Nick Blonski, UNM DPT ’21
As physical therapists in the world of direct access many times we are the first people to welcome physical therapists into the world of health care. One of our main jobs as physical therapists is to do a comprehensive systems screen and provide a full evaluation comprised of a subjective and objective examination. Undoubtedly at some point during your time as a physical therapist or even a student physical therapist you have been confronted with a patient that asks about nutrition or you feel would benefit from discussing nutrition. This can be an incredibly awkward situation, as it seems like something we should be able to discuss due to the effects it has on physical abilities. So the questions become what are we allowed to discuss with our patient, when should we refer a patient, and whom should we refer a patient to?
According to the American Physical Therapy Association nutrition is within our professional scope of practice as physical therapists. Our role as physical therapist in regards to nutrition allows us to screen and provide information about diet and nutritional issues to patients.1 It is also important to remember to check both the physical therapy practice act for your state, along with practice acts for nutritionists and dieticians within your state. A good rule of thumb for providing information about nutrition is using information that can be publically found. One good resource that you can refer patients to is https://www.choosemyplate.gov/. The My Plate website can help you as a clinician explain a healthy diet and also has many resources including printable free documents you can provide to patients.
When trying to figure out if you should refer a patient for further nutritional consultation a few criteria can point you in a referral direction. If you feel uncomfortable trying to provide nutritional education it is better to refer to a specialist to maintain high quality of patient care. It is also essential to refer a patient for nutritional education if the patient needs help with meal planning, or needs to talk about specific macronutrients and micronutrients. Lastly, it is important to refer a patient that has special nutritional needs. This can qualify for athletes trying to plan a nutritional plan to improve performance or a patient with diabetes that needs nutritional modification to maintain quality of life.
When choosing whom to refer to it is important to know the difference between a nutritionist and a registered dietician. A registered dietician is someone in the United States that is required to become registered with the Commission on Dietetic Registration (CDR), where as a nutritionist does not. Dieticians are regulated by government regulations whereas a nutritionist who choses to not go by dietitian or registered dietitian are typically free from government regulation.2 This again is dependent on the state you practice in and should be researched when referring a patient for nutritional consultation.
When working with patient it is important to provide the highest quality of education and service. This includes the education we provide on nutrition as it can play such a huge role in a patient’s health. Taking time to review websites such as My Plate and familiarizing ourselves with basic nutritional facts and preparing printable handouts can improve our ability to answer patients’ basic nutritional questions. Knowing when to refer a patient and who to refer to can also greatly improve the quality of care a patient receives and can improve our patients’ quality of life.
1. “Role Of PT Diet Nutrition.” APTA, www.apta.org/apta-and-you/leadership-and-governance/policies/role-of-pt-diet-nutrition.
2. “Distinguishing Between Dietitian vs Nutritionist.” Dietitian vs Nutritionist, www.nutritioned.org/dietitian-vs-nutritionist.html.