Who Should Dish Up Nutrition Advice?

(page 2 of 2)

Levels of Recognition

The dissenters say regulation restricts competition and gives preference to certain philosophies or techniques in areas where there is genuine disagreement, such as nutrition. The Coalition for Natural Health, a national organization that monitors licensing efforts around the country, says "help is on the way" in Michigan in the form of proposed legislation that will make the legislation passed last year more flexible in enabling nutritionists to disseminate health information.

Because of all the friction, states vary the levels of recognition accorded to certain health professionals such as dieticians and nutritionists. While 46 states have enacted laws regulating nutritionists and dieticians, some take the less restrictive certification or registration approaches. Certification restricts the use of a title like "certified nutritionist" to individuals who meet defined standards, but doesn't restrict the services that professionals can provide, as licensing does. And registration only requires practitioners to sign up with the state.

For an entrepreneur like Kowalski, the current situation is a little like being in suspended animation. While she doesn't know how the final regulations will come out, she fears a precedent has already been established with the official recognition of ADA training and protocol. She says she engages four different nutritionists who have certification under non-ADA-sanctioned programs. "Are they [the MDA] implying that such people aren't qualified?" she asks.

Protection vs. Limitation

The MDA, for its part, is inconsistent in what it says will and won't be sanctioned under the upcoming licensing regulations. In literature it has distributed about the "myth" of dietetics licensure, it states companies selling nutrition products won't be affected and "individuals and groups may also conduct classes and share information."

But in response to a description of some of the "coaching" services and cooking classes Kowalski's company provides, Charity Simkins, the MDA's at-large director of legislation for state issues, says, "We strongly urge them to join our association." If not, "They're going to have to have the supervision of registered dieticians." She allows, though, that, "There's going to be a gray area…that the [registration] board is going to have to make determinations about."

Kowalski, for her part, expects to become actively involved in trying "to influence the final outcome" and tries to take heart from the legislation's stated intent that the licensure board, "Shall not promulgate rules under this section that diminish competition or exceed the minimum level of regulation necessary to protect the public."

This seems, then, another example of the emerging struggle in public health today: protecting the public vs. providing freedom of choice. Too often, regulators invoke the battle cry of protection in order to limit consumer options.

David E. Gumpert covers business/health issues and also writes the biweekly What Entrepreneurs Need to Know column.