A recent rule change that allows registered dietitians (RDs) to independently order therapeutic diets for inpatients should free up hospitalists to focus on other, potentially more pressing issues, says a hospitalist. In the past, therapeutic diets could only be prescribed by a physician.
Issued by the Centers for Medicare & Medicaid Services, the revised rule enables RDs to "operate at the top of their license," says hospitalist Melissa Parkhurst, MD, FHM, medical director of the Nutrition Support Service at the University of Kansas Hospital in Kansas City, who says she's in favor of the change.
Dr. Parkhurst is hopeful that the rule will spur conversations on what RDs and others—non-physician practitioners and physician assistants, for example—can do to continue to free up physicians for other duties.
"Any time you can allow the different disciplines to work directly with patients to help in that hospital stay, you are not only hopefully bettering the care of the patient, but you're helping the primary attending physicians as well," Dr. Parkhurst says. "The idea was not only to hopefully improve the timeliness of getting nutrition intervention started with patients but also to … allow everybody to do what they're good at."
Together with SHM and the Alliance to Advance Patient Nutrition, Dr. Parkhurst has advocated on behalf of better collaboration to address the nutritional needs of hospitalized patients. She sees allowing other care providers to do more independent work as part of the overall reform movement that is changing healthcare delivery.
"The days of all aspects of the patients care being dictated and initially coming from the primary attending—those days have been changing and going away,” she adds. “This is just another piece of that puzzle." TH