Jj. Hart et al., NEPHROLOGISTS AND INTERNAL-MEDICINE PHYSICIANS EXPECTATIONS OF RENAL DIETITIANS AND GENERAL CLINICAL DIETITIANS, Journal of the American Dietetic Association, 97(12), 1997, pp. 1389-1393
Objective To document and compare nephrologists' and internal medicine
physicians' expectations of renal dietitians and general clinical die
titians. Design Subjects completed a mailed survey. Respondents provid
ed demographic information and used a 5-point Likert scale to note whe
ther each of 14 job functions was appropriate for general clinical die
titians, renal dietitians, or both. Subjects Five hundred forty-one ph
ysicians registered with the Ohio State Medical Board (OSMB) were surv
eyed. Within this group were 283 nephrologists (the population of neph
rologists registered with the OSMB) and 258 internal medicine physicia
ns (selected randomly by the OSMB). A total of 133 physicians (25%) re
turned the survey; 119 surveys were usable: 70 from nephrologists and
49 from internists. Statistical analyses performed A composite variabl
e was created by coding and summing physicians' responses regarding di
etitian job functions. This variable was averaged for both physician c
ategories. A t test was conducted to compare composite variable result
s between the two physician groups. Results At least 50% of nephrologi
sts and internists agreed that both types of dietitians should conduct
nutrition assessments, determine patients' energy needs, evaluate med
ication-nutrient interactions, recommend diet and tube-feeding orders,
instruct patients about physician-ordered diets, and teach nutrition
concepts to hospital interns. Few physicians agreed that either type o
f dietitian should order diets, tube feedings, or diet instructions. A
pplications/conclusions Clinical dietitians can educate physicians abo
ut dietitians' roles informally in their institutions and formally by
supporting programs like The American Dietetic Association Physician N
utrition Education Program. In addition, dietetics educators can hone
their students' communication and problem-solving skills to promote po
sitive physician-dietitian interaction.