042 – Action Alert – Illinois Dietitian Licensing Bill – My Interview with Diane Miller

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Nutritional freedom is at risk in Illinois and other states.

ACTION NEEDED IN ILLINOIS

Oppose Senate Bill 2936 – Dietitian Nutritionist licensing bill!

Diane MillerWhat the Bill Does:

S.B. 2936 would extend Illinois monopolistic Dietitian and Nutrition services law until 2023 and increase the penalties for unlicensed practice to $10,000 for each offense. The definition of Dietetics and Nutrition services is so broad that it make illegal anyone who practices within the nutrition field that does not have a licensed including herbalists, naturopaths, nutritional consultants, and even people like housewives who talk about food and herbs all the time. To read H.B. 2936, Click HERE.

OPPOSE Illinois S.B. 2936

Illinois current monopolistic Dietitian law is up for repeal in 2013 and Senate Bill 2936 is attempting to extend the law until 2023.The Illinois Dietitian and Nutrition Services law is one of the most restrictive monopolistic Dietitian laws in the U.S. And the new bill would make it even worse, increasing the civil fines for unlicensed practice to $10,000, including anyone who practices in the field of nutrition if they are not licensed as Dietitian Nutritionists. This law needs to be repealed NOW! The bill received unhelpful amendments on March 2, 2012, keeping in place all of the violation penalties for practice without a license and continues to move forward, now referred back to the Committee on Licensed Activities.

What you can do to TAKE ACTION:

Immediately contact all the members of the Senate Committee on Licensed Activities listed below to let them know you Oppose S.B. 2936. Then, contact your personal Senator and Representative to tell them to Vote NO on S.B. 2936. Contact legislators by phone, email, or personal letter or by going to their website and filling out their contact form. Also, keep in touch to come to any future hearings.

If you want to register your opinion right now, you can do so at this website: Alliance for Natural Health

Diane Miller

Diane Miller JD is a Minnesota attorney, and Legal and Public Policy Director of the acclaimed National Health Freedom Coalition (NHFC) and it’s sister organization, the National Health Freedom Action (NHFA).

{ 21 comments… read them below or add one }

1 Mary March 14, 2013 at 9:00 pm

Steve, I am a licensed dietitian from Ohio. You seem to think it is easy to prosecute harm for nutrition misinformation. Unless the wronged person had taken a tape recorder along, how can you prove in court what the person said? I will give you a sad example of misinformation causing severe protein malnutrition in a young child. I have the case study someplace, but it involved a child around 18 months. About four months before, advice given at a health food store advised the parents to put the child on a “Mucless” diet that was very low in protein to cure sinus problems. Since the problems continued, addition “counseling” at the health food store restricted the child to vegetables juices and not much else. Due to deterioration in health over the four month period, the child ended up at the local children’s hospital. The child was so protein deficient that the recent hair color had changed to red on the otherwise black hair of a black child, signs of kwashiorkor (think starving children in Ethiopia with their matchstick arms and legs and little swollen bellies filled with fluid). Child protective services was called, but the family took the child out of the hospital as they could not believe they had done anything wrong. The parents then took the child to a local Seventh Day Adventist Hospital which is known to have ties to a lacto-ovo vegetarian diet and the dietitians there were able to convince the parents to provide additional foods to the child’s diet.
Other examples include a phone call from an elderly lady whose husband was dying from bone cancer. Some well meaning person at a health food store had given the wife advice to only provide a strict vegetarian diet for her husband. Out of love for her husband she had followed the diet faithfully, but now her (dying) husband was begging for an egg to eat and she called the dietitian hotline to get permission to fed her husband an egg! I met numerous cancer patients in the hospital in the last stages of their disease whose family members had been given advice by chiropractors or other “nutrition experts” to limit many foods in their diet. The worst is the raw foods diet. These severely limited diets further reduce the little remaining quality of life for these unfortunate individuals.

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2 Steve Lankford March 15, 2013 at 8:51 am

I think your examples provides an opportunity to expand the discussion. It is always sad when someone gets advice that does not help or is harmful. But I think that such events deserve further examination. There are certain presumptions that may seem to lead to obvious conclusions but are actually only not necessarily indicative of a much larger issue. I will try to explain my position more clearly.

1 Practically every health care professional is at risk for giving advice or service that does not work out and may lead to harm. We all know there is risk to modern medical care whether it is provided by doctor’s, nurses, dietitians, etc. Medical degrees and licensing do not guarantee safe and effective outcomes. The amount of health problems caused by the medical profession is well documented. We accept a certain amount of risk when we accept medical care.

2. Likewise, there may be alternative practices or practitioners who give bad advice. The question is whether the frequency of these events is so significant that we should outlaw all alternative services. Some will say that no risk is acceptable when dealing with alternative services and the only risk we will allow is to put yourself into the hands of the medical profession. Others, like myself, say that it is an individual’s choice to choose their advisers and health service providers, and I suggest that the risk to benefit ratio is very low. If the only way to lower the risk to zero is to outlaw all alternative services, I suggest that is excessive and not reflective of the actual or relative risk of harm.

3. You say it is difficult to prosecute a case. That is how it should be. I believe that if there is a case against an individual that is persistent and/or pervasive then it requires that the case be made. The fact that it is difficult should not be a deterrent if it is truly the concern to remove those who are providing dangerous advice. It is simply not enough to accuse someone, you must be able to make the case. The problems with an individual who gives bad advice should not be imputed to all other practitioners.

4. I believe it is the responsibility of dietitians to make their case. If these problems are so pervasive, then it should not be a problem to document these issues over time. Yes, it would take time and money, but when you are considering outlawing a whole class of services, then it should be required that the complainers make their case. If the problems are rare, and too much bother to document and build a case, then one might suggest that dietitians are making the problem seem much larger than it really is. If you say it is a big problem, then it should be possible to define the problem without relying on only anecdotal reports.

5 Using the first example of the child. Was any effort made to go any further to make sure this did not happen again? Was there any effort to identify the person giving the advice and proceeding according to the laws that are already in place? Did anyone including dietitians, licensing boards or the parents make any effort to address this particular issue with the offending person? If may not be easy to prosecute, but if others feel it is not worth pursuing that should tell us something about the overall importance of such an issue. This does not mean it isn’t important to the family involved, it does mean that we cannot set public policy because of the actions of a very small number of people. The overall risk to our population is low, and the upside to having access to alternative providers is great.

6. In the case of the cancer patient. The person is dying from bone cancer. Changing to a vegetarian diet is not going to kill this person. It is possible that changing the diet might improve their quality of life. So that advice does not require outlawing. Certainly the patient should be able to choose the diet they want. At this stage of life, quality of days is important. But it is not life threatening or dangerous advice. One cannot blame family members for seeking out additional advice when there is no more medical help.

7. The fact that these are the best examples that can be provided by the dietitian community, suggests to me that there are not significant numbers of problems. Do problems exist? Likely. Are they so common that huge numbers of consumers are being harmed? For this there seems to be no evidence. The fact that consumers complaints are virtually non-existent suggests that consumers are satisfied with the services they are receiving. The fact that consumers are spending after-tax, discretionary dollars suggests that they find value in the services that they receive. The fact that there are virtually no prosecutions would suggest that the problems that do exist are not the norm, and not worth pursuing.

So while you find such cases disturbing, it does not seem to warrant outlawing all other alternative health care service providers. Just my opinion.

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3 Lance November 26, 2012 at 8:16 pm
4 Steve Lankford November 26, 2012 at 9:19 pm

Is this an attempt by the Florida dietitians to cast unlicensed nutritional advisers as “blood sucking vampires”?

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5 Venessa Rodriguez November 14, 2012 at 10:50 pm

This is an interesting conversation, and while I’m sure that all of us in this convo are for the greater good and safety of the public, I believe this bill is about protecting the “integrity” of the RD profession and eliminating market competition, as evidenced in this Forbes article: http://www.forbes.com/sites/michaelellsberg/2012/07/10/american_dietetic_association_2/

As an Illinois resident and consumer, I would like to keep my freedom of choice regarding my health care and nutrition options, thank you very much.

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6 Steve Lankford November 14, 2012 at 11:09 pm

This is the time for Illinois citizens to speak up for nutritional freedom. Contact your legislators. For additional insight listen to my recent interview with Pam Popper, who suffered under the Ohio Dietitians Law.

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7 Cindy Rushton November 13, 2012 at 3:09 pm

PS….just found your bio. Are you kidding me!!!??? A “degree” from Instituto Naturista? Gee…I don’t see any science classes. OK, I’m done here. You are an idiot Steve.

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8 Steve Lankford November 13, 2012 at 3:40 pm

What is your problem with my degree? I don’t live by that degree. I don’t use any designation of degree. I don’t pretend to be a nutritionist or dietitian. It is a part of my history. So what is your problem? I have a degree that you don’t like or what. I did study anatomy and physiology, chiropractic, massage, nutritional, herbal medicine and many other courses that were not very common in 1973.
And so you think I am not qualified to have an opinion on the topic? This is the derisive attitude that turns so many against you. You think you know more than anyone else and you want to put down those who don’t agree. Dietitians get no respect? Boo Hoo. Get used to it. The alternative health movement has already been accepted by a lot of Americans and the shift is greater than the dietitians will be able to contain. It is your own limited approach to nutrition that moves consumers to other providers. It is the marketplace saying it wants choice and alternatives in nutrition services.

Call me an idiot. That’s just crude. It says more about you than me. Again I say, prove your point. You get nowhere by attacking me.

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9 Cindy Rushton November 12, 2012 at 7:22 pm

Well, as a licensed and registered dietitian in the State of Illinois, I have seen NUMEROUS patients harmed by “nutritionists”. A registered and licensed dietitian has a pre-med background, 1200 hour internship and has sat for boards. The term “nutritionist” could refer to ANYONE off the street. It’s like someone calling themself a “counselor” who could be anyone without credentials. Nutrition is biochemistry and how the body utilizes nutrients differently with illness and body systems/organ failure: i.e. kidney failure, liver failure, diabetes, GI tract failure, cancer, etc. People who call themselves “nutritionists” have NO clue about anatomy, physiology or any of the issues mentioned above as they have had NO MEDICAL TRAINING. To a lot of people “good nutrition” is preaching to eat organic and take supplements. That is NOT what being a nutrition expert is about. Licensure needs to stand in order to help protect the public.

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10 Steve Lankford November 12, 2012 at 7:55 pm

Several thoughts here. We always hear about injured and harmed consumers. However the evidence of their existence is lacking. Where are these harmed people? If there are harmed people what have you done in Illinois to report the offenders. You have a strict law so you should have evidence that there are offenders. You should have evidence of prosecutions to defend the need for the status quo. I for one, would love to see anything that can back up your assertion.
Maybe dietitians should make a case for medical dietetics to make some distinctions. But to suggest that all nutritional speech and consulting should be restricted to only dietitians is to suggest that all levels of nutritional speech are dangerous. This is simply not the case.
I think it is likely that consumers who have body systems/organ failure: i.e. kidney failure, liver failure, diabetes, GI tract failure, or cancer as your examples are likely already under a doctor’s care. If you have evidence that unqualified providers are doing harm then, again, make your case with facts. Just stating that it happens is not sufficient proof. There is also a huge area of nutritional benefits to be had that does not involve the serious medical conditions that you mention.
To suggest that all other nutritional counselors are under qualified is a judgement call that is not backed up by any facts. You assert these things as if it is common knowledge but in the grand scheme of things the dietitians have a poor track record of showing that others are being harmed. Many nutritionists are highly trained and provide safe and effective service. I think you are afraid of the competition. Consumers who use other nutritional providers are not confused. They know they want something different that standard medical dietetics. They are freely choosing another service. That should be their right.
Some people think that dietitians are not so well qualified when we look at their track record of improving America’s health. What dietitians do, they can do well enough but the do not serve the community who is convinced that conventional medical dietetic advice is lacking. Those consumers want options that dietitians do not provide.

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11 Cindy Rushton November 12, 2012 at 11:26 pm

Steve….don’t know where you are getting your info. Are you in the medical field? OK, you want examples, I’ll give you examples…….there was a patient in the hospital you had taken massive amounts of Vit A for YEARS because a trainer at his health club told him he needed it for an ergogenic aid in weight lifting. Guess what? He took it for SO many years, that by the time he was hospitalized, his liver was failing and unless he got a liver transplant he would die. I also many times had outpatients who had previously seen a “nutritionist” who “prescribed” herbs and told them to “go off their meds”. Guess what? Their livers were severely harmed. I’ve also seen people who were told to take certain herbs to “cure” their diabetes and to ignore the meds their doctor prescribed for them. Guess what? By the time it was discovered how out of control their diabetes was…..their kidneys were failing and they ended up on dialysis. Those are just a few examples.

You obviously have NO clue what a dietitian does or their training. Steve, do you know ANYTHING about medicine? Are you a disgruntled “nutrition wanna be?” Perhaps you are one of soooo many “trainers” who have screwed people up. What I have been trying to say is that nutrition is NOT throwing out the latest fad, just talking about weight loss, eating your vegetables and taking supplements (none of which is monitored by the FDA unless people start dieing).

You just don’t get it, do you? Most people don’t. If you think nutrition counseling is just sitting down and talking nice-nice about food fads, organic foods, etc. you are SO wrong. When you have the same medical training I do to know how diet needs to be altered with liver failure, to know about food-drug interactions, to know what to say to someone who has Celiac disease, diabetes, heart disease, is on dialysis, has cancer and going through chemo and on 20 meds, with NO appetite and has become skin and bones……THEN let’s talk how you or any other “nutritionist” out there thinks they can practice the same as we can.

Hell, what’s next? You want to practice medicine too? GET A CLUE STEVE!!!! You really don’t know what a registered dietitian does, do you!? I hope I’ve enlightened you!

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12 Steve Lankford November 13, 2012 at 3:09 am

Well it seems I have struck a nerve. So let me take it further. My bio is on my site so if anyone wants to see my history you can see it there. If you visit my site you will see where I am coming from. I am no mystery to anyone who takes the time to look.

So let me address the three examples you cite. This is a good start. Now what is the clinical evidence that supports your conclusions. You report cause and effect and in order to know that there must be some analysis and or diagnosis that exists. If there is documented evidence of medical harm then one would expect several other facts to exist. Anytime someone is poisoned by a vitamin or supplement (which is what you are implying) then others would be involved. This could be reported to the poison control center, the FDA, the medical licensing and dietetic licensing boards. There could be actions taken against such individuals. If your cited cases are valid then there should be a trail of evidence. Otherwise it is only hearsay, not evidence.

I do know something about nutrition as I have been in this field for 40 years. You would know that if you ever looked at my site. Am I disgruntled? Only if dietitians are my only choice for nutrition services. Somehow you are trying to equate all nutritional advice with harmful nutritional advice. They do not equate any more than all medicine is the same as bad medicine. It is a fact that millions of consumers are choosing to get nutritional advice from sources other than dietitians. They are spending millions of their own discretionary dollars for alternative nutritional care. Giving the amount of people who are receiving these services and the number of people who are practicing these services one can make some assumptions.
Consumers are generally happy with these services and the complaints are few. The difficulty that the dietitians have is that they can’t seem to prove the case that all of these nutrition services are dangerous.

You bring up these claims of danger and harm. It would seem that these problems that you cite are not documented. These people are already seriously ill. You would need to show that the nutritional advice is what made them worse. You can’t just assert it. My position is that if the dietitians cannot prove actual harm then they have no right or expectations of exclusivity and your claims have to be considered suspicious. What you have cited is only your opinion and what you have from me is my opinion of your objection. You have not made your case, but I am willing to learn. Show me what you got and we will discuss it.

I do have a clue to what dietitians do. My best friend has of the same opinion as mine. His daughter has a masters in dietetics so I know very well what dietitians do. And I know what kind of nutritional advice they give and what kind of foods they approve. While I don’t follow their advice, I do respect they service they provide. I don’t think they should control all nutritional services. They should focus on serving their clients and not limit consumer choice. If there are dangerous players then get the proper authorities involved and go after them. The victims can sue for damages. If this isn’t happening then you have a very weak case.

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13 Nathan November 1, 2012 at 4:17 pm

Your ridiculous. Of course there should licensure for dietitians. If not that likes saying anyone could be a chiropractor or a doctor or a nurse. It is not prohibitive to the other disciplines who are licensed and have credintials. For example if you are a licensed natrapath you can practice nutrition, a chiropractor that is licensed can practice nutrition. why should just anybody who wants to be able to give nutrition adivce that is crazy.

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14 Steve Lankford November 1, 2012 at 8:14 pm

You’re ridiculous. If you are going to insult someone, try to spell it correctly. What is ridiculous is to presume that only dietitians are qualified to discuss nutrition. These licensing laws do much more than protect the title of dietitian. They go so far as to outlaw all other nutritional speech. Nutritional speech goes on all the time without harm to the public. There is not a problem with consumers getting confused as to who is providing the nutritional advice be it dietitian or nutritional counselor, or weight loss coaches to health food stores. Consumers generally know who they are talking to and they choose those services because they want them. There is no justification for giving dietitians the power to shut others down. This does not mean that no controls exist. There are already legal remedies if someone is doing harm. The reality is that there are practically no cases of alternative practitioners doing harm from giving bad nutritional advice. Nutritional advice is not inherently dangerous and does not require prohibitions against all other practitioners.

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15 Ashley November 12, 2012 at 7:44 pm

So let me get this straight… what you’re saying is that people who do not have the proper educational background and credentials can do no harm giving out inaccurate nutritional advice? I am a licensed dietitian in the state of Illinois and I think that you could not be more wrong. I workout at a fairly well known fitness chain and over hear personal trainers (who are not licensed to give out nutritional advice) give clients what could be very harmful advice regarding the amount of protein intake. I once overheard a trainer tell a client that she needed 2 grams of protein per POUND of body weight! Now if you know anything about nutrition, such as a registered and licensed dietitian does, you would know that if a person continued to take in that large amount of protein for months or years at a time it could lead to kidney failure. Now how is that not harmful advice? We need to keep licensure to protect the uneducated consumer from receiving this kind of advice that could be very harmful to their health. There is a reason why registered dietitians have to go through 5-6 years of schooling to even sit for our boards.

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16 Steve Lankford November 12, 2012 at 8:08 pm

See my previous comment.
So what did the state of IL do about this grievous offense? Did this person who gave the advice get prosecuted? Did the person receiving the advice get harmed? Did they develop kidney failure? Anecdotal stories like this are no proof of harm and likely no reason to get offended. Saying that this advice is harmful is not enough. Dietitians should be able to document cases of harm and cases of prosecution.

How do we know that these harm people exist? Dietitians have records. That is a start. If there is someone who is harming consumers and misleading the public then the IL dietitians have an obligation to bring forward that evidence. If you have not prosecuted any cases under your existing law then where are these offenders and harmed consumers. Again, I would love to see the case studies or analysis that gives you confidence that you are correct. Advice overheard in a gym is hardly convincing. Conventional wisdom is often wrong. It’s not what we don’t know that bothers me, it’s what we think we know that ain’t so that worries me. It seems to me dietitians are trying to create conventional wisdom about the harm to consumers that does not exist. For dietitians to be so convinced would suggest that there is strong and compelling evidence for their position, but the failure to produce such evidence suggests that no such evidence exists. Dietitians, prove your case.

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17 Cindy Rushton November 12, 2012 at 11:41 pm

Steve…..I DID try to prosecute one “nutritionist”. The State wanted the patient to file a complaint, but they would not. People are afraid to make waves. Is that all you want to harp on “show me the evidence, show me the evidence” Geez. Do you know how many people are harmed by physicians and the doctor never gets prosecuted or had their license taken away?!! Does that mean that you should practice medicine??

Thank you Lance and Nathan…..you get it. Credentials DO mean something. They mean that someone has had to have a LOT of training to get to where they are. Are they fool – proof? No, but they are much better than someone having no credentials, hanging out a shingle and calling themselves a “Nutritionist”. People put their lives into these people’s hands. Sales clerks at GNC give out medical advice. I have heard it.

Steve, I don’t know what your story is……but obviously you have got it out for dietitians for some reasons. Hey, if you want to be one….I dare you to be able to survive the coursework: biochemistry, a year of organic and inorganic chemistry, a year of anatomy and physiology, microbiology, psychology, business, sociology, food science, food sanitation, pharmacology and 1200 hours internship working in hospitals, clinics and a variety of community settings. THEN passing a board exam and taking continued education each year. Not too many professions even need to do that.

Gee, if I was looking for a nutrition expert….I think I’d pick someone who has had this training vs “I like food and supplements and eating organic is cool.”

18 Lance November 1, 2012 at 10:39 pm

I have to agree with Nathan.
There is no way to tell who is qualified to give nutritional information unless they have the proper credentials.
What is wrong with protecting the consumer and making sure they are getting a qualified individual for their nutritional needs?

Anyone can claim they are an expert on anything if there is no oversight.

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19 Steve Lankford November 2, 2012 at 2:17 am

There are ways for consumers to know the qualification of anyone they visit. All they have to do is ask. There are many other providers who are able to give nutritional advice. Anyone considering service can ask about the provider’s qualifications. There is nothing wrong with protecting the consumer when there is some risk or danger. The absence of harm would suggest that alternative nutrition providers are generally, for the most part, providing safe and effective service. Otherwise complaints would abound and that is not the case. The idea that you have that suggests that dietitians are the only one with proper credentials is not shared by the millions of consumers who seek alternative nutritional advice.

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20 LAUNIE J SOREM October 19, 2012 at 12:02 pm

Great job! Keep up the good works!
I have sent your message out on my FB and all my lists!
Thank you Diane.
Launie J. Sorem

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21 Steve Lankford November 13, 2012 at 4:04 am

Let me get this straight. So you have one case you tried to prosecute and the patient did not want to file a complaint. This tell me two things. Only one case? Hardly worth the effort it would seem. The patient won’t file a claim? How bad can it be? One case who won’t complain. Can you see why I am suspicious of your claim? You talk about a big problem but you can’t really show any significant evidence that the public thinks this is a problem. The problem exists because you seem to believe the exception is the rule. I don’t get your point about physicians who harm others. How is this point germane to the discussion?

Credentials mean something I agree. Dietitians have a rigorous field of study and they have a right to be proud of what they do. I am not disputing what dietitians do or what it takes to do what they do. I respect their chosen profession for them and those they serve. No one is suggesting that someone can call just themselves a dietitian. That is prohibited and we get that. Don’t call yourself a dietitians. There is no problem here.

The problem lies in the your desire to claim that all nutrition advice and services are dangerous, and that many people are being harmed and the consumers must be protected. The problem is that you can’t make your case. You may not like it, but a lot of people consumers have decided that they want more choice and they are willing to pay for it. So unless you can make a better case, then it is likely that dietitians will not prevail. A consumer voice will speak louder than a poorly crafted augment that seems self serving.

You also seem to ignore the fact that many credentialed nutritionist have as much if not more education that dietitians. To completely ignore them as an educated group who can provide significant services and to cast them disparagingly does no service to your argument. You are painting a prejudicial argument that cannot be taken seriously by people familiar with the issue. It sounds desperate when you fail to address the issues completely.

When we fought this battle in Wisconsin, there was a hearing in the Senate. I was there and testified. There were over one hundred people who traveled from around the state to testify of the benefits they had received from alternative nutritional providers. The dietitians could not produce one consumers to testify to their claim of harm. It spoke volumes and so this is their cause I champion. I want consumers to have choice and I want choice in nutrition services. We know where to find a dietitian if we need or want one. We are not confused. We know we want choice.

Now there are people who are working on a crafting a reasonable solution. If one assumes that there should be a compromise that would allow alternative practitioners and provide some consumer protection. These bills which are being developed would make it incumbent upon alternative practitioners to state their credentials, explain the services they provide, declare that they are not dietitians and it provides remedies for those that harm consumers. This would allow alternative providers to practice safely, consumers would have full disclosure, dietitians would have title protection and there would be legal remedies for those that violate the requirements and/or harm consumers. Dietitians are generally opposed to such a compromise because it requires that they admit that they are not the only providers and it undermines the argument they have been making all these years.

Now if you want to constructively contribute to the discussion, you will have to address the disparity between your claim and the reality that the nutritional market place is changing around you. If dietitians can’t forge a reasonable compromise, then they will continue to be opposed by the many people who want alternative providers.

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