Pd

TfitwscttpcfsSt

i

m

r

t

Cd

r

SBT2

P

o

c

L

(

M

s

W

p

OF PROFESSIONAL INTEREST

1

erformance, proficiency, and value of the

p

bvmde

v

$$tac8B

edWw(eta

sploths

afcfjtim

Ng1Tt

he House of Delegates (HOD) input from Spring 2001 identi-ed that the number one issue for members was the concernhat salaries do not always meet expectations when comparedith the required scientific background for dietetics profes-

ionals. This salary concern also related to competition/en-roachment in the marketplace, promotion of the profession ashe food and nutrition expert, and competencies/training/con-inuing education. The House Leadership Team (HTL) ap-ointed the Tactical Workgroup to address all these relatedoncerns by preparing this backgrounder addressing the “Per-ormance, Proficiency and Value (PPV) of the Dietetics Profes-ional.” For the complete PPV Background Paper, refer to theeptember 2002 Journal of the American Dietetic Associa-

ion(2002;9:1304-1315).The Tactical Workgroup identified the following mega-

ssues questions for the HOD Dialogue Session:

� How do we reduce the gap between the level of perfor-ance, proficiency, and value of the dietetics professional?� What is the individual dietetics professional’s responsibility

elated to performance, proficiency, and value?� What is ADA’s expected role and responsibility to address

his issue?� What other organizational units or organizations, eg, CDR,

ADE, ASPEN, have expected roles and responsibilities to ad-ress this issue?� What is the institution’s (practice site) expected role and

esponsibility to address this issue?

UMMARY OF THE KEY POINTS IN THEACKGROUND PAPERhe consolidated comments on the mega issue list (Spring001) reported that members contribute low salaries to the

The complete background paper was prepared by the

erformance, Proficiency, and Value Tactical Workgroup

f the ADA House of Delegates. The members of the Tacti-

al Workgroup included: Ellen Owens Summo, DTR, (At-

arge Delegate: DTR) Chair; Marsha Schofield, MS, RD,

PID-Food and Nutrition Management); Neva Cochran,

S, RD, (Texas); Bonnie Spear, PhD, RD, (Alabama); Kes-

ey Kieselhorst, MS, RD, (Pennsylvania); and Marion

inkler, MS, RD, (Rhode Island); and ADA staff support

rovided by Karri Looby, MS, RD and Harold Holler, RD.

Copyright © 2003 by the American Dietetic Association.

0002-8223/03/10310-0015$30.00/0

cdoi: 10.1053/S0002-8223(03)01210-0

376 / October 2003 Volume 103 Number 10

igger issues of dietetics education, demand of dietetics ser-ices, lack of career tracks/ladders, gaps in certifications, andinimally documented evidenced-based practice. The respon-ents also commented that ADA should focus on efforts tompower the member to negotiate higher fees and salaries.The ADA 2002 Dietetics Benefits and Compensation Sur-

ey reports a median total cash compensation for RDs of45,800 and a median total cash compensation for DTR’s of31,000. For an executive summary of the survey, please refero the Journal of the American Dietetic Association, Febru-ry 2003 issue (2003;2:243-255). The entire report can be pur-hased for $50 by calling our Customer Service Center at 800/77-1600, ext. 5000 and request the ADA 2002 Dietetics

enefits and Compensation Survey.

ADA has demonstrated that it has the capacity to affect thenvironment in which dietetics professionals work. Through aecade-long campaign, the Association sought support inashington, DC for new benefits in the Medicare program thatould allow seniors access to medical nutritional therapy

MNT). In 2001, President Clinton signed into law the first newntitlement in 20 years providing MNT for seniors with diabe-es and renal disease through Medicare. The benefit becamevailable in 2002.

While Medicare MNT is expected to increase demand forervices by RDs, it was approved by Congress because of theotential benefit to senior citizens. Drawing from the lessons

earned in that effort, ADA will continue to focus on consumerr patient needs and benefits in order to win support fromhose who ultimately decide which services are reimbursed byealth care systems. That is the approach behind MNT expan-ion efforts in Medicare and private sector outreach.

ADA also is challenged in today’s health care system to beble to demonstrate the effectiveness of MNT services. Theocus on standard practice guidelines and outcomes researchomes in response to that challenge and the profession’s questor excellence. Only through measurement, analysis, and ad-ustments can dietetics professionals systematically improvehe quality of their services. Those services with highest valuen the marketplace are likely to see further increases in de-

and.In its latest published projections (Monthly Labor Review,

ovember 1999), Bureau of Labor Statistics (BLS) projectsrowth in total US employment for all occupations between998 and 2008 of 20.3 million new jobs or an increase of 14.4%.he projected growth in employment for dietitians and nutri-

ionists between 1998 and 2008 is 10,000 new jobs or an in-

ietetics professional: An u

date

rease of 19.1%. In addition, BLS projects that between 1998

and 2008 there will be 11,000 jobs available for dietitians andnutritionists due to the need to replace workers who retire,become disabled, die, or leave the field.

An HOD Task Force (Future Practice Roles, Spring 2001)examined the issue of future practice roles for dietetics profes-sionals. Overall, the task force saw a positive future for theprofession of dietetics, but saw urgency for the Association totake action. Their examination indicated that the profession isprogressing forward; however, they are not sure if dietetics iskeeping pace with the other health care professions.

The task force further reported that there is a need to ex-pand the role of the RD especially as it relates to the utilizationof the DTR and other associated professionals. This may facil-itate increased salaries. However, increased salaries are depen-dent on practitioners negotiating these increases. The Associ-ation empowers members to actively engage in the process ofnegotiating higher salaries. This can be accomplished throughcontinuing education activities at the local, state, and nationallevels.

ADA’s new mission is, “leading the future of dietetics.” As aprofessional association, ADA works toward this mission byhelping members achieve their common goals, while at thesame time observing the legal and ethical restraints a demo-cratic society imposes on businesses and professions. As a le-gitimate business, ADA must avoid participating in activitiesthat that could be portrayed as price fixing. However, ADA canwork to increase the income opportunities for dietetics profes-sionals by assisting them to shape the environment in whichthey work. Additionally, ADA can create tools that membersmay use to raise their perceived value, their income potential,and negotiate salaries with employers.

As a result of the HOD Dialogue and Motions a Performance,Proficiency, and Value (PPV) Task Force was then appointedin November 2001. The Task Force reviewed the HOD Back-grounder on PPV and the recorded comments from the HODDialogue Session to carry out their charge. Their work culmi-nated with the development of the Performance, Proficiency,and Value (PPV) Plan that used several approaches to addressthe issue. The PPV Plan immediately follows.

PPV PLANThe Performance, Proficiency, and Value (PPV) Task Force

developed the PPV Plan, which was approved by the House

of Delegates in May 2002. The PPV Plan uses several ap-

proaches to address the issue of compensation for dietetics

professionals. The major focus of the plan is on profes-

sional development activities that could be provided by the

Association and used by members along with the collection

of survey data by ADA for utilization by members. The Plan

also provides guidance to members to position the dietetics

professional as a valued resource within various practice

settings. Ultimately, the Plan offers the Association and

members with concise and do-able tactics for addressing

this number one member concern.

Members of the task force include, Nancy Nevin-Folino,

MEd, RD, CSP, LD, CFCS, FADA, Co-Chair (Ohio Delegate),

Susan Calvert Finn, PhD, RD, FADA, Co-Chair (ADA Past

President), Beth Leonberg, MS, MA, RD, CSP, FADA (Chair,

Pediatric Nutrition DPG), Deborah Lasker, MS, RD (Cali-

fornia Delegate), Suzanne Vieira, MS, RD, LDN (Rhode Is-

land Delegate), ADA staff support provided by Karri Looby,

MS, RD and Harold Holler, RD.

The tactics noted for each strategy were developed by

the Task Force and are examples of how the strategies

can be made concrete. Many of the tactics below are

interactive and relate to work presently underway by

ADA, as well as relate to the recommendations of the

Continuing Professional Education (CPE) Task Force.

The tactics may need more than one year for implemen-

tation.

Below is an update of the Association’s programs and

initiatives that ADA has implemented within the last

year to achieve some of the goals and outcomes of the

PPV Plan. Members are encouraged to provide feedback

regarding their efforts for career enhancement and

compensation.

Goal #1: ADA invests in various approaches to closethe gap between performance, proficiency, and valuefor the profession of dietetics.

Strategies to Achieve Goal #1:

1. ADA will identify educational opportunities for all

levels and areas of practice to enhance value and

compensation for services.

Tactic:a. ADA publishes the PPV Backgrounder in the Journal of

the American Dietetic Association.Action:

i. ADA published the PPV Backgrounder and Plan inthe September 2002 (2002;9:1304-1315) and the Oc-tober 2003 Journal.

Tactic:b. ADA develops and provides educational opportunities

(such as workshops; seminars; meeting; Web-based CPEcourse; audiotapes; CPE articles; tools) on the following:business skills, marketing skills, negotiation skills, man-agement, resume and job description development, andidentify career laddering opportunities which supportthe Professional Development Portfolio.

Actions:2003 FNCE Education Sessions (See the Summary)ADA committee and organizational unit activities:

i. Development of a Leadership Orientation Manual fornewly elected leaders—available late May 2003.

ii. Planned the publication of three (3) professionalmodeling articles for the Journal in the “Business ofDietetics” column, that focus on career laddering andcareer strategies (July, September 2003, and Janu-ary 2004).

iii. Establishment of a Professional Development Cen-ter—offering CPE year round using ADA’s Web site.

iv. Establishment of the Professional DevelopmentCommittee (joint HOD/BOD committee) to guide thedevelopment of the Association’s Professional Devel-opment Program to enhance member value andachievement of the Association’s strategic plan.

Tactic:c. ADA conducts member roundtables or discussions

where members who are looking for a career change canspeak with some members who have been successful.This could be done at FNCE (in collaboration with DPGShowcase) or at an affiliate annual meeting or DPG spon-sored seminar.

OF PROFESSIONAL INTEREST

Journal of THE AMERICAN DIETETIC ASSOCIATION / 1377

Actions:2003 FNCE Education Sessions (See the Summary)

2. ADA will identify tools designed to provide profes-

sional growth and development.

Tactic:a. ADA develops and disseminates a collection of “Top 10

PPV Actions” cardsActions:1. Cards distributed to attendees during FNCE 2002 session

“2002 Dietetics Benefits and Compensation Survey.”2. Cards distributed to delegates during the Fall 2002 and

Spring 2003 HOD meetings.Tactic:

b. ADA publishes sample job descriptions for various prac-tice settings.

Action:1. ADA published sample job descriptions for various practice

settings, titled: Job Descriptions: Models for the Dietetics

Profession. Members can purchase the publication for $50by calling the Customer Service Center at 800/877-1600,ext. 5000.

3. ADA will identify financial opportunities for practi-

tioners to enhance their value via grants and awards.

Tactic:a. ADA investigates grant opportunities for PPV specific

activities, such as participation in an externship in a busi-ness or food company.

Action: None to date.Tactic:

b. ADA incorporates criteria into existing awards with afocus on activities related to PPV.

Action: None to date.

4. ADA will identify data needed to enhance practitio-

ner’s ability to negotiate.

Tactic:a. ADA conducts a scientifically valid salary survey of die-

tetics professionals (according to geography, practicesetting and length of practice; specific to dietetics). Thefirst step will be the collection of job descriptions of prac-titioners.

Actions:1. ADA published sample job descriptions for various practice

settings, titled: Job Descriptions: Models for the Dietetics

Profession.2. ADA published the 2002 ADA Dietetics Benefits and Com-

pensation Survey. Members can purchase the report for$50 by calling the Customer Service Center at 800/877-1600, ext., 5000.

Tactic:b. ADA provides directions to members on how to effec-

tively evaluate and use salary survey data to influencecurrent and potential users of dietetics services.

Action:1. ADA presented the preliminary results of the 2002 Dietetics

Benefits and Compensation Survey during the 2002 FNCEon Sunday, October 20. The session included a short pre-sentation demonstrating the tools needed when negotiatingsalaries and how to effectively use the salary data for annualreviews and performance evaluations.

5. ADA will identify target audiences and alliances to

market the value of the dietetics professional’s ser-

vices.

Tactic:a. ADA identifies key audiences and alliances to influence

regarding the value of the dietetics professional.Actions:1. ADA Foundation Childhood Obesity Initiative

a. ADA and ADAF are taking a leadership role in addressingthis national health concern. ADA has kicked off theFamily Nutrition and Physical Activity Screening Initia-tive. This project will result in a tool for assessing ge-netic, sociodemographic, dietary, physical activity andparenting factors to assess various family determinantsof children being overweight.

b. In collaboration with the National Heart, Blood, and LungInstitute and the National Parks and Recreation Associ-ation (NPRA), ADA also is a partner in the Hearts N’Parks program.

2. Policy Initiatives and Advocacy Group’s legislative activitiesa. ADA works at the local, state, and national levels to in-

fluence policy on issues such as obesity, food labeling,nutrition monitoring, medical nutrition therapy, childand elderly nutrition, food programs, biotechnology, andfood safety.

b. Advocating that Congress expand the MNT benefit tocover cardiovascular disease, cancer, osteoporosis, HIV-AIDS, and other conditions. Current bill introduced re-lated to CVD MNT Benefit.

Dietetics professionals can reduce the gap between perfor-mance, proficiency, and value in the work place by taking ad-vantage of the opportunities and resources provided by ADA,and participating in initiatives and programs that further en-hance the value of RDs and DTRs as the leading source of foodand nutrition information. Dietetics practitioners will enhancethe perceived value of their services using documented out-comes, licensure, policy initiatives, and professional develop-ment. The Task Force recommended the below activities formembers to use as a guide when addressing salary issues andcareer advancement.

Goal #2: Members adopt various approaches toenhance personal value

Strategies to Achieve Goal #2:

1. Members will commit to lifelong learning to actively

engage in self-development throughout their career

in dietetics.

Tactics:a. Members actively participate in the Professional Devel-

opment Portfolio process to enrich and develop skills.b. Members publish or present local success stories on ne-

gotiation, career advancement, using survey data andother resources from ADA. Publish a “Q & A” which allowmembers to assist other members.

2. Members will develop personal skills and competen-

cies for development and enhancement of practice.

Tactics:a. Members participate in educational opportunities (such

as workshops, seminars, Web-based CPE course; audio-tapes; CPE articles; toolkits) provided by ADA, affiliates,

OF PROFESSIONAL INTEREST

1378 / October 2003 Volume 103 Number 10

districts, and DPGs to increase their skills in business,negotiating, managing, marketing, and resume develop-ment.

b. Members use available resources to enhance their jobdescription by incorporating performance documenta-tion such as: more responsibility and accountability, in-creased scope of practice, demonstrate value to the in-stitution or job setting, and identification of career ladderopportunities.

3. Members will use information and data to enhance

understanding of performance, proficiency, and

value related to the practice of dietetics.

Tactics:a. Members support and participate in salary surveys con-

ducted by the Association.b. Members use the data with employers (potential or cur-

rent) and other users to demonstrate their value.c. Members network to inform other members of data and

tools that have been successful.d. Members contact targeted alliances and audiences using

Association data to inform them of the value of the pro-fession.

4. Members will identify skills needed to expand scope

of practice.

Tactics:a. Members use knowledge from other practitioners to fa-

cilitate increasing their scope of practice.b. Members identify educational activity needed for ex-

panding scope of practice.

5. Members will measure practice outcomes to demon-

strate value to practice settings.

Tactics:a. Members use MNT and reimbursement for services (in-

come) to demonstrate value and outcomes based ontheir involvement in patient/client care.

b. Members participate in outcome studies to provide datarelated to the value of dietetics services and cost/benefit.

SUMMARYThe major focus of the plan is the possible professional devel-opment activities provided by the Association and used bymembers. Ultimately, the Plan offers the Association and mem-

bers concise and doable tactics for addressing the number onemember concern of compensation and benefits.

All organizational units of ADA will examine opportunitiesfor developing tools, gathering data, and exploring tactics tobuild on current programs that will close the gap between per-formance, proficiency, and value for the profession. Likewise,members are encouraged to use ADA resources, such as thePPV Plan’s tactics to build their professional developmentplans. Members should also consider investigating outside ser-vices or employer resources that compliment the opportunitiesthat ADA offers.

The following Professional Development Sessions areplanned for the 2003 Food and Nutrition Conference & Expo inSan Antonio (October 25-28).

Saturday, October 25, 2003

5:00-7:00 pm—Live Up to Your Dreams: Opening SessionRoss Keynote Address, Dot Richardson, MD

Sunday, October 26, 2003

8:30-10:00 am—Customer Satisfaction: Creating Demandsfor our Services

8:30-10:00 am—ADA Forum for Students and New Profes-sionals

10:30-12:00 pm—Managing your Professional DevelopmentPortfolio

1:30-3:00 pm—Adding Value Through Differences: AnyoneCan Become a Leader

3:30-5:00 pm—The Enterprising Dietitian: Building a Diabe-tes Business with RN Partners

3:30-5:00 pm—Business and Communications: Career Op-portunities for Dietitians

Monday, October 27, 2003

8:00-9:30 am—Positive Attitude: The Key to Success in Nu-trition and Dietetics

12:30-1;30 pm—ADA’s Reality Show: Real Stories, RealMembers, Real Prizes

2:00-3:30 pm—Communications Seminar: How to Manageyour Mouth

4:00-5:30 pm—You can Have it all: Leadership and Life Bal-ance

Tuesday, October 28, 2003

8:00-9:30 am—Gain-Gain: A New Look at Salary Negotiation10:00 am-11:00 am—Negotiation Skills for Young Profession-

als10:00-11:00 am—Member Forum: How to Get Involved, ADA

Needs You

OF PROFESSIONAL INTEREST

Journal of THE AMERICAN DIETETIC ASSOCIATION / 1379