Having been a Senior Lecturer in Dietetics for 4 years, and a practicing Dietitian for nearly 20, I have spent quite a lot of time thinking about what makes a good dietitian and what makes a good dietetic consultation. It’s important to think about whether or not we are giving the best service we can and to ensure we are giving the customer what they want and need. In my experience, most dietitians are by nature “helping” people and are concerned that they are doing a good job. But how do we know that we are doing a good job?
As a child and younger person, I visited a few dietitians and had mostly good but variable experiences as a client. I found this experience really useful in my practice. It’s a valuable exercise for a clinician to look at things from the perspective of the client.
I was really pleased to find a study, published this month, which looks at patient experiences of dietetic consultations. These kinds of studies are vital so that we can look at how we can improve consultations and modify them to be more effective for our clients.
In the qualitative study, seventeen patients undergoing consultations with a dietitian were interviewed about their experiences of their consultations. There were some interesting features in the results.
What Patients/Clients Liked/Disliked about their consultations
- It was really important to the patients that they thought that the dietitian was really listening to them. When patients did not feel a dietitian listened, they described the consultation as a negative experience.
- A good rapport between the patients and the dietitian was essential.
- Important that the dietitian was approachable and friendly.
- Body language was important – open body language, friendly facial expressions and the placement of furniture in a non threatening manner.
- Feeling of not being judged and establishing trust.
- Professionalism and the feeling the dietitian was an expert.
- The ability of the dietitian to empathise. It helped if the dietitian had some experience of losing weight or experiencing a medical condition similar to that experienced by the patient.
- Most liked a non prescriptive approach, guiding rather than instructing and letting the patient set goals and targets.
- Patients liked working together with their dietitian, negotiating action plans and treating the consultation as a partnership. They saw this as an important factor in the effectiveness of the consultation.
- All appreciated behavioural change advice and found this useful rather than just getting instruction.
- Positive feedback and motivation – felt this was better with frequent visits.
- Different types of resources (likes and dislikes varied) but generally the patients liked resources to be in a form they could understand.
- It was important to patients that information and advice was explained. This made it easier to follow advice.
- Patients liked consistency in information, especially between health care personnel involved in their care.
- Dietitians adapting advice to personal needs and situations.
- More frequent appointments – important for motivation and to build relationships.
- Enough time for consultations.
- Having the same dietitian through course of treatment.
- Some patients were frustrated with repetition in explanations.
- Found conflicting information frustrating.
- Textbook advice that wasn’t flexible.
- Most disliked a prescriptive approach (although some did like this).
- Limited consultation time – being rushed.
- Dietitians not being available, infrequent appointments.
- Different dietitian each time the patient attends a new appointment.
There is some interesting food for thought there. Time, frequent visits and support and a friendly, empathetic nature are all vital to ensuring clients are satisfied with the service they are receiving from their dietitian. Working in partnership and making sure advice and plans are tailor made are also vital. These are all things I aim to achieve in my own consultations and I would hope most dietitians do too.
Are you getting a good service from your dietitian or have you done when you have visited one? What made it good or bad? Do you agree with the above points or is there something you’d add or take away? I’d love to hear your thoughts
Hancock R.E.E., Bonner G., Hollingdale R. & Madden A.M. (2012) ‘If you listen to me properly, I feel good’ a qualitative examination of patient experiences of dietetic consultations. J Hum Nutr Diet.