NEPHROLOGISTS AND INTERNAL-MEDICINE PHYSICIANS EXPECTATIONS OF RENAL DIETITIANS AND GENERAL CLINICAL DIETITIANS

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.