
The Texas telemedicine breakthrough - jseliger
http://www.star-telegram.com/opinion/opn-columns-blogs/other-voices/article168731522.html
======
karmajunkie
This makes it sound like Texas is somehow leading the country in telemedicine.
The real story here is that despite early progress in this area, doctor's
groups successfully lobbied to have heavy restrictions put on telemedicine in
the past few sessions, because the legislature in Texas is generally up for
sale to the highest bidder, and the bill that passed simply eases up on those.

------
Overtonwindow
Another area that is sorely in need of telehealth reform is dietetics and
nutrition. Nineteen states require a license to provide any type of nutrition
guidance, education, etc. but they only allow dietitians, people with just a
bachelors degree in something like food services, to qualify for that license.
The laws are written so that even tele-health is completely out of bounds when
it comes to nutrition. I hope more states wipe out these prohibitive licensure
laws when they do more to protect market share, than public health.

~~~
calvano915
All new Dietitians must have a Masters starting in 2024, and all current RDs
have completed a Dietetic Internship with practical experience in addition to
Bachelors in order to sit for the registration/licensure exam for some time
now. I don't know about elsewhere, but in NV anyone can legally say they are a
Nutritionist but cannot practice as a Dietitian, so there are ways to provide
general nutrition guidance without being an RD. In addition, anyone can run a
blog or write books with their advice, etc.

I want someone who has verifiable expertise if I'm receiving medical nutrition
therapy from them. Perhaps the portability of licenses is too restrictive, but
elimination of licensure is a bad idea for many medical aspects of nutrition
(beyond basic weight loss or general guidance).

~~~
Overtonwindow
Actually Nevada's law is a lot of smoke and mirrors. They can practice
nutrition, but they cannot call themselves a Dietitian. That's fair. They can
practice as a dietitian, nutritionist, whatever they want. The law was
completed neutralized a few years ago.[0]

Medical Nutrition Therapy is a scam. It's the dietitians trying to practice
medicine in the diagnosing and treatment of diseases. There is no medical
necessity to licensure for nutrition, and the last thing we want is dietitians
trying to pretend they're doctors.

Show me one example of actual harm from bad nutrition advice. The Academy of
Nutrition and Dietetics has been running a contest for years trying to come up
with one good example and they've failed. Ohio just passed a law that moved
the board of dietetics under the state medical board, dissolving that whole
board. States have finally caught on that there is, never has been, and has
yet to be found, any actual harm or threat to public health from the practice
of nutrition. It's just market exclusivity. They don't want the competition.

If you want to be sure the person you're receiving care from is qualified
enough, ask them. Make your own judgement. Don't depend on the government to
create a monopoly for one profession/modality in the name of public health.

[0]. Nevada Revised Statutes section 640E.090(a), (d), and (2) is the
exemptions which totally guts the law.

