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Referral Systems in Ambulatory Care—Providing Access to the Nutrition Care Process

      As the American Dietetic Association (ADA) continues to revise and clarify steps of the Nutrition Care Process and Model, members are inquiring about how supporting activities such as referrals relate to nutrition services provided by food and nutrition professionals. Previously published articles about the nutrition care process clearly describe the four steps of nutrition care provided by registered dietitians (RDs) (
      Nutrition care process and model: What is your vision for the future of dietetics?.
      ), but the process does not specifically define how a referral (by a physician or qualified health care professional) relates to the nutrition care process. Screening and referrals for nutrition services are considered crucial antecedent steps to nutrition care. This article identifies the financial, legal, and organizational factors that influence referrals to RDs. Specifically described are referral-related policies within the government, private sector, and state licensure laws. Further, the article clarifies when and why referrals are needed and suggests how a comprehensive referral system in practice might be developed.
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