My State Bans PTs from Providing Nutrition

May 26, 2019

My State Bans PTs from Providing Nutrition. What Do I Do?

 By Dr. Sean M. Wells, DPT, PT, OCS, ATC/L, CSCS, CNPT® , NSCA-CPT, Cert-DN


So you’ve looked into several online courses for nutrition in the hopes of helping your patient get better, faster. As you are scouring these online classes you stumble across the fact that you, as a physical therapist (PT), cannot provide nutrition in your state. Seriously? Is this true? Maybe. So, should you simply drop the idea of enrolling into a certification course on nutrition -- absolutely not!

 It should be made very clear that any healthcare provider can offer nutritional information for general health. Whether you call yourself a nutritionist, CNPT® , or health coach, offering generalized health and wellness nutrition information is permitted for almost every state. Such a rationale makes perfect sense: we need people in our country eating better food for better health. The legal issue really comes when you begin to offer disease-specific nutrition counseling.

Disease-specific nutrition counseling is reserved, in several states, only for registered dieticians (RDs). Dieticians have a 4 year degree specific to nutrition from an accredited program. Similar to a nurse, PT, or medical doctor, dieticians know their stuff regarding nutrition and disease states. As such, they can provide good guidance on how a person can greatly modify an entire diet to help reduce, eliminate or modify disease.

 Will such rules or laws eliminate the need for PTs to know nutrition? No way! PTs take courses on medicines and surgical techniques even though they will never (legally) use them on their own. Having a good grasp of what a surgeon is doing in the operating room or what a medicine may do to a patient can impact physical therapy. Nutrition is much the same: food can either positively or negatively impact healing, functioning, and performance. Understanding how food can impact human physiology and rehabilitation can be used during patient education, for referrals to RDs, and/or to improve collaborative care.

 Moreover, what does disease-specific nutritional counseling actually mean?

We go very in-depth with this discussion in our second online continuing education course covering assessment and history taking. In brief, disease-specific nutritional counseling is like a PT consult: history taking (with diet analysis), examination, diagnosis, and prescription. Do all PT patients need such a thorough dietary process for their issues? Probably not...and that’s why they never end-up at the RD’s office. For example, my 75 year old male with knee arthritis would likely not be an appropriate candidate for an RD consult based solely on his knee pain -- right? But could a PT recommend the patient to reduce his alcohol intake, increase his consumption of fruits and vegetables, and decrease his intake of refined oils in hopes to reduce knee pain? Of course! These are general recommendations that fit general healthy paradigms and also conveniently  “fit” for helping someone with joint pain (based on the literature). In providing general recommendations that can help him, without a consult (history, dietary exam, etc.), it would not be considered disease-specific nutritional counseling. You’ve offered clear general healthy dietary patterns.

Does this seem like a grey area? Well it is and it varies from State to State. Our first and second course go into depth about the legality of nutrition and counseling, providing resources to providers to ensure they maintain compliance. Moreover, the role of the PT is not to eliminate the RD: it’s to improve health and functioning of patients within their respective level of training and education. Having a certification from reputable providers, like our team, helps a PT show competency and training to a patient, State Board, or other provider. Plus, offering generalized recommendations like eating less refined food, eating more specific fruits, vegetables, and/or seeds, is unlikely to create harm or replace the RDs role in healthcare. In the end, our continuing education courses do not promote PTs to advise clients to consume supplements or implement crazy dietary methods that are not evidenced-based: our continuing education courses emphasize solid dietary guidelines based on research and effective treatment of issues. It is up to you as the PT to implement them as best suited for your patients, setting, and State.

 Learn about our online courses:

There is much more to be found in our evidenced-based, board-approved online continuing education courses for physical therapists.

Enroll today and progress through our 3 course sequence starting with nutrition basics, then the assessment/prescription process, and finally a specialty focus on select populations and specialized nutrition topics. Complete all 3 courses and earn the title of the Certified Nutritional Physical Therapist (CNPT®). Enroll today and join the movement of PTs wanting to give their patients more!


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Learn about the Top 5 Functional Foods to Fight Inflammation and Pain in Physical Therapy. 


Keywords: online continuing education, neurological, physical therapy, CEU, online course


Keywords: continuing education, physical therapy, nutrition counseling, legal, practice act, Enroll today and become a CNPT!

Disclaimer: The above article is written as opinion piece and does not convey specific legal and/or practice act advice. Students and participants need to check their State laws, practice act, and other legal restrictions before implementing nutrition interventions or assessments. The consumer of this article and our courses acknowledge that the State laws, practice acts, and restrictions can and do change. The Nutritional Physical Therapy team cannot be held liable for changes to such laws: the student, PT, or person engaged in such nutrition actions are responsible for examining laws and regulation as they see fit.


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