis is cancer, the nutrition diagnosis may be inadequate energy intake, swallowing difficulty or involuntary weight loss.
Can Dietitians Help Manage Medical Diagnoses?
While dietitians cannot diagnose medical conditions, they can help manage various conditions as part of the healthcare team. Some diagnoses that dietitians can help with include:
- Celiac disease
- Obesity
- Hypertension
- Anorexia nervosa
- Diabetes
- Failure to thrive
- Irritable bowel syndrome
References:
RDN’s Complete Guide to Credentialing and Billing: The Private Payer Market