Monday, 30 June 2014

Dietitians

Dietitians care about dietitians, which is why we get so fired up when "our profession" is criticised.  But have we in fact lost touch with our customer, the people we are here to serve? And if so, why?  

One protracted, stand-out, criticism of dietitians in Australia is that their professional association, the Dietitians Association of Australia (DAA) has partnerships with the food industry.  Corporate partnerships are criticised because of the trickle-down effect to the individual dietitians on the ground.  It is subtle.  But it is real.  History tells us it is real.  In particular "the people with the most money have the greatest influence".  And health professions are not protected from the influence of corporate sponsorship.  

Dietitians, as the tertiary trained, accredited, experts in the relationship between food and disease, are certainly not immune from the subtleties or even the blatant influence of corporate sponsorship.  I wrote about our American dietitian counterparts here.  Either way, the public criticism has triggered important debate amoung dietitians, and has resulted in many dietitians writing "Posts in response...." across the socialmediasphere.

Consider this: it is not individual dietitians the public is debating (necessarily).  The public are pointing out our association - the Dietitians Association of Australia (DAA) - has ties with the food industry. The public is pointing this out because they are concerned.  And the evidence suggests they are RIGHT to be concerned. The public is equally critical of the Heart Foundation (and the income generated from the Tick program), gifts and funding to political parties and individuals, and of course, we have a case in point in the "Big Pharma" evidence unravelled over years and continues.

We as health professionals need to be clear we do not want to be in a manufactured vulnerable position. We know better.  


Why do our professional associations 
continue with corporate sponsorship despite the evidence...?


It is like asking why people still smoke cigarettes
despite the evidence? 


I want Australian dietitians to ask DAA to listen. To notice. To not ignore what the public are actually saying. We should use this same "fight" toward DAA not to the public, not to the people we are simply here to serve. The public really do honestly have a point. 

There is more than enough evidence to know any corporate sponsorship will have some influence on the decision-making and/or action and/or outcome. To many, the group Dietitians for Professional Integrity (DFPI) may seem extreme, radical, a "translator of conspiracy theory" when in fact, they are evidence-based. Simple as that. They are publicly calling for their professional association the Academy of Nutrition & Dietetics (AND) see "the evidence".  Any ties between the food industry and dietitians/dietitians associations will mean lost credibility. 

DFPI gone public after many years of trying to get change from the inside. Sure, our American colleagues have more obvious corporate sponsorship of their CPD activities, but why wait until ours (DAA) is that far gone?? Why wait for another generation of dietitians to pick up our fight?

DFPI also know what the AND do reflects on every single dietitian on the ground. It does not matter if as individuals they've worked their ass off for years and continue to do so daily, it does not matter if they've shed tears before during and after their professional practice year, it does not matter if they know about science, and it does not matter if they can even critique a paper.....because the individual dietitians' collective public front is the Academy of Nutrition and Dietetics. As long as the AND continue to defend their corporate sponsorship, the individual dietitians know their work on the ground is undermined. Whether perceived or real, whether intentional or not, as long as those ties remain, critique is valid because it is evidence-based.

It is time to change. Australia is in a unique position to lead because we are relatively small but, growing rapidly. Producing more than 400 graduates a year!  And, based on the latest DAA annual report, of the total income to DAA, only 13% is drawn from industry sponsorship! It's not much....there MUST be another way. 

I encourage all dietitians to facilitate change from within - that would be the ideal outcome. Because if we do not listen to public opinion, and continue to defend despite the evidence on the exact point they are making.....the link between corporate $ and organisations....we all lose. I for one do NOT want to see that happen. 

The public is who we've signed up to listen to. To serve. If they have lost faith, whether we think they should or not, it is time to listen harder. I would like to see in the Annual Report, in the part where all the meetings attended for the year are listed, to see more meetings with consumer groups, even public forums, and fewer meetings with industry. 

Do not get caught up in "which food/diet is best" with celeb chefs, or anyone else. Stick to the main point of criticism, an advocacy organisation can never truly advocate while there is corporate ties. 

Yes?

Other blogs by me
[Series] Posts in response (prn)
Pete Evans
Dietitians


[Series] Trust in professional integrity (March 2014)
March is [unofficially] professional integrity month 
The story of dietitians for professional integrity
What is professional integrity?

[Series] Are dietitians effective? (July 2013)

Heads up GPs, we can save $billions together

[Other stuff]

Pete Evans

On June 18, 2014, a boy called Pete Evans made a post on his FB page which started with his highlighting of the corporate partners of the Dietitians Association of Australia (DAA).  The "DAAs corporate sponsors" is publicly available information, and there is further detail in the DAAs Annual Report, also publicly available.

Now, I had no idea who Pete was until his post was posted on the Dietitian Connection Student's FB Page, and even then...Master Chef Schmaster Chef.....but what I did notice is this: whoever this Pete boy is, the Australian public follow him, like him, probably love to the point of commitment, and appear to hang on his every word.  And that. is. amazing!

This "public like of Pete" made me look differently at my dietitian colleagues' social media stuff, and at the DAAs social media follows and likes.  Disclaimer: I have not done a proper "data-mining" or "cross-sectional survey" to make this observation....I simply make this statement about my preliminary observation: it is mostly dietitians liking and following dietitians, and not "the public" as is the case for Pete.  :(


If I had the time to start another PhD I would say this observation would be the kicker to a very important scientific research question: why has Pete got more likes than my professional association?


Pete has more "likes" :(

 Pete: likes=202,380, DAA: likes=9,878[as at 7:02pm 30-06-14]

[eeek 7:10pm Pete: l=202,420, DAA: l=9,879]

What's that? I am not a member of the DAA so why do I keep referring to it as "my" professional association? Because I am a dietitian.  I always will be.  And whether the DAA embrace me as part of their team or not, I am "on the team" - I am with and for every single dietitian in the Universe.  It is because of this, I want the best for all dietitians, and for the profession. 

Here below is what I posted on the Dietitian Connection Student FB Page in response to the post on Pete's post that day. (In the meantime, I watched Pete's FB page and the comments coming through from the general public and dietitians).  



....................................................
So i am TOTALLY FOR US (dietitians). I do also care that the body who represents dietitians, DAA, sees the post by Pete as a kind of "wake up call" about how the public views DAA, and therefore, views dietitians. We can do better. Read on....

1. Scientific studies have flaws, interpreting scientific evidence has flaws, translating scientific evidence to the individual has flaws. 

2. A health advocacy organisation who relies on corporate funds is no longer in the business of health & advocacy, it is in the business of making money and will defend that position strongly. Who cares what "Pete" does in the corporate/health arena, "Pete" is a brand.  "Dietitians" is our brand.  The difference between the "Pete" and "Dietitians" as a brand is that we need to take a higher level of expectations of self - if we want to be taken seriously we need to take the higher moral ground so-to-speak - did you read my professional integrity post? Well it says stuff in there about this.

3. When it comes to "what to eat to be healthy" dietitians really do not OWN this - and we certainly do not have all the absolute answers - the mediterranean diet comes to mind, populations with years of culinary knowledge and skills and total health - usually ruined by the manufactured demand of the food industry away from health.... just an example .....

4. Focus on what we (dietitians) are good at - supporting the individual in front of us to navigate their way to health, their health, their choices as best we can. Blatant plug - this is the kind of iterative exchange between dietitian-client i am trying to build a system to capture so you have this immediate data exchange and reporting of what works for this person at this time.

5. To me, when you look across social media - it is dietitians talking to dietitians [for the most part] and not dietitians engaging the public, the people we are here to serve - clearly there is a gap between what we think of ourselves and what the public thinks of us. What is it about Pete that he has such a massive public following?? and please don't answer with "eat more F&V is not sexy enough". Lets damn well make it sexy! 

6. Whenever we openly criticise other views with "we are the experts trust us" it might actually be damaging our profile - totally my hypothesis - but printing "please trust us" on a t-shirt does not = better health outcomes. If it does, i will get one.

7. Pete, in his post, not necessarily across his entire philosophy, has valid points. We would do well to listen with an open mind and leverage this as a first step to closing the gap between what we want the public to think, and what the public actually think.

8. Bring on the celebrity dietitian - and please give them space to make mistakes occasionally - if you are concerned about something - email them, and email them a clear argument with evidence and be open to discussion - PLEASE these are your colleagues, use the complaints process ONLY where there is a SERIOUS and TRUE risk to a person/people. If you really are concerned past emailing the person directly - email me and I will look over your argument critically. Once you put someone through that complaints process, you are effectively crushing the potential of one. If we keep crushing each other, HOW are we EVER going to get ahead in this game??

9. Keep at it. Change is exciting. Not scary. Ever.


Other blogs by me
[Series] Posts in response (prn)
Pete Evans
Dietitians


[Series] Trust in professional integrity (March 2014)
March is [unofficially] professional integrity month 
The story of dietitians for professional integrity
What is professional integrity?

[Series] Are dietitians effective? (July 2013)

Heads up GPs, we can save $billions together

[Other stuff]