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Forbes: Leaked Documents — American Dietetic Association is Intentionally Using State Legislatures to Block Alternative Nutrition Providers and Restrict Free Speech

July 10, 2012

Exclusive Leaked Documents: American Dietetic Association is Intentionally Using State Legislatures to Block Alternative Nutrition Providers and Restrict Free Speech

[Disclosure: My wife is a weight loss consultant whose work could conceivably be seen as competition to Registered Dietitians. Also, as I have written about extensively in this piece for Forbes detailing my own journey overcoming Bipolar II, I have been a longtime consumer of holistic nutrition counseling services from people who are not RDs.]

In January of this year, health and nutrition blogger Steve Cooksey received a disturbing letter from the North Carolina Board of Dietetics/Nutrition.

The letter contained a 19-page markup of Cooksey’s own blog, highlighting in handwritten red pen an extensive series of changes the Board demanded that Cooksey make.

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He had to make these changes, the Board censors told him, or he would face arrest (according to the NC dietetics licensing statute the letter cited) and up to a month and half in prison, a criminal record for blogging in America.

Specifically, the Board censors said, he had to remove or change all writing they construed as constituting “nutrition advising” or “nutrition counseling” without a license—which was a lot.

Bloggers around the nation reacted in upset and outrage at the Board’s censorship of Cooksey’s blog. “This is the sort of story you expect to come from a third world superstitious kleptopcracy – yet it happened here on American soil, in North Carolina, thanks to good old fashioned state-level bureaucracy,” writes Mytheos Holt on TheBlaze.com.

“The state board declared that Cooksey couldn’t even offer free and private advice to his friends over the phone. With that kind of legal standard, who among us would not be a criminal?” writes Kelly Jane Torrance on WeeklyStandard.com.

Here’s an important twist on this developing free speech story. Forbes was granted exclusive first-look at a new series of internal documents, freshly leaked by outraged members within the Academy of Nutrition and Dietetics, the professional association behind the NC State Board of Dietetics/Nutrition which censored Cooksey. (That association is also known widely among the public by its old name, the American Dietetic Association–I use the two names equivalently in this article.)

In these newly-available internal documents, which I quote and outline at length in this article, the American Dietetic Association:

  • Openly discusses creating and using state boards of dietetics/nutrition (including in NC and in every other state in the union) for the express purpose of limiting market competition for its Registered Dietitian members.
  • Openly discusses a nation-wide plan of surveilling and reporting private citizens, and particularly all competitors on the market for nutrition counseling, for “harming the public” by providing nutrition information/advice/counseling without a license—through exactly the same means by which Cooksey was reported to the NC Board. Again, for the explicit purpose of limiting marketplace competition.

Background

Three months ago, I wrote an article for Forbes entitled “Is the American Dietetic Association Attempting to Limit Market Competition in Nutrition Counseling?” Notice the question mark at the end of the title.

At that time, I had access to only one already-available internal ADA document, which rabidly attacked market competitors, and seemed to imply that the ADA should take legistlative action to restrict this market competition.

(“We must be aware that existing legal and regulatory constraints on practice are unlikely to prevent robust, broad competition in these growth areas,” writes Pepin Tuma in that document; Tuma is now Director of Regulatory Affairs at the ADA.)

Despite the obvious implications of that document, at that time I did not have any direct “smoking gun” linking the ADA’s explicit intention to limit marketplace competition (expressed in that document), with its aggressive action in the legislative sphere to create the very kinds of dietetics practice acts, and state boards of dietetics, under which Cooksey was threatened.

All that has changed now.

Next: The Smoking Gun Document

In the wake of that original article, I received an email from Judy Stone, Executive Director of the Michigan Nutrition Association, a coalition of Michigan nutrition consumers and practitioners. The subject line of her email to me was “ADA Smoking Gun Document. Naturally, I was intrigued.

Stone showed me a new internal document which had just been leaked to her from someone from within the ADA. This new document was far more detailed than the one I had access to when I wrote the last article. In the new document Stone showed me, the ADA openly strategizes on how to create NC-like licensure laws and dietetics boards across all 50 states, for the express purpose of limiting competition.

With this new document, there is now direct evidence linking the ADA’s stated desire to limit competition, to their legislative action (about which the ADA lies to the public, by saying the laws they are creating and lobbying for are designed to protect public safety, not limit competition.)

This document—among many others—had recently been leaked to Stone and the Michigan Nutrition Association, by members within the ADA disgusted by the organization’s monopoly-seeking behavior in state legislatures.

(Stone told me: “The ADA has not just angered non-dietetics nutrition professionals, but its own members as well, many of whom simply don’t want to be associated with this kind of power-grabbing under the guise of protecting the public. Willingness to share incriminating internal documents is one of the only ways for those members to effect change in their trade organization run amuck,” alluding to  additional documents she has ready to share.)

She also gave this internal ADA document to the Alliance For Natural Health, a longtime critic of the ADA. The Alliance has now published the document on the Web.

The document opens boldly: the purpose of the document is to help allow “the profession of dietetics to be identified as the preferred and qualified provider of nutrition services.”

The document focuses on what it calls a “Mega Issue,” which is this: “What is needed to create greater understanding among RDs/DTRs of the value of licensure and the importance of active engagement to the long term future of the profession?”

In other words, the “Mega Issue,” as the document puts it, has nothing to do with protecting public health or safety, as the ADA claims frequently when it talks about its licensure efforts in public and with legislative representatives. Rather, the Mega Issue focuses around protecting the health, safety (and presumably profit margin) of… the profession itself.

The internal document then goes into what can only be described as a tirade against competitors:

There is a proliferation of nutrition-related titles and credentials available to individuals seeking a foothold in the field. . . . Many aggressively challenge the notion that dietitians should have practice exclusivity outside of the clinical setting, and they continue pushing legislative initiatives that allow use of the “nutritionist” title and permit them to perform holistic and other nutritional counseling.

The ADA further bemoans that. . .

As government funding for preventative care and wellness increases and private insurers continue expanding clinical coverage to include visits to nutrition professionals, there will likely be a concomitant growth in the number of competitor health care professionals willing to provide some form of nutritional counseling. . . . Registered Dietitians and Dietetic Technicians, Registered (DTRs) face a significant competitive threat in the provision of various dietetic and nutrition services.

All of this is particularly bad, the professional association says internally, because:

State affiliates [chapters of the ADA] have experienced organized opposition to licensure in all states in which current laws have been proposed. Grassroot opposition has been focused on the American Dietetic Association and has included arguments that dietitians lack preparation to delivery wellness and nutrition care outside of the hospital setting, that licensure creates a monopoly and restricts freedom of choice of provider by the public, creates job loss for non-RDs providers. . . and that licensure requires those who practice to be members of ADA (Appendix A). Rather than respond individually to these media campaigns, ADA can achieve a position of strength by developing and executing an initiative that supports licensure and the dietetics profession while adding member value. [Emphasis added]

Notice the focus on “adding member value.” NOT “protecting the public” or “ensuring public safety” but “adding member value.” Again, spoken like a true professional association.

What Next?

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