I generally post on food and my thoughts on health, but I feel like this is important enough to make an exception! Medicare has decided that only physicians, nurses and physician assistants are qualified to provide people who are very overweight with nutrition counseling services.
Let me start off by saying I don’t really have a horse in the race. I don’t accept Medicare and obesity has never been my primary area of interest or practice. But no matter how you look at it, this is a huge problem.
Most doctors receive little to no nutrition education–1/2 a day, tops. Nurses receive about 20 hours.
Is that who we want supporting weight loss and behavior change?
I’ve had the pleasure to know many fantastic doctors and nurses, and despite their huge among of knowledge and skill in their field, they rarely have the training or experience for intensive, long term nutrition counseling. Unlike RDs, they didn’t get training for 5 (or more) years on nutrition and behavior change.
And think about it. How long do you have to wait to see your primary care doc? Can you see them being available sessions for weekly sessions for weight loss clients? I’m afraid this just doesn’t compute for me.
To the best of my knowledge, nurses and doctors that accept Medicare are increasingly squeezed and overworked. So not only do they lack the knowledge, they also lack the time to give quality services or learn more so that they’re able to.
Lots of people stand to lose here. As far as I see it, the only people who benefit are those selling surgery or diet pills/shakes, and there’s been some question of conflict of interest among those who made this decision.
And this isn’t even a matter of debate over RDs vs CNS vs other nutrition or coaching degrees. At the end of the day, if the people who can provide this service according to Medicare don’t have the time or training to actually do it, people simply miss out on this benefit. Or, people will only get support if they can afford to pay for it out of pocket. It also makes it more likely that people wanting to lose the weight will fail, because they won’t have the support the need.
And this affects pretty much everyone, because either the hundreds of dollars that could go for nutrition counseling will now be tens of thousands for surgery, or increased medical expenses. So, if you’re so inspired, you can call your government representatives
And now, we return you to your regularly scheduled program of munchies and stress relief.
If an RD works in a Dr.’s office could they bill then and provide this service?
My understanding is yes, as long as they are billing and under the supervision of the doctor, although it’s not explicitly mentioned in the ruling.
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