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Government Affairs ::
Frequently Asked Questions Regarding the Business & Professions Code
Section 2585-2586 |
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Q: Who
can use the titles Dietitian; Registered Dietitian (RD); and
Dietetic Technician, Registered (DTR)?
A: Only a person who meets the qualifications in
California Business and Professions Code, Section 2585 (a) can
use the above mentioned titles. |
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Q: Can a
health professional who was trained in another country work as a
Dietitian, Registered Dietitian, Nutritional Professional or
Dietetic Technician, Registered?
A:
No, not
until it has been determined by the appropriate
registration authority that the individual possesses the health
professional qualifications identified in stature. The
individual must meet the qualifications in the B&P Code, Section
2585. Individuals possessing a Nutrition Educator or Nutrition
Consultant Certificate cannot work as a dietitian and are not
qualified nutritional professionals unless they obtain the
proper registration status. |
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Q: Who
can prescribe or order a diet?
A:
The diet
must be ordered by the patient’s physician but when the MD
specifies “Dietitian to order diet” and there is an approved
written protocol that covers the patient’s circumstances, then
the RD can determine the diet. If the patient’s condition is
outside of the parameters established by the protocol, the
general delegation noted above is inadequate. |
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Q: A
physician has approved a protocol specifically allowing the RD
to modify the caloric level or sodium level of a therapeutic
diet. If the RD has received a physician referral to provide MNT
and then determines that the diet should be modified, can the RD
change the diet order?
Note:
the “diet”
can be changed. The “order” cannot be changed. This is
the nuance we need to be careful about.
A:
If the
physician uses a protocol specifically to establish the
parameters of what the RD may provide absent specific
instructions from the physician, then changes or implementation
pursuant to that protocol are proper. The RD is not changing the
order but is implementing the order from the MD. This is
precisely the type of situation that physicians seek to use a
protocol – establish the parameters and let the RD handle the
details within those parameters but obtain a re-evaluation by
the physician if those parameters are exceeded. |
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Q: An RD can
provide MNT, accept and transmit verbal orders, and order medical
laboratory tests with an established written protocol approved by the
patient’s physician. What is the purpose of the protocol and are there
any limitations?
A:
The approved protocol is an alternative to a written prescription or
entry in the patient’s medical record that is signed by the health care
provider detailing the patient’s diagnosis and the desired objective of
dietary treatment. The protocol authorizes and controls the provision of
medical nutritional treatment only. Only a physician can authorize MNT
via protocol, although certain other health care providers are allowed
to prescribe dietary treatment by written orders.
Additional protocol may be developed and approved to allow a RD to
accept verbal or electronically transmitted orders from a physician to
implement medical nutrition therapy. In addition, an approved protocol
may authorize a RD to order medical laboratory tests related to
nutritional therapeutic treatments. |
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