The Role of the Dietitian in Healthcare

By Jamison Williams, MS, RD/LD

The role of the Registered Dietitian/Registered Dietitian Nutritionist (RD/RDN) in healthcare continues to grow.  RDs are nutrition experts.   Recently, the governing organization of dietitians has allowed RDs to choose which credential they prefer in their practice: RD or RDN.  A Registered Dietitian Nutritionist is equivalent to a Registered Dietitian; however, an individual who simply labels themselves as a “nutritionist” may not have the same academic background as an RD/RDN.  There are three main fields where RDs are employed:  clinical, community, and research.  Some RDs will wear two or all three hats within their practice.  

Most individuals are familiar with the clinical dietitian.  Clinical RDs are generally employed in a hospital or healthcare facility.  These RDs work closely with other members of the healthcare team including physicians, physician’s assistants, nurses, speech pathologists, and occupational therapists among others.  The primary job in this field is to ensure that the nutritional needs of patients are being met.  This can come either in the form of oral intake or through nutrition support.  Clinical RDs working in Intensive Care Units will likely be making recommendations for Enteral Nutrition (tube feeding) and/or Parenteral Nutrition (TPN).  Enteral Nutrition is generally used when the majority of the GI is intact but the patient has issues ranging from swallowing difficulty to esophageal cancers.  Parenteral Nutrition is used when there are major issues with the gastrointestinal tract that greatly impact normal digestion.  In summary, the clinical RD is a treatment specialist.        

Community dietitians generally work to establish proper nutrition habits through education in order to prevent chronic disease.  Wellness programs and WIC are examples of these.  The heart of the community RD’s role is to erase the knowledge deficit, and sometimes the financial burden, of eating a proper diet.  These folks are educators.  Oftentimes they have a background in exercise or work closely with exercise specialists.  This is to better service populations through the old adage “an ounce of prevention is worth a pound of cure.”  If appropriate dietary and physical activity habits can be established, the risk of developing chronic diseases drops tremendously.      

The research RD serves a critical role for both the clinical and community RD that is often underappreciated.  Research RDs collect data in order to analyze treatment methods in regards to nutrition therapies. As nutrition scientists, these individuals work to test existing and experimental recommendations.  This is usually done in the form of model organisms such as mice and pigs.  The results of these experiments help to shape the best practice recommendations for both clinical and community dietitians.  These professionals are usually employed through hospitals or universities.    

As previously mentioned, many dietitians wear multiple hats.  Before being eligible to sit for the Registered Dietitian examination, all RDs must complete an internship that focuses on community, clinical, and management.  This prepares RDs for the majority of issues they will deal with in the workplace.  Clinical RDs are able to provide nutrition education for general health and refer to appropriate professionals for exercise prescription.  Community RDs are able to provide diets specific for disease states, and most are able to provide information about enteral and parenteral nutrition.  The training for RDs contributes to this necessary crossover effect.  

Everyone can benefit from meeting with a dietitian.  Whether you are needing healthy snack tips, detailed weight loss plans, nutrient dense recipes, or nutrition therapy for chronic diseases (diabetes, heart disease, kidney disease, autoimmune issues), or sports performance, a dietitian will be able to help you develop a plan.  A meeting with a dietitian, when combined with an assessment from an exercise specialist, is the best prevention currently available for chronic disease.  Nutrition and exercise are the forefront of health.  In terms of treatment for diabetes, dietitians can have a major impact on managing blood glucose levels.  After all, treatments for diabetes are all correcting for dietary intake.  

In most cases, meeting with a dietitian will require a referral from a primary care provider.  Speak with your provider if you are interested in meeting with a  dietitian.