Why is Scope of Practice Important For Health, Wellness, & Nutrition Practitioners?
If you provide information, advice, services, or courses in the health, wellness, and nutrition space, then chances are likely that you’ve heard the term “scope of practice” thrown around as well as advice to make sure you operate within your “scope of practice.” But, what does that really mean and why does it really matter?
Scope of practice refers to those activities that a person is legally permitted to perform, which is increasingly determined by laws enacted by state legislatures and by rules adopted by the appropriate licensing entity.
You’ll want to consider your own training and licensures and make sure that the services you are offering and the advice you are giving fall squarely within your own scope of practice and do not exceed your licensing or certification in a way that would encroach on the scope of practice of another certification you do not have.
So, for example, if you are a Registered Dietitian, you want to be careful to not to make any comments or recommendations to your clients that could constitute diagnosing, treating, preventing, prescribing, or curing any illness or disease, as this is typically considered within the scope of practice of medicine and strictly reserved to doctors. Depending on the licensure requirements of the states in which you are seeing your clients, you may, however, be able to practice medical nutrition therapy which generally allows you to tailor nutritional recommendations to manage or prevent a disease or condition, although this may vary from state to state based on the language of the specific law. You will also want to be careful that you do not offer any mental health advice or physical activity advice that may fall within the defined scope of practice of a mental health therapist or physical therapist, depending on the states you in which you operate.
Or, for example, if you are an unlicensed practitioner or nutritionist such as a Nutritional Therapy Practitioner, a Health Coach, or a Functional Diagnostic Nutrition Practitioner, generally you cannot take any actions that would constitute medical nutrition therapy (which involves using nutrition to treat a specific medical condition or diagnosis), since in most states, this type of service falls exclusively within the scope of practice of a registered dietitian. Further, you cannot take any actions that would fall within the scope of the practice of medicine, mental health therapy, or physical therapy as discussed previously. You will also need to be careful to review the laws of the states in which you see clients, as many states prohibit or restrict nutrition care services for those that are not eligible for licensure in that state.
Scope of practice is monitored at a state level, and the laws of each state overrule any guidelines given by private certification programs around what they perceive the scope of their graduates’ training to be. So say, for example, you are an unlicensed nutrition/health coach, and you received your training from a specific private organization that gives you a scope of practice that fits within their view of what you have learned. Please be aware that the scope of practice provided by your organization will NOT trump the laws of your state/the states in which you take clients. So even if your organization’s scope of practice says you can do something, if it is not permitted by law in the applicable state, then you cannot legally participate in those actions.
Scope of practice can be an incredibly nuanced area to understand, and you may think it is easier to just ignore the finer points of the law than to fully understand it because it can be so complex. Or, maybe you see other online coaches and nutritionists offering certain services, programs, or courses so you think it must be okay because they are doing it.
We want to caution you against this type of thinking. Understanding your scope of practice and making sure you are complying with that scope of practice is important for 2 reasons.
First, there is an ethical argument to always operate in your scope of practice. If you exceed your scope of practice, there is risk of causing harm to clients if you provide advice in areas where you have not been trained or which touch on the areas reserved for licensed practitioners such as a registered dietitian or medical doctor.
Second, there can be serious legal ramifications of operating outside your scope of practice. If you were to get sued by your client or if they were to file a complaint against you with a government agency (if applicable in your state) or your certification association or organization, one factor that a court or agency may look at was whether you were operating within the scope of practice as stated by your training organization and/or if your activities encroached on a defined scope of practice for which you do not qualify for licensure (such as medical nutrition therapy, practicing nutrition in states which only permit those with certain licensure to do so, or diagnosing or treating medical conditions). If you were operating outside of your scope of practice, then it is more likely a court may decide you were negligent or otherwise at fault if a client issues a complaint against you in court. Also, there is risk that you can get investigated by the applicable licensing board of the state in which you exceeded the scope of practice and face consequences as permitted by the laws, which include being charged with a misdemeanor, paying fines, and even being subject to jail time (although we are only aware of fines ever being assessed).
We do not share these consequences with you to scare you, but rather to make sure that online health, wellness, and nutrition professionals are aware of these laws and that scope of practice issues have important implications for you and your business. Since Kristin is an NTP herself and Kelly and Kristin have both benefited from the life changing services of an NTP, an RD and a CCN, we both know of the incredible power of the services rendered by nutrition professionals and health coaches. We want to further empower this community to better understand the bounds of the services they can legally provide so that they feel empowered to keep serving clients within those bounds. We always recommend that you take the time to understand these laws and work with an attorney who can specifically advise you on how to interpret them as it relates to your individual practice.
To serve our community, we have developed a very comprehensive webinar which goes into further detail on all of these topics, and it includes a summary of the following:
- What is scope of practice and why is it important?
- What are some of the different designations/certifications that you can have and what are the implications of those designations?
- What are the ethical and legal implications if you operate outside of your scope of practice?
- What are state nutrition laws and how do I find them?
- How do I know which state’s laws apply to me and my business?
- What if I provide services to clients in multiple states?
- What is the difference between a “green” state, “yellow” state, and “red” state? Who makes those designations and what do they really mean?
- How do I read a state statute?
- If I break a state’s laws, what could happen to me?
- If I operate my business in a “red” state, what are some practical steps I can take to still be able to make a livelihood?
- How can I use disclaimers to protect myself from liability from a scope of practice perspective?
Check it out here! Note that this webinar has been specifically tailored for unlicensed nutritionists, health coaches, Certified Nutrition Specialists, and Certified Clinical Nutritionists, as navigating state nutrition laws and scope of practice issues can be particularly challenging for this group. We hope this blog post and our other free resources will be helpful for our Registered Dietitian community!
ALTHOUGH KELLY AND KRISTIN ARE LICENSED ATTORNEYS IN THE STATE OF TEXAS, NEITHER THEY NOR DOTTED LINES CO.. LLC ARE YOUR ATTORNEY, NEITHER THEY NOR DOTTED LINES CO., LLC HAS AN ATTORNEY-CLIENT RELATIONSHIP WITH YOU, AND NEITHER THEY NOR DOTTED LINES CO, LLC KNOWS YOUR BUSINESS. THE INFORMATION IN THIS POST IS NOT TO BE CONSIDERED LEGAL ADVICE, AND YOU SHOULD NOT CONSIDER IT A SUBSTITUTE FOR LEGAL ADVICE. WE ALWAYS RECOMMEND CONSULTING WITH AN ATTORNEY IN YOUR LOCAL JURISDICTION SINCE THEY WILL BE ABLE TO ADVISE YOU AS TO YOUR PARTICULAR SITUATION AND ALSO PROVIDE YOU WITH INFORMATION SURROUNDING ANY NUANCES OF YOUR LOCAL LAWS THAT WE SIMPLY CANNOT ADDRESS IN THIS POST. FURTHER, WE DO NOT GUARANTEE ANY SPECIFIC RESULTS.