Home is where the jobs are: home health care offers dietitians new career option.

The US Bureau of Labor Statistics predicts that job opportunities for dietitians in home health care will increase 91% between the early 1990s and the year 2005 (1) - a sunny forecast in a health care industry clouded by news of hospital mergers, funding shortfalls, and staff reductions.

The emerging importance of home health care reflects the convergence of several factors. These include a growing number of older persons (who typically need more medical interventions), advances in medical technology (which allow sophisticated treatments such as infusion therapy to move into the home), and economic pressures (it saves money to move patients from institutions back to their homes).

Dietitians now are outnumbered by other health professionals working in home health care, but opportunities abound for those who learn what home care employers need and how dietitians' skills can be marketed to fill those needs. To help readers begin exploring career options in home health care, the Journal sought the advice of two registered dietitians who are successfully working in the field. Carroll A. Reider, MS, RD, left hospitals for home care 5 years ago and is now a nutrition consultant in Santa Monica, Calif. She is also coordinator of the Home Care Network of the Dietitians in Nutrition Support (DNS) dietetic practice group (DPG). Dorothy C. Humm, MBA, RD, director of Meals On Wheels and nutrition therapy for the Visiting Nurse Service of Rochester and Monroe County in Webster, NY, has worked in home care for 11 years. She is cochair of the Home Care Subunit of the Consultant Dietitians in Health Care Facilities (CD-HCF) DPG. Their combined insights and experiences are presented in this article as answers to questions about career opportunities in home health care.

Where Do Dietitians Work?

"If you talk to six dietitians working in home care you're likely to come away with six variations on the employer-employee relationship," notes Humm. Most dietitians work either as direct employees or as consultants to home care agencies. They also often find jobs with pharmaceutical companies that offer home care services to patients receiving infusion products. …