Nutrition counseling: guidelines for the practicing physician.

Americans thrive on news about food, nutrition, diets and fitness. Testimony to this phenomenon is the predominance of popular literature related to these topics in the print and broadcast media. All too often the emphasis is on overnight or simple solutions to complex problems. The public is an easy mark for the "health peddler" who lacks credentials but possesses effective motivational skills and speaks with conviction about unfounded promises and exaggerated outcomes. Nutrition misinformation wastes billions of dollars every year but the greatest harm occurs when needed medical intervention is delayed or ignored. Patients expect physicians to be able to answer nutrition related questions and to know where to refer them for further nutritional guidance when needed. (1) In order to assure appropriate referrals, physicians need to know where to find a qualified dietitian/nutritionist and how to verify appropriate credentials. When a patient is referred to a dietitian for nutrition assessment and counseling, the expectations should be clear to all concerned and should include a plan for follow-up communication. This article describes the basis for and benefits of a partnership between the physician and dietitian in providing quality health care and patient education.