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.
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.
thanks for this Elizabeth! and thanks for taking the time to write it and for reading the newsletter!
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.