Diversity In Dietetics

Diversity in Dietetics: Pro Bono vs. Quid Pro Quo

DR� CAREE J� COTWRIGHT

PHD, RDN

DIVERSITY LIAISON

It is customary for attorneys to offer their services pro bono, or free of charge, for clients in need� Another common practice in the legal field is arranging a quid pro quo for their clients� Grammarly defines a quid pro quo as “doing something in exchange for something else�” I offer a unique application for both terms when considering how to promote diversity in the field of dietetics�

I have a close friend who offered her dietetics skills pro bono, and she gained understanding and empathy in a way like no other� My friend volunteered at a local health clinic to give her talent to people who would otherwise not have access to a registered dietitian� The sessions changed their lives, but unexpectedly also changed hers� She told me that she volunteered all those years because she was an outsider through and through�

"Here I was trying to develop a nutrition education resource for an audience that I knew nothing about� I wasn’t southern, I didn’t know anything about the south, and I’d never struggled with limited income, so I wanted to just hang out with people that I intended to serve� "

Since she couldn’t just “hang out” and get to know everyone, she opted to use her RDN skill set as an “in” so that people would have a reason to want to hang out with her (in appointments)� She found that her pro bono sessions quickly became a quid pro quo� “I got to learn about their lives, and they got to learn about how to manage diabetes,” she told me with a bright smile� My friend also revealed her volunteerism could not be a “one-off�” She gained full immersion with her clients� She got to know their challenges, but more importantly, their strengths�

In my own ventures into being a nutrition entrepreneur, I seek to determine how to interpret scientific messages to the masses� I am sifting through nutrition research outcomes and landing them on the plates of everyday people so they can take it in bite by bite� When I started, I wrestled with knowing the endgame and ultimately the pay scale for what

Here I was trying to develop a nutrition education

resource for an audience

that I knew nothing about� I wasn’t southern, I didn’t know anything about the south, and I’d never struggled with limited income, so I wanted to just hang out with people that I intended to serve�

I was doing� One day, I decided to just do it and give it away� I’ve been putting myself out there; speaking, teaching, cooking and leading in my way� I honestly do not know where this pro bono approach will lead, but I do know it is a part of my mission, which somehow makes the path seem clearer� I hope you are inspired to promote diversity in dietetics without expectation� You may find that your pro bono heart leads your mind to a quid pro quo that you never expected� After all, learning about yourself and others while offering your clients a place at the table with delicious, hearty, nutritious nuggets, of course, is priceless�

Caree J� Cotwright is a registered dietitian, lover of food and cooking and an assistant professor at the University of Georgia�

Keeping Your Virtual Practice HIPAA-Compliant

ALISSA RUMSEY

MS, RD, CDN, CSCS

DIRECTOR OF MENTOR SERVICES

While virtual practices have been growing in popularity over the past few years, the COVID-19 pandemic caused more dietitians than ever to turn to telehealth to provide patient and client care� When implementing telehealth in a private practice setting, it’s important to take steps to understand the current legal regulations around patient and client confidentiality�

The Academy of Nutrition and Dietetics Code of Ethics states that all dietitians must “Safeguard patient/client confidentiality according to current regulations and laws�” One of those laws is the Health Insurance Portability and Accountability Act of 1996, otherwise known as HIPAA� Individuals and companies who are known as “covered entities” are legally required to comply with the HIPAA law� CMS�gov defines a covered entity as healthcare providers who submit certain HIPAAcovered transactions electronically; the “certain transactions” are all related to billing insurance and making inquiries with insurance such as statements of benefits� Dietitians in private practice who accept insurance must comply with HIPAA regulations; dietitians who do not accept insurance may not fall under the regulations of HIPAA� However, compliance is considered a best practice and patient/client confidentiality is part of our code of ethics�

When thinking about patient and client confidentiality, there are several factors a dietitian in virtual practice must consider:

1 Where you chart/keep client notes

2 Where/how you store client information

3 Communication with clients, including video conferencing systems

4 Methods of payment

5 The physical location of both the client and the dietitian

According to HIPAA guidelines, a provider must have a business associate agreement (BAA) on file for any platform or technology that the provider is using to store or process client information and communicate with clients� For example, a BAA is needed when using a video conferencing system to talk to your client, when using Google Workspace or other email providers, and when using an electronic health record to chart and store client information�

For this reason, Electronic Health Records (EHR) or telehealth platforms are useful tools as they provide an all-in-one confidential, secure, HIPAA-compliant portal in which you can chart, store client information, communicate with clients, accept payments, process insurance transactions and more� Popular EHR platforms include SimplePractice, Practice Better, Kalix and Healthie� Many of these platforms have HIPAAcompliant video chat capabilities built into them� Another popular free HIPAAcompliant video conferencing system is Doxy �me� Certain video systems like Zoom offer you the ability to sign a BAA with them and be HIPAA-compliant for a fee�

In addition to considering the technology you use and how you communicate with clients, the HIPAA law requires that all practitioners deliver a notice of privacy practices (NPP) to clients which outlines how you use and disclose a person’s protected health information (PHI) and the patient/client rights� You must get written acknowledgment from your patient/client that they received and reviewed your NPP� In addition, a practice’s NPP must be posted on the business website (and in the office, if the business has a physical location)�

Lastly, when conducting virtual patient or client sessions it’s important that you have a secure space where you can carry out the session confidentially without any of your family members or other people around to hear your conversation�

Alissa is the founder of Alissa Rumsey Nutrition and Wellness, a weightinclusive virtual private practice, and the author of Unapologetic Eating: Make Peace with Food and Transform Your Life� In addition to her private practice, she works with dietitian entrepreneurs to help them start and grow their nutrition businesses� Alissa calls New York City home and spends her free time exploring the city’s food scene and searching for patches of green space to sunbathe in�