Today’s ADA: Almost 100 years Later, Have We Lost Our Way?

by Katie Andrews

This was my first year attending the American Dietetic Association’s (ADA) Food and Nutrition Conference and Expo (FNCE). Held annually, the expo brings registered dieticians (RDs), representatives from food brands, and food and nutrition policy experts under the same roof to discuss the latest in food technology and nutrition science. Additionally, FNCE (pronounced by those in the know as a rendition of “fancy”) is the sole opportunity for the House of Delegates (HOD) of the ADA to hold their annual in-person meeting. As an ADA student volunteer, I had the unique opportunity to work at the HOD meeting.

There were many things that surprised and impressed me at FNCE. The amazing selection of speakers, the vast quantity of food samples in the expo center (ideal for the grad student on a budget), and the various cooking demonstrations and book signings were all worth the two five-hour shifts that I worked. But what took me most by surprise wasn’t the talking robot in the expo center or even Anthony Bourdain’s quick-witted (and sometimes a bit R-rated) sense of humor at the closing session. No, what most caught my attention was the tenacity and passion I saw expressed at the HOD meeting.

On the table was whether to introduce a multidisciplinary membership category within the ADA. I naively assumed this was a no-brainer issue, one that would be voted on and approved with a quick show of hands. The ADA didn’t already have a multidisciplinary membership category? Why wouldn’t they allow other health professionals to be members? Oh, how wrong I was. Upon being told that I wasn’t to let any members hold the microphone on their own, for fear of long speeches, I realized this was most definitely not going to be determined by a show of hands. Don’t let anyone tell you that an RD has a quiet nature or will take things lying down. I can most definitely tell you, they do not.

Let me provide a little background here: the ADA was founded in 1917 by a group of women “dedicated to helping the government conserve food and improve the public’s health and nutrition during World War I.” Obviously we’ve come a long way since then. By 1940, the Executive Board of the association had developed an authorized seal symbolizing the characteristics of the profession: “a balance scale, representing science as the foundation and symbolizing equality; a caduceus, representing the close relationship between dietetics and medicine; and a cooking vessel, representing cookery and food preparation.” Right from the beginning, a relationship between dietetics, medicine and food was present.

However, the association has always had one strict rule about membership: you must have an active RD credential (or a similar credential approved by the Commission on Accreditation for Dietetics Education), be a student in the process of completing an RD credential, have an approved international credential, or be retired from an approved credential. The Board of Directors invites some honorary members, but they do not hold any voting rights and represent less than twenty percent of all members.

So, that mission statement of combining the field of dietetics with medicine and food seems to be lacking in terms of membership. There are no MDs. No professional chefs. No members of the food industry. Oh, unless they also happen to be RDs. So where is the cross-disciplinary collaboration that embodies the original mission of the association? Perhaps some of these opportunities are being missed, bringing me back to the topic du jour of the annual HOD meeting at FNCE: Is it finally time to open our doors?

This is not a new topic under discussion. According to the ADA’s own documentation and research, consideration of adding a multidisciplinary membership category dates back as far as 1984. In the board’s proposal to the HOD, they quote A New Look at the Profession of Dietetics, which insists that “…the condition of membership in The American Dietetic Association be as open and voluntary as possible. It is our belief that such membership should be available to all persons who are actively involved in, interested in, and committed to dietetic service, education, research as practitioners, teachers, investigators, administrators, or as responsible and involved laymen.”

The HOD revisited this issue in 2001, 2002 and 2007, and still with no resolution. The board continues to cite research from other sister organizations, touting the benefits of collaboration, especially in terms of awareness and the promotion of sound science and education. Most importantly, however, is the need to remain relevant as nutrition roles in schools and restaurants continue to become more prevalent. If we don’t want to play in the same sandbox as doctors, chefs, or school lunch practitioners, we might soon find ourselves alone.

So what’s the hold-up? Clearly if this has been discussed for almost three decades, there are serious concerns from the HOD. This brings me back to that passion I experienced at the annual meeting. The topic dominated the morning and the members spent much of the time discussing potential pros and cons within small breakout groups. Once the discussion was opened up, many concerns emerged – the most popular being that allowing non-RDs to be ADA members would make the membership, and therefore the dietetic profession, less relevant. Quite ironic, considering that was exactly what this proposal was trying to prevent from happening.

The potential risk to job security is reason enough for anyone to disapprove of this change. However this lack of collaboration is obviously hurting the ADA. Membership numbers have gone down, which means that less money is coming in. The HOD may have reservations, many coming from the members they represent, but I thought it would be beneficial to consult some other experts in the field – members of the ADA here at Friedman and our very own dietetic interns (future RDs).

Allison Knott, a first-year Nutrition Communication student at Friedman, was a practicing RD in Georgia before moving to Boston to pursue her degree. She is currently a member of the ADA, paying a student rate rather than the (rather high) $216 of dues that her employer used to pay. “The ADA has great newsletters and is a positive resource for networking,” Knott says, “but why wouldn’t we open up membership to other disciplines? We are medical professionals too – if they have multidisciplinary membership we should as well.”

Lindsey Toth, a recently credentialed RD who is completing her final semester at Friedman agrees, commenting that a multidisciplinary category would “maintain the presence of the ADA in non-traditional dietetic roles,” where perhaps we were invisible in the past.

Both women commented that being an exclusive association would only hurt the ADA moving forward. “Segregation isn’t positive,” Toth said, “and RDs need to be involved in the decisions and progress that MDs and nurse practitioners make with patients. Access needs to go both ways.”

Alternatively, the dietetic interns at Friedman raised similar concerns as the HOD – namely that we would be risking our expertise if we were to share our research by opening membership. The women were also quick to point out that we “wouldn’t be where we are today as practicing dieticians without the ADA.” Even with the differing opinions on this topic, the ADA still holds real value for Friedman students.

So it may be that the ADA reaches its hundred-year anniversary without resolution to this issue. At the conclusion of the meeting, the board left armed with the HOD’s concerns and suggestions and will reconvene to draft a new proposal, including some specifications on what fields would be allowed membership and what titles these “guest” members would be allowed to use. Some members would like to see the issue dropped completely – considering that only 50% of students applying for dietetic internships are placed, they believe the ADA has larger issues to tackle.

No matter what, we can expect to see the fiery passions of RDs return as the debate of multidisciplinary membership continues.

Katie Andrews is a first year Nutrition Communication student and is also enrolled in the dual Simmons program to pursue her Dietetic Internship. Like many students at Friedman, she loves nothing more than food – cooking it, eating it, talking and writing about it!

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