Five things to consider before referring to a dietitian

Dietary advice is all around us. It’s on Facebook, television commercials, reality shows, documentaries and the internet, not to mention out of the mouths of friends.

Whilst a dietitian should be an obvious choice for reliable nutritional advice, which dietitian is right for the job?

To become an Accredited Practising Dietitian (APD), all dietitians must have completed a tertiary-level course approved by the Dietitian’s Association of Australia (DAA). This may be a Bachelor of Science degree followed by a one to two-year post graduate diploma or Master’s degree, or a four-year integrated undergraduate course

The title of Advanced APD is awarded to an APD who is a “proactive leader who integrates high-level nutrition and dietetic skills to generate new knowledge to influence the health of the community”. About 1% of DAA members are Advanced APDs and may be a marker of experience or specialised knowledge.

Dietitians are your on-hand qualified nutrition experts ready to help patients dispel myths and find the most practical approach to dietary change.

When choosing who to refer to, it is worth considering that one dietitian won’t suit all of your patients.

Despite the prevailing model of care encouraging co-location of allied health GP practices, it’s appropriate to find the right fit for your patient. One dietitian is unlikely to be both skilled and interested in renal, eating disorders, food intolerance and weight related issues. The current model creates some difficulties for primary health-based dietitians in developing specialised interests and skills, but freedom to refer outside of the practice would assist with this.

For example, many people in the community assume that all dietitians are skilled in weight control due to the interpretation of the word ‘diet’, however this too, is a specialty area often requiring specialised equipment, strategies, tools and attitudes to get the most from the consulting relationship.

When selecting a practitioner, consider the following:

1. EXPERTISE: Guide patients to an Accredited Practising Dietitian (APD) or an Advanced Accredited Practising Dietitian (Adv APD).
2. MATCHING INTERESTS: The Dietitian’s Association of Australia (DAA) hosts a “Find an APD” search on the home page, enabling you to identify location and area of specialty to draw from. For example, you can choose a relevant postcode and ‘gastrointestinal problems’ to find dietitians comfortable in assisting patients in this area.
3. LOCATION: Choose a practitioner in a convenient location for your patient as visits may be frequent or need to fit around work and home commitments. Convenient may be close to home or work.
4. CONSULTATION OPTIONS: Many dietitians offer home visit, clinic, telephone or telehealth consulting services which may improve patient access and compliance.
5. FUNDING OPTIONS: Patients may require National Disability Insurance Scheme (NDIS), Medicare, Department of Veterans’ Affairs (DVA) or Private Health Fund options, these are also visible via “Find an APD”.

WHAT YOU CAN EXPECT: Providing a written referral either to the patient or via Medical Objects is valuable to the dietitian to get a complete understanding of the patient’s condition, along with your (and their) expectations of the intervention. You can expect feedback after the initial assessment, when there is any significant change or an issue to confer on, and at the end of treatment. Dietitians usually appreciate any additional input you have along the way too.

FURTHER DEVELOPMENTS: Stay tuned for the introduction of 20 rebated dietetic consultations per year accessible to those with a range of eating disorders – anorexia nervosa, bulimia nervosa, binge eating disorder and atypical presentations from 1 November 2019 under Medicare.

The introduction of the NDIS has introduced opportunities for individualised care plans which may involve consultations with carers and food providers, the development of meal plans, telephone support and any service format that enhances patient capacity. Seek out NDIS approved providers.

DVA are looking to introduce telehealth consultations enabling patients to access the dietitian with the right expertise for their needs without needing to be local. This will be a major step forward. Look for DVA approved consultants.

There are 2000 APD’s in Australia offering private practice consultations; help your patients find the right one to maximise their chances of achieving their nutrition and health goals.

This article was written by Amanda Clark, practising dietitian.
Amanda Clark is an Advanced Accredited Practising Dietitian, author and owner of Great Ideas in Nutrition – BUNDALL – TWEED – LISMORE.