Physicians' perceptions of the role of clinical dietitians are changing.

Clinical dietitians are the only professionals trained to provide nutrition care (1); however, only a small part of the knowledge and skills acquired during their professional training is practiced in the hospital on a daily basis (2), and the level of responsibility assumed by clinical dietitians is determined to a great extent by physicians (3). Dietitians identify themselves as nutrition decision makers more often than do physicians (4). According to a 1984 report of the Commission on Dietetics of The American Dietetic Association (5), dietitians were satisfied with their careers but not with their image.

Several studies (6-9) have examined the perceptions of physicians concerning the level of responsibilities of clinical dietitians. in 1956, Burling et al (6) indicated that dietitians and physicians interact directly for only a fraction of the total patient load. However, they claimed that physicians' recognition of dietitians as highly skilled professionals was increasing. According to Spangler (7), in 1971 physicians believed that the main contributions made by dietitians were determination of food preferences and provision of dietary instructions to the patient. More recent reports (8,9), which compared general dietitians with nutrition support dietitians, indicated that physicians view nutrition support dietitians more positively than they view general clinical dietitians. Physicians also believe that general clinical dietitians are more involved in food preparation and clerical tasks than are nutrition support dietitians. The authors (8) suggested that the more positive perception of nutrition support dietitians was related to their broad social contacts with other health care team members.

In our study, we surveyed a selected group of physicians to learn their present beliefs regarding appropriate activities and educational background for clinical, hospital dietitians.

Methods

Questionnaires were mailed in winter 1988 to physicians listed in the yellow …