Dietician Licensure Protects Dieticians and Not the Public

By Pamela A. Popper, posted February 13, 2004

In 1987, the Ohio legislature passed a law creating the Ohio Board of Dietetics. As has been the case in almost every state where dietitian licensure has been proposed to the legislature, the impetus for the law was not public demand, but dietitians wanting a board, licensure, title protection, and turf protection. Not one member of the public in Ohio testified that licensure was desired by the public, or that it would benefit the public in any way.

Ohio State Representative Don Gilmore had reservations about this law from the time it was passed. I have included a copy of a letter he wrote expressing some of his concerns, all of which actually became reality during the next several years.

Problems began shortly after the law was passed. The Board received national attention as a result of its interference with the activities of a visiting well-known nutritionist from California who had intended to present a continuing education program at a hospital. A story was featured in an issue of Dr. Julian Whittaker's newsletter and is attached as Exhibit B.

Over a period of time, the Ohio Board of Dietetics adopted more and more stringent Rules and Regulations governing the practice of dietetics. Some of these regulations include: 

• No one except a dietitian can use ANY title indicating expertise in the area of nutrition. This means that people who have earned Masters Degrees, Ph.D.s and titles such as "Certified Nutritionists" are not allowed to use their titles in Ohio. The Board has taken aggressive action against people who violate this rule, conducting expensive investigations and issuing cease and desist orders against legitimate practitioners who were using their earned credentials. 
• Only dietitians are able to give advice to people about nutrition and health, provide educational programs or be involved in developing policies about nutrition. 
• Until very recently, even activities such as public speeches about nutrition and conducting general classes on nutrition were strictly prohibited. I was told that showing a movie about diet constituted unlicensed practice because any activity that might cause someone to change dietary habits is defined as the practice of dietetics. Again, aggressive action was taken against people who tried to exercise their first amendment rights and many of them were put out of business.

I am a nutritionist with a M.S. and Ph.D., and also a naturopath registered to practice in Washington, D.C. The Ohio Board of Dietetics began an investigation of me and my business for unlicensed practice in 1987 that lasted for several years and has cost tens of thousands of dollars. During the time that I was engaged in my conflict with this Board, I was threatened with criminal prosecution, as well as incarceration for refusing to comply with the terms of one of their subpoenas that demanded, among other things, a list of my clients and practitioners like me who had spoken at my health center.

The good news about the bad things that happened to me was that legislators who were appalled at the situation have introduced a bill that would repeal much of the original 1987 bill. During hearings for this legislation we have discovered many things: 

• The Board finds its "prospects" for investigation by perusing the yellow pages, looking for flyers in health food stores and encouraging dietitians in the State to notify them when they find out about a non-dietitian's activities. A review of the files by the legislature found no consumer complaints. 
• During one 6-year period of time, the Board investigated 795 people and took disciplinary action against 287 individuals, most of who were not dietitians. This resulted in numerous people being put out of business, as most of these people did not have the resources available to me, and served to restrict access to health information by Ohio citizens. 
• The Board has not been able to produce one person who has been harmed by advice given by a non-dietitian. Examination of the files did not identify anyone who had been harmed either. 
• Numerous people came forward to testify about the Board's heavy-handed investigation tactics and the impact these investigation had on their lives and financial status. 
• Numerous members of the public testified that they specifically sought out advice from non-dietitians, and believed that it was their right to do so. 
• Numerous individuals testified that they specifically sought out educational programs that did not promote the philosophy of dietitians and the American Dietetic Association.

It has become clear to everyone that the principal purpose of the Ohio Board of Dietetics has been to protect dietitians from competition and to make sure that the only information that Ohioans get about nutrition comes from dietitians. This is unfortunate since dietitians represent one school of thought about nutrition - a philosophy that more and more Americans disagree with.

Contrary to what most people believe, the American Dietetic Association is not a public health organization. It is a trade group that takes huge contributions from manufacturers and agricultural organizations. Their "position papers" on a number of health and nutrition-related subjects are, literally, bought and paid for. These are advertising messages, not scientific research. This organization controls the educational programming and registration of the thousands of dietitians in the U.S., and influences the thinking and practice of most dietitians. It is my personal opinion that the influence of industry on the practice of dietitians is one of the reasons why nutrition in institutions such as hospitals, schools and nursing homes continues to be abominable.

Although everyone agrees that dietitians have a right to form a trade group, restricting nutrition practice to only those who belong to that trade group is certainly not in the best interest of the public, and is unconstitutional.

The 1987 law passed in Ohio has been detrimental to the state in many ways: 

• It has put people out of business. 
• It has restricted the right of Ohioans to seek information they want from the source of their choice. 
• Enforcement of the law has cost hundreds of thousands of dollars - licensure fees for dietitians have continued to increase to cover the cost of the Board's enforcement programs. 
• Hearings, meetings, analysis of files and other activities related to repealing this awful law have cost hundreds of thousands of dollars during the last 3 years. 
• Hundreds of hours have been invested by legislators working to reform this law - time that would be much better spent dealing with crucial issues such as improving our educational system.

The U.S. faces a health care crisis today - over half of the people in this country suffer from degenerative disease. We need more, not fewer people working on this problem. Assisting dietitians in establishing a monopoly in another state is not in the public interest. I encourage you to vote against any attempt to do so.

Pamela A. Popper is is the founder and Executive Director of The Wellness Forum, a chain of health and wellness centers located throughout the United States and the Far East. This article was presented as testimony to the Virginia Legislature in January of 2004.