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⌚Times They Are A Changing? (for the Dietetics Profession)
Are we at an inflection point in the dietetics profession in the U.S? Things are certainly changing.
If you've been a dietitian for a decade or more, you may not realize how different things are now, and how they are continuing to change. One big change is that the DICAS Match program has been discontinued.
🧐Next, check out the ACEND data for enrollment in dietetic internships and the match rates https://www.eatrightpro.org/.../diversity-enrollment...
For example:
In 2012 there were 24,205 students enrolled in dietetic education programs
in 2022 there were 16,327⬇ students enrolled in dietetic education programs
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In 2013 there were 2,963 openings for dietetics match and 50% matched
In 2023 there were 4,202 openings for dietetics match and 85% matched
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In April 2013 there were 223 internship spots that went unfilled
In April 2023 there were 1892 internship spots that went unfilled
🏫This drop in enrollment is not unique to nutrition programs and is being seen in various majors and allied health programs across the country, especially at small, private universities and some regional public universities.
In the case of dietetics, the domino effect of the drop is enrollment is that internship spots are going unfilled. In a recent Facebook post we heard from dietitians and DI directors all over the country about fewer interns in programs, and fewer interns to mention mentor. This means that fewer RD2B are taking the RD exam and there are and will be fewer RDs for the next few years.
What is this drop in enrollment attributed to?
A drop in birth rate
The post-Pandemic effect of people reluctant to get into health care or medical care related fields.
Students unwilling to pay high tuition in an uncertain economy.
Instead of going into nutrition and dietetics programs, students may be going into nursing or other medical or allied health fields.
In the case of dietetics, an added factor may be the Master’s requirement which went into effect January 1st, 2024.
How will this affect the profession of dietetics? Since there are and will be a drop in the number of dietitians…what will this mean?
There are a lot of unknowns:
Will this increase salaries for dietitians as it becomes more competitive to hire RDs? Currently according to an Indeed.com survey of 11K dietitians, the average salary across the U.S. is $56K. Will we see that increase due to demand and the Master’s degree requirement?
Will certain RD duties/responsibilities be outsourced to diet techs, RNs, NAs, or wellness coaches?
Will some businesses begin using AI in place of RDs?
Will telehealth and virtual RDs working remotely replace RDs working in-person in some settings?
This article (see hyperlink), specifically about dietitians in long-term-care (LTC), offers a look at how LTC facilities may have to cope with a shortage of RDs by offering flexible hours, using remote and telehealth options, contract RDs, using other workers to do certain duties and (and this may be the silver lining) raise salaries to attract and retain more candidates.
What do you think the future holds for dietetics and dietitians?
As a Board Certified Health and Wellness Coach (NBC-HWC), please for the love of all that is holy do NOT allow "health coaches" or "wellness coaches" to take over any RDN role! Okay, maybe I should say do NOT allow unless they have (1) very specific training, and (2) possibly another credential. Why? Sadly, many of the board-approved coaching programs teach and promote misinformation. (I know, I know, there are RDNs who are somehow not-evidence-based too, but as far as I can tell it is a much smaller percentage of the professsion.) There is no specific educational background required, so many coaches (like me) have no background or degree in nutrition, chemistry, biology, etc. and most of them (unlike me) don't know how to evaluate published studies beyond the People-Magazine level of presentation. The Board exam for coaches is largely focused on coaching skills within the coaching scope of practice--as it should be. There are very few questions concerning general health and nutrition, all of which are based on very basic guidelines (like MyPlate). This is because education is not the heart of coaching--coaches don't teach, they help clients make client-centered, client-directed lifestyle changes. Coaches without other credentials should not be handing out anything more than very basic dietary advice (e.g. eat more vegetables, watch added sugar intake)Creating dietary plans for specific illnesses is NOT within the scope of practice for a coach, yet I've seen coaches insist the ONLY health diet for [insert-a-condition-here] is paleo, or sell Plexus (an MLM) to their clients as it will absolutely "help" with [insert-a-condition-here]. I'd add that the non-board-certified coaches are even worse than the board-certiied ones. My dudes, as a not-RDN, please DO NOT let coaches take over nutrition. Sure, rely on the sane among us to help share accurate information, but don't let us into your scope of practice. It's a terrible idea.
I see absolutely no reason not to be paying RDNs at the same rate as other allied professionals (OTs, PTs, STs, etc.) -- except that reimbursement hasn't kept pace with that of those professions, while the cost and length of time getting that education is similar to that of allied professions.
Also, our profession has ALWAYS suffered from "hairnet syndrome." Too many people, including many health professionals, still view us in the kitchen stirring cauldrons of soup more than they see us in the CCU doing nutrition assessments and NFPEs, or with various specialty certifications. Medicare reimbursement is also lower. As for private 3rd-party payers, we all know their reimbursement rates, and their coverage. Some even lock RDNs out of their networks. It's mind-boggling how Medicare won't reimburse RDNs for MNT to address the most common killer/chronic health condition (heart disease), but they'll gladly pay for a stint, angioplasty, or bypass. Those procedures may happen anyway, but MNT, if involved early enough, can delay and possibly prevent many CV procedures, and at the least, is well known now to help speed recovery and shorten hospital stays.
Of course, Medicare is only allowed to reimburse for CKD and DM, and that's why passage of the MNT Act is so critical for health care and our profession -- it would make it easier to add MNT coverage for more chronic conditions.
Another unfortunate problem is a ton of other less qualified persons are branching out into our scope of practice. Less educated or qualified "health coaches", many with very little training, not licensed, etc., are "nutrition coaches" -- a term that hasn't even a legal definition. This really muddies the water for us -- and confuses consumers.
When you get "ACTION ALERTS" in your mailbox from the Academy, it's a chance to RESPOND to your congressional reps. Key term: ACTION alert. It's not a "PASSIVE alert." It might be our best shot at better reimbursement, and attracting more people to the profession.
Just my opinion.